New Effective Date and Lead Time Requirements
February 4, 2013
Beginning with April 1, 2013, effective dates, the following underwriting polices will be implemented for all 1 – 49 BCBSM and BCN new business groups.
- The group’s rate renewal year and plan year must be aligned on the first of the month.
- A 21 calendar-day lead time is required for all new business except for those groups enrolling in a BCBSM Health Equity CDH plan, a BCN HBL, HRA or HSA plan. These plans still require a 45 calendar-day lead time.
- The 21- or 45-day lead time is from when the managing agent receives the complete and accurate submission.
Example: An agent requesting an April 1, 2013, effective date for a 25-person new business group must have a complete and accurate enrollment submission to their managing agent by March 11, 2013.
Important: Requests for short-lead time or retroactive exceptions for a group-wide change will no longer be approved.
The first of the month policy is to accommodate future reform mandate requirements while the lead-time policy ensures membership records are activated and members receive their ID cards by the group’s coverage effective date.
Incomplete or late submission and requests for other than the first of the month effective date will be processed as follows:
- The group’s effective date will be adjusted to reflect the required 21 calendar-day lead time, but the group’s rate renewal year and plan year will be the first of that month.
Example: An agent is requesting a May 1, 2013, effective date, but does not have the enrollment package to the managing agent until April 20, 2013. The group’s coverage effective date will be May 11, 2013, but its rate renewal year and plan year will be May 1, 2013.
Other than the first of the month request: Both BCBSM and BCN will allow another day digit coverage effective date, but the group’s rate renewal year and plan year will reflect the first of that month.
Example: The group is requesting a May 15, 2013, coverage effective date. BCBSM and BCN will approve the group’s request for the May 15, 2013, coverage effective date, but its rate renewal year and plan year will be May 1, 2013.
Your enrollment submission is complete when it includes all of the documents listed from the new business (PDF) check list.
If you have any questions, please contact your SBAM Agent Relations Director, Jeff Thomas, at (517) 242-5558.