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Blog

Good Neighbor Travel Insurance Blog

Health Net Group – new underwriting guidelines for 2012

May 9, 2012 By : Doug Gulleson

Good Neighbor Insurance provides group health insurance to our clients.  One of the best group insurance companies in Arizona is the Health Net Group plans.  You may view request more information on this option for your organization by going to our Arizona web site at www.gninsurance.com or call us at 480.633.9500.

Effective in 2012, Health Net is coming out with some new underwriting guidelines for their Small Group Products.  Some of the new guidelines are:

  • Case Completion Deadline:  Groups not completed by the 25th CALENDAR day of the month will be moved to the next available effective date.  If the 25th falls on a weekend or holiday, the deadline will be the following business day.
  • Copies of ID Cards:  Groups with MORE THAN 50% of the total eligible population waiving for valid reasons is required to submit copies of ID cards.
  • Carve-Outs:  The following documentation is required for all carve-outs:
    • Require letter from group or broker on Company letterhead, describing basis for the carve-out and include names, titles and SSN’s of those eligible.
    • Must have a minimum of 5 ENROLLED employees.
    • Require individual medical underwriting, regardless of group size.
  • Former PEO Groups:  Groups contracted with a PEO will not be considered for coverage as the employer-employee relationship is between the PEO and the employees.  However, HN will consider groups leaving a PEO.  The following documentation will be required:
    • Copy of document severing the contract between PEO and Employer (from the PEO).
    • 2 weeks of payroll from the employer or professional payroll company.
    • Proof of prior coverage through the PEO in the form of group contract, prior carrier bill, or copies of medical ID cards for the majority of those enrolling.

NOTE:  Groups that did not have medical coverage through the PEO will be treated as newly established groups.

  • Newly Established Group:  A minimum of 4 weeks of payroll prior to the requested effective date must be supplied.

Doug Gulleson loves to scuba dive overseas and makes sure he has his U.S. health care and overseas health care, www.gninsurance.com , information with him at all times when he travels Keep our blog close by you, www.gntravelinsurance.com, for continual updates on the changes with the U.S. health care system.

Doug Gulleson

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