Revised WA SBG Underwriting Guidelines effective January 1, 2017

Roundtable discussion: the role of brokers in health care reformBelow are the January 1, 2017 Washington SBG Underwriting Guidelines which are also posted to the Broker Portal and The Hub. Click on the link below to download/view.

 

Washington Underwriting Guidelines

 

Highlight of Changes

  • Employer groups may elect only one medical plan.

 

  • For groups of 1-3 eligible employees, 100% participation is required.
  • For groups of 4-9 eligible employees, 75% participation is required.
  • For groups of 10-19 eligible employees, 50% participation is required.
  • For groups of 20+ eligible employees, 25% participation is required.

 

  • All new groups requesting coverage on the 1st must be submitted by the 20th of the month prior for which coverage is to be effective.

 

  • Form 5208A/B is required for all groups that have been in business long enough to have one. Note: Groups that have not been in business long enough to have Form 5208A/B may submit 4 weeks of payroll.
  • Ownership documents must be submitted for owners not appearing on Form 5208A/B.
  • 2 weeks of payroll is required for new hires not on Form 5208A/B.
  • Washington Enrollment & Eligibility Inquiry Form

 

For your convenience, here are the links to the updated Washington SBG Portfolio Guide and Washington SBG Renewal Guide which reflect the change of only being able to choose one medical plan.

 

These changes are effective 1/1/17 for new business. These changes for renewing groups will be effective 4/1/17. A separate and detailed email communication will go out about the changes for renewing business soon.

 

If you have any questions regarding this announcement, please contact your Health Net Account Executive or Account Manager.

 

 

 

 

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