SBC's and Writing New Business

[ABC]

The SBC's are going to be a huge obstacle for writing new business. If the employees have to be informed of the plan design 90 days prior to the change then this is going to be difficult.

Group renewal comes out 60 days prior. So we are already 30 late on making a decision. Any application collection is at least a week.

My conclusion is renewal dates are now going to change every time a group switches.

Owners and controllers are going to have to change the way they address group health benefits.

 

[Ann H]

The SBC's are going to be a huge obstacle for writing new business. If the employees have to be informed of the plan design 90 days prior to the change then this is going to be difficult.

Group renewal comes out 60 days prior. So we are already 30 late on making a decision. Any application collection is at least a week.

My conclusion is renewal dates are now going to change every time a group switches.

Owners and controllers are going to have to change the way they address group health benefits.

Hi ABC. Can you help us clarify this issue? My understanding was that it was 60 days rather than 90 days. Then I found information stating that the HHS rules were amended in February 2012 to soften this waiting period for renewals to 30 days. It appears that there is still a 60 day deadline when "the health plan or issuer" modifies the terms of the contract, but does that mean the Employer?. I'm still confused about the deadline for providing employees with SBC's if the employer is planning to renew as is, or to change plans at the annual renewal date.

 

[ABC]

"• Employees must receive a finalized SBC no later than 30 days prior to the renewal date. "

This is what I am being told which is good compared to the original 90 days.

To write new business or to move it, you really are going to have to underwrite the case at least 60 days prior to the renewal.

 

[ABC]

On writing new renewal business, the SBC can be sent 7 days after the policy numbered has been issued.

If the case stays with the current carrier, the SBC has to be sent out 30 days prior to the renewal.

If you are moving a group off of their renewal date then the SBC has to go out 60 days prior to the move.This aspect of the law will prohibit moving business.

If someone has a different view on this please post.

 

[Ann H]

Thanks, ABC for that clarification. To date, I have not found it clearly stated in a single document, and I'm going from document to document to try to piece together the timelines. Frustrating. I have a group of 43 employees renewing 1/1/2013, and they'll probably change carriers... Fun.

 

[bukev1]

from a group rep on the matter....

We have further clarification from the state of Florida on SBCs in small group. In our SBC employer guide its states that are SBC needs to be included in the enrollment materials. If you look at Q2 in the attachment it states that a health insurance issuer must provide the SBC upon application for health coverage. An open enrollment meeting is not considered an application for coverage therefore you don’t need the SBC and can use our benefit summaries when conducting meetings. xxx is sending out the SBC to new business groups once we receive application.