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New Jersey News

Aetna

Aetna has made some positive changes to make the AFA process a little easier & quicker. Changes are effective for May 1st, 2018. They are sending this in advance of their Broker Webinar "AFA What You Need to Know and What's New" that has been postponed until April. 

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horizon blue cross blue shield

 Horizon wants to remind brokers that the conversion deadline for April 1, 2018 renewing groups or off anniversary conversions is Friday 3/23/18 at 12:00 noon. Any groups that are submitted after this deadline will be moved to a 4/1/18 effective date.  Horizon has determined that if a group is accepting their existing ACA plan renewal, no paperwork is necessary.  Only if a group is converting to a completely different ACA plan alternative or if they are moving from a pre-ACA plan to an ACA plan would conversion paperwork be necessary. It is imperative that complete paperwork as mandated above be submitted in as timely a manner as possible.  Conversions without all required documentation or submitted after deadline face the risk of losing their requested conversion date and being moved to the next month.  

Below are links to the full communication, Horizon's Conversion Request Form, and Small Group Health Plans:

affiliated physicians

Invoices from APEHP will now be sent via email to the group's administrative billing email address.  Invoices are typically generated between the 15th-20th of each month for the following month.

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horizon blue cross blue shield

For your reference, attached are the guidelines for Horizon BCBS BOR effective dates.  Please review these guidelines carefully, and be sure to have the group date the request appropriately, in order to ensure you receive the earliest possible effective date available. Horizon will not accept revised BORs to change the effective date once the BOR has been submitted.

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Aetna

Ready to get your clients started with Aetna Funding Advantage (AFA)? Great! To ensure members have no coverage gaps, Aetna is providing you with their new submission deadlines so you can get your AFA cases in on time.

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