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NJ Office - 973-257-5558

fna@fnainsurance.com
UHC Oxford 2015
 
NJ Employer Renewal Date and Plan Year Verificaiton.  If the NJ group wishes to move their renewal date to January 1, 2017:
Below is what is needed for transitional relief:
 
  • They must complete and submit a New Jersey Renewal Date Change and Plan Year Verification Form (for New Jersey Transitional Relief [2-50]), which will be included with the quote information, and a signed copy of the rate information by November 15, 2016.
  • Contract year benefit accumulation periods (deductibles and out-of-pocket-maximums) will reset on January 1, 2017. Calendar year benefit accumulation periods will reset on January 1, 2017.
  • The group will be responsible for notifying employees of plan changes 30 days in advance of the new policy effective date and for distributing a new Summary of Benefits and Coverage (SBC).
  • The group’s 2018 renewal date will be January 1, 2018.
  • If a group has multiple Transitional Relief policies, the renewal date must be moved to January 1, 2017 for all policies. Otherwise, the group will need to move to an Affordable Care Act (ACA) compliant plan design for all policies.
  • Groups will only be permitted to move to different plans within the same product, and cannot renew to a different product. A move from an Oxford PPO to EPO or an HMO product, for example, is not allowed. Any other change after this renewal date would require a new ACA compliant plan design. In addition, you must be the Broker of Record to make changes for your customers. o Groups that make changes within the same product will need to submit a letter of request, signed plan designs and rates, and the New Jersey Certificate of Understanding.
 
If they do not move their renewal date to January 1, 2017:
Any client that is scheduled to renew on or after February 1, 2017 and prefers to keep their current renewal date will no longer have the option to renew their Transitional Relief coverage. These clients will need to enroll in an ACA compliant plan design.
 
What exactly this is?
When the ACA came into effect the plans changed obviously, metallic values, actuarial values, etc. But in the state of NJ, they were allowed to offer the new plans or keep their old plan when the new plans came into effect. You just can’t take both a new one and old one. It’s one or the other. Keep the old plan or take the new ACA plan. Think of grandfathered plans but it’s called transitional relief. So the group can keep their transitional relief plan (the plan they had before the ACA plans came into effect) but has to change the effective date to 1/1. Deductibles and MOOP will reset.
 
• They must complete and submit a New Jersey Renewal Date Change and Plan Year Verification Form (for New Jersey Transitional Relief [2-50]), which will be included with the quote information, and a signed copy of the rate information by November 15, 2016. Click below to download the form.