NY Office - 516-352-7000

NJ Office - 973-257-5558

fna@fnainsurance.com

 

PLEASE SEE IMPORTANT PROCESS FOR 4TH QUARTER HORIZON RENEWALS:

Horizon-BCBSNJ has communicated that for the 4th quarter renewals, which includes October, November, and December, groups will be permitted to renew within their existing Pre-ACA plan.  With 4th quarter representing the highest volume of renewing membership, the decision to grandmother these groups supports the need to create a smooth renewal process and to help focus on retention efforts.  In the event a group does not opt to stay in their Pre-ACA plan, they will then need to move to an ACA compliant policy with SAPD.  

Below outlines the communication process and notifications that will be sent to your groups in regards to their renewal options.

Group Communication
•    October Renewals (ACA Notification):  The original 90 day non-renewal letter has already been released regarding the ACA regulation.
•    October ACA Renewals:  Renewals will be released from Horizon no later than July 31st to the groups and will include a cover letter with the recommended mapped ACA plan.  It will also include the option to stay in a Pre-ACA plan.  Horizon will include a marketing brochure of their PCMH product to promote the value of the new plan offering.
•    October Pre-ACA renewals:  Groups renewing in October will receive under separate cover a Pre-ACA renewal referencing that they may renew as is.  This will go out from Horizon no later than July 31st.
•    November and December renewals:  November and December renewals will receive the same notifications as outlined above.

Important to Note:
Please be advised that groups with only a Pre-ACA HMO offering will be exempt from renewing into that same plan. This is because the HMO product has been withdrawn. The HMO membership remaining in Small Employer is insignificant.  Those groups must renew into a ACA compliant plan.  However, if a group has one HMO sub-group and another non-HMO sub-group, the group may elect prior to the renewal to move the HMO members into the existing eligible Pre-ACA plan by using Member Maintenance.    This would permit a group to renew as is into their existing Pre-ACA plan.

Groups opting to “renew as is” into the Pre-ACA plan will be required to submit signed conversion paperwork accepting the Pre-ACA plan to eyoung@fnanj.com by noon the 9th business day prior to renewal.  10/1/14 conversion deadline is noon on Thursday, 9/18/14.    

Groups not electing to maintain their Pre-ACA plan will be required to submit signed conversion paperwork accepting either the Proposed Preferred or an alternate ACA plan to eyoung@fnanj.com by noon the 9th business day prior to renewal.  10/1/14 conversion deadline is noon on Thursday, 9/18/14.

Thank you for your timely submissions in this process.
Michele Burke  and FNA of NJ