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UHC Oxford 2015

**Important Broker Alert**

UPDATES to Oxford’s Underwriting Guidelines to meet DFS Guidance - We received the following up updates from UHC Oxford regarding changes to the underwriting guidelines for new and renewing groups for coverage starting on 1/1/18.  We have posted them to our website for you to review.  The most important details in order to comply with DFS guidance are as follows:

UHC has recently updated their 2018 underwriting guidelines for new and renewing groups for coverage starting on 1/1/2018 they are available from the link below  for your reference.  Below you will find detail on the items that have been updated in order to comply with DFS guidance.

To qualify as a group eligible for coverage under Employee Retirement Income Security Act (ERISA), a group must have at least one common law employee who is both eligible for and enrolled in the coverage.  If no "employees" are covered by the plan, an employee benefit plan does not exist.

As a reminder, the following individuals are not eligible employees and if enrolled, do not satisfy this requirement:
a.    a person who does not meet the common law employee definition under Department of Labor and Internal Revenue Code rules.
b.    a former employee who is covered through retiree benefits, COBRA or state continuation;
c.    an employee who does not live, work or reside in the  United States;
d.    individual proprietors/owners and their spouses (“sole proprietors” or “partnerships”).  

Sole props must have at least one other eligible employee that also enrolls.

The New York Department of Financial Services (DFS) also provided additional guidance surrounding the small group annual open enrollment period.  A link to the DFS guidance is included below:

http://dfs.ny.gov/insurance/health/market-rules-guide.pdf

NOTE that The IDEA portal will be updated to reflect this guidelines in the near future.

PDF icon2SM Click here to download the full pdf document