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UHC - Important Information: NY Policies and Off Renewal Buy Downs
 
 
As we approach 2015 and continued changes in our industry and market, UHC is clarify some important issues regarding New York small group (1-50) business that you have been asking about.  Please read the below carefully and as some of it is NEW and some is just a reminder.
 
The new requirements are effective immediately for 1/1/15 business and forward.
 
1.    Off Renewal Buy Downs – As of 11/18/14, off cycle buy downs will not be allowed. Our past practice waived the 60 day notice requirement in our group contracts/policies for off cycle buy downs when the group had a financial
hardship. 

2.    Terminating a group and re-writing on a subsequent month will be permitted as follows:
a.    Group provides 60 day advance written notice of termination. If 60 days’ notice is not provided they will need to stay on the current policy or move to the next available effective date once proper notice is provided.
b.    The group will need to confirm that they will change their Policy Year and their Plan Year as stated in their ERISA Group Health Plan Documents.
c.    No deductible or other cost-share credits will be given for prior contract years.

3.    Federal Open Enrollment (OE) Period –  As a reminder, the Federal OE period is available for new OHI business, not renewing business. All groups that enrolled for during last year’s OE period (effective date 1/1/14) will be audited for participation in conjunction with their upcoming renewal on 1/1/15.
a.    If the group passes the audit, we will renew them.  
b.    If the group fails the audit – we will term the group. Please ensure that your clients that want to remain on an OHI product must meet our participation requirement (60%).
 
Please note these requirements apply to New York small group business.