1-50: Important Updates to the 2014 Admin Manual

Jun 05, 2014

The 2014 Affordable Care Act (ACA) Small Group Administrator Manual has been updated to include all policy changes.

Here is an overview of what has changed:

Item	Pre ACA groups	ACA groups
Late enrollment	First of the month following receipt of application provided there is not a waiver on file	No longer accepted. Must wait until group’s next Open Enrollment/Anniversary month
Waiting period	Up to 6 months	Either first of the month following date of hire (DOH), or first of the month following 30 days, not to exceed 60 days¹
Newborn baby	First of the month following date of birth (DOB) Can be enrolled over the phone 30 days to submit application	Effective date is DOB Cannot enroll over the phone – must submit application 60 days to submit application
New spouse/domestic partner	First of the month following event 30 days to submit application	Effective date is date of event 60 days to submit application
Age determination (billing)	First of the month following age change	Age change not calculated until group’s next Open Enrollment/Anniversary Month. Note: Age for new hires is based off their age when they enroll, not at what their age would have been at the group’s original effective date or anniversary.
Qualifying event	30 days	60 days
Newly eligible employees	30 days from eligibility date	45 days from eligibility date¹
ACA phone and fax number	Phone Number: 800-627-8797 Fax Number: 805-499-0842	Phone Number: 855-854-1429 Fax Number: 855-750-2227
No primary or secondary Medicare rate	Continues for non-ACA business	No longer applies
Incomplete documents	First of the month following receipt of completed application	Application must still be received within given time frame. No extra time given for incomplete applications
Terminations	First of the month of request received	First of the month of request received² (Exception: In the case of the death of a single subscriber, benefits will now be terminated the day after death)
Retro activity	None	None

Get your copy of the updated manual here.

For questions regarding the updates to the 2014 ACA Small Group Administrator Manual, please contact a member of your b&p Sales Team - 888.722.3373.

¹See page 8 of the Group Administrator Manual.
²See page 15 of the Group Administrator Manual.