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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.

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