Submitting a Group!

The Group Health Submission Process

By: Lori Liles – New Business Consultant 

Now that you’ve completed your Group Health Presentation, and the company has decided they want to move forward with a health plan, the group will need to complete the required paperwork.  There will be questions on the paperwork that the employer might not understand and they are going to look to you for guidance.  Assisting your client in filling out the paperwork will strengthen the relationship you are building with them.

The required documents that need to be submitted are as follows:

• The Benefit Program Application (BPA)
• The Benefit Plan Selection Form (BPS)
• The Employer Group Information Form (EGI)
• The Employee Applications (Enrolling and Waiving for all eligible Full Time Employees working 30 or more hours per week)
• The Wage & Tax Form (UI 3/40) and W-4s for any new hires not listed on the Wage & Tax (if applicable).

For some groups additional paperwork may be needed.

For a Start-up Company, in addition to the above required documents the information below will also be needed:

• Articles of Incorporation
• Partnership Agreement if applicable
• Jesse White Letter
• SS4 Letter 
• Payroll Documents if the Group doesn’t have a Wage & Tax yet.  If payroll hasn’t been generated yet then W-4s for all the new hires
• Letter on Company Letterhead with a list of employees and their working status (example FT, PT, Term etc)

For a group with an Owner, who is NOT on the Wage & Tax (UI 3/40) the information below will also be needed:

• Owners Certification Form
• K1’s  (S-Corp, LLC, Partnership) or Schedule C (Sole Proprietorship)

The submission process has several steps that take time, so advise your client to get all of the documents to you early to avoid any delays.  

The Steps to a Clean Submission Process are as follows:

• Assist your Group in completing the required paperwork.
• Collect all required documents (BPA, BPS, EGI, Employee Applications- Enrolling and Waiving, Wage & Tax, etc) as described earlier in this blog.
• Email your Customer Service Representative all documents needed for your Group’s submission in the same email. Include the name of the Group and the Effective Date in the subject line. A group can’t be enrolled with BCBS without all the required documents. Please do not send a partial submission.
• After your CSR has reviewed all documents they will contact you for any missing information.  Once they have received the missing information the CSR will begin the enrollment process and email you an Account Summary to be reviewed by yourself and your client. The client will need to verify the effective, billing method and employee’s enrolled look correct.  If something isn’t correct, please notify your CSR for the necessary corrections.  Once the Account Summary has been verified the client will need to sign off on that Account Summary.  The group can’t be released to BCBS until the employer has signed the Account Summary confirming the information is correct.
• Once your CSR has received the signed account summary back they will send to BCBS to continue processing the submission.  Underwriting will review and may come back and ask for additional information.
• A Welcome Letter will be generated once approved and within 48-72 hours ID Cards will be mailed to the employees.

It is important for you and your client to be aware that there are many moving parts to getting the policy issued, and that’s why it’s best if the information be submitted at least two weeks before the effective date.  Our goal is for the process to run as smoothly as possible for your group and for you the agent.

Through this blog series, I hope you learned about how to find new business, the questions you should ask to evaluate a group, the paperwork needed for your group submission and how long the submission process may take.  If you need help at any point, please reach out to myself or your CSR. We’re always happy to help!

For questions or assistance please contact Lori Liles at lori@midwestga.com or 847-631-6621.