OCTOBER 2012
IN THIS ISSUE
  Introducing HealthEssentials EPO: A Low-Cost Alternative for Small Groups
New Underwriting Guidelines for Small Groups
  Serving Your Clients in Their Neighborhoods
Better Outcomes, Reduced Costs
We Have Big Plans for Western NY
New Program Lowers Hospital Readmissions, Reduces Costs

New Underwriting Guidelines for Small Groups

Beginning November 1, we will be updating our underwriting guidelines on community-rated plans for small groups, including sole proprietors. Among the major changes are:

  • Participation has been increased to 60 percent
  • Waiver eligibility is being changed so that coverage by another carrier is no longer a valid waiver reason
  • Effective November 1, 2012 for new business, groups may choose up to two products in the product suite but need a minimum of five enrolled employees. Groups may choose up to three plans in the EmblemHealth suite provided they have a minimum of 20 enrolled employees. Until further notice, renewing and existing groups that already have members enrolled in more than one particular benefit plan type may renew in the same plans.

If you have questions about the new guidelines, please contact your EmblemHealth sales representative.

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