August 10, 2012

Updated Termination Process When Premiums Are Not Paid

We are writing today to let you know about an important change in the way we process terminations resulting from the non-payment of EmblemHealth premiums.

Under the terms of the Group Policy with EmblemHealth, premium payments are due and payable by the first day of the month for which coverage is provided, with a 30-day grace period for payment.

Beginning with premiums due on or after September 1, 2012, if we do not receive the group's premium payment within the grace period, the group's coverage will be terminated retroactively to the last paid date of coverage.

Example of September's Coverage Cycle

 DATE  ACTIVITY
August 15 Invoices for September's premium payment are mailed on approximately this date.
September 1 September's premium payment is due.
September 30 This is the last day of the 30-day grace period to pay September's premium.
If September's premium is not paid by the end of the grace period (September 30), the policy will be terminated retroactively to September 1 (the last paid date of coverage).

Our process to date has been to terminate coverage at the end of the grace period and seek to collect the unpaid premium. However, we are terminating coverage retroactively to the last paid date of coverage since we have found that most groups make no payment by the end of the grace period because they no longer wish to be covered by EmblemHealth.

We continually review our processes for the most effective solutions and anticipate this change in the termination process will facilitate your group's administrative duties.

Within the next few days, we will be sending a notification letter to the affected groups. We also will include a notification in their September invoices.

If you have any questions about this change, please contact your EmblemHealth representative.

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