Page 54 - 2022 Large Group benefits

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Underwriting guidelines summary1
Product offerings
• Groups of of 51 or or more eligible employees can select a a a a a a maximum of of three medical plans and up up to two drug options • Groups with less than 300 enrolled contracts are required to enroll enroll in an an an Independence pharmacy plan Participation requirements2
• For groups of of 51 or or or or or more a a a a minimum participation level of of 75 percent is required for each worksite • Independence will count waivers in the the eligibility calculations For example credit is given for those eligible eligible subscribers who opt out because they have coverage coverage through a a a a a a a a a a a a a a spouse are are an an eligible eligible dependent to 26 or or or or enrolled in Medicare Medicaid or any other government issued coverage coverage • Individual coverage through a a a a a a a a a Federal or State exchange is not considered a a a a a a a a a valid waiver • For groups covering early early retirees (under age 65) 100 percent percent participation participation of of of the the early early retiree retiree population is is required The group group must consist of of of a a a a a a a a a minimum of of of 75 percent percent participation participation for the the active employees Employer contribution requirement2
For contributory plan plan offerings
the the employer must contribute a a a a a a minimum of of of of 50 percent of of of of the the calculated gross monthly premium for each plan plan offered Benefit plan changes
• Upgrades are not allowed off-anniversary • Groups may downgrade off-anniversary (limitations apply) 1
• Downgrades will be allowed only if the the the effective date date of the the the change is greater than 180 days prior to the the the next anniversary date • Groups of 51-99 making a a a a plan change will be required to select from the new product portfolio • For groups of of 100 or or or or or or more more changes
changes
changes
to to to to one or or or or or or more more of of existing existing medical medical plan designs will will require require all benefits
to to to to be be changed to to to to the new product portfolio Pharmacy only changes
changes
changes
will will not require require changes
changes
changes
to to to to existing existing medical medical plan designs High-deductible health plan funding limitation2
For fully insured accounts that offer a a a a a a a a a a a a a a a high-deductible health plan (HDHP) the the the employer cannot fund fund more than 50 percent of of of the the the the the the annual annual deductible deductible deductible deductible Providing a a a a a a a a a a a a a a a secondary/supplemental product to fund fund the the the the the the annual annual employee/family deductible deductible deductible (including the the the the the employer covering the the the the the cost of of the the the the the deductible) is not permitted Submission guidelines All offerings
are are subject subject to to to final underwriting review and and and and acceptance Additional guidelines and and and and policies may apply and and and and are are subject subject to to to change This document is is is for for informational purposes only and and and is is is not intended to to to be all-inclusive 1
Refer to the the complete Underwriting Guidelines available via Sales Portal 2
As permitted by the the state and and and federal legislation and and and mandates