Quoting and processing renewals has become significantly more complex. Carriers require Producers to process the renewal transaction in the proprietary carrier portal for certain market segments. Your time and talents should be used elsewhere, building stronger relationship with your groups and creating new sales opportunities.

Renewals are distributed by the General Agency within 48 hours of receipt.  Once you have reviewed the renewal with your client and a decision has been made for the new plan year, you can simply submit your client’s renewal decision directly via @ the NFP-BNGA Support Team  or through the NFP secure upload feature

For carrier specific renewal guidance,  click the carrier logo below.


(Level-Funded Health Plans)

UPMC

Please refer to the appropriate Benefit Plan Summary Brochures of the applicable platform (non-ACA compliant vs. ACA) for compliance requirements and business rules on multiple plan offerings and participation.  If your group has a dual option in place currently, they may renew the dual offering with a maximum of two plan choices.   If you do not have a dual offering in place currently, depending on group size, you may still be eligible to put a dual offering in place.  Please call or email the NFP-BNGA Support Team with these requests.

If a group is eligible and wishes to offer multiple plans, please indicate on the renewal rate sheet,  the plans selected and the following information.

  • The UPMC Benefit Election Form for each employee enrolled
  • If the client is offering two or more plans, confirmation of  any change to the membership is required.

Small groups that do not submit renewal changes will be auto-renewed with their current medical (or mapped coverage if the current plan is unavailable to renew) plan design 30 days prior to renewal.  If a client will be making a change in plan design please notify us as soon as possible to request the group not be auto-renewed. UPMC will not permit any plan changes after the plan effective date.   Note:  If the group does not offer medical benefits and has stand alone supplemental benefits in place, a signed renewal copy is required. Stand-alone supplemental plans will not be auto-renewed.

upmc docFor groups who may be considering an HMO planmembers must choose an in-network Primary Care Provider (PCP). Please have the members indicate their PCP here on the UPMC Benefit Election Form

  • Note: If members do not choose a PCP for referrals, the health plan will assign one to them.  Because out of network providers are not covered, it is important to make sure all providers and specialists are in-network.

Clients utilizing BenefitWallet for current HSA administration: Benefit Wallet will no longer be the administrator of employee HSA accounts. At renewal clients will have an option that waives maintenance fees for participants. This new option is called UPMC ConsumerAdvantage.  If they wish to utilize UPMC ConsumerAdvantage please have the HSA Group Set Up Form completed by the company.  Also, the roll over form for employees is needed if they are transferring funds from Benefit Wallet to ConsumerAdvantage.  Employees do not have to move their accounts from Benefit Wallet to UPMC ConsumerAdvantage, but if they do not, any Benefit Wallet maintenance fees would be applicable.

Clients utilizing an HRA will need to submit an updated HRA Group Set Up Form.

Non-ACA Renewal Process

UPMC does not automatically include their 100% Consumer Driven options as alternatives on the non-ACA compliant renewals.  When you see plans listed that have an HRA or HSA in their title, they are most likely a part of the HealthyU product line that involves coinsurance of 90% or 80%. If you are seeking pricing for one of the following options, please outreach to our office and we will request rates from the carrier:

  • HRA $1250_100% (15/3050Rx not subject to deductible)
  • HRA $2500_100% (15/3050Rx not subject to deductible)
  • HSA $1400_100% (15/3050Rx after deductible is satisfied)
  • HSA $2800_100% (15/3050Rx after deductible is satisfied)

ACA Renewal Process

There is one pharmacy option available for UPMC’s ACA plans:rx

  • $15/$40/$75/$95

Please refer to the 2020 product portfolio in your renewal email for additional information.  You will notice while reviewing the benefit summary guide the Small Business Advantage networks are Standard (HMO) and Premium (EPO & PPO) in addition to the Inside Advantage and MyCare Advantage tiered network products.

Supplemental Coverage

If supplemental coverage is not currently offered and is selected at renewal, New Applications will be needed for participants to be enrolled . Use this UPMC Benefit Election Form

dentalUPMC has made a change regarding dental. Groups that do not carry supplemental coverage for their employees currently are only eligible to elect a plan that does not include Orthodontic coverage.  Renewal rates include all of the non-ortho plans.  Previously these groups were only eligible to enroll in a Basic dental offering for the first 12 months

If your client does carry dental and is considering UPMC for replacement coverage, please let us know if you would like to see  rates for the plans with Ortho coverage. These rates can be requested from the Underwriting department for your review.

Vision Care

  • UPMC has partnered with NVA to offer a new competitively priced national network vision program.
  • Vision Care rates are included within the renewals.

Dental Discount 

  • UPMC’s discount program is available for groups with either a standalone plan option or along with the Basic Dental Advantage offering.  See the Dental Discount Brochure.

 

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United Health Care

  • If a client wishes to make any renewal plan changes they must indicate selections on the renewal document and provide a signed copy prior to the renewal effective date.  Changes will not be permitted after the renewal effective date.
  • Alternate medical plans are shown for consideration along with Dental, Vision, Life, AD&D.
  • Please share a copy of the completed renewal via email to the NFP-BNGA Support Team
  • If the group does not wish to make changes from the outlined renewal plan, no action is required and they will automatically renew the suggested plan design.  Please let us know the client’s decision.
  • Keep in mind: underwritten All Savers rates can be requested at renewal if participation requirements are met (minimum 2 enrolled employees, and 50% or greater participation).
    • Currently enrolled members do not need to provide medical questionnaires, but any new enrollees would need to complete the form to be included on the quote.

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UnitedHealthcare Level-Funded (formerly All Savers® ) Health Plans

helpful hintsYour client can renew their current plan level or they can choose a new plan level.  Employers do not need to resubmit paperwork, but they MUST CONFIRM THEIR PLAN LEVEL and default plan for the group if they are making any changesIf the employer elects to change their current plan level, default plan, or open employee selection, a signed document describing the change is required. Please provide confirmation of renewal determination to my attention via m.

If the employer has elected to offer multiple plan options, employees who choose to keep the default plan may do so without any additional action.   If employees wish to choose alternate plans, you will need to provide us with a listing of employee plan selections.

New employees can be added during this renewal period, up to the effective date. Each new employee must submit a completed Employee Enrollment packet. Download it here. Membership changes can be emailed to the NFP-BNGA Support Team  or to adminallsavers@unitedhealthone.com.

All Savers will mail the renewal letters to the employer no more than 60 days prior to the renewal effective date.

After the plan is renewed, new ID cards (if there are plan changes) and other renewal materials will be sent via USPS mail.

The All Savers Billing and Collections Form. will be used for commission purposes and is therefore required to be submitted at enrollment.

If competitive rating is available we are willing to request consideration for rate relief, but the Underwriting Department advises that the best rates are being released with the renewal.

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Highmark

  • If the client wishes to make any plan changes they can indicate selections on the renewal and submit prior to the effective date.
  • Please email a copy of the signed renewal to the NFP-BNGA Support Team
  • If no change is desired please confirm the plan designs they wish to auto-renew for update in the carrier portal

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Guardian

  • Any plan changes need to be submitted prior to the group’s renewal effective date.
  • If you are in need of alternate plan designs from those shown on the renewal package please do not hesitate to reach out.
  • Please email signed renewals to the NFP-BNGA Support Team

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