April 21, 2016
Enhancements to the small group recertification process
We have streamlined our small group recertification process with changes that should make this important process of recertifying group size much smoother for employers.
The most significant change is that groups are now selected for recertification based on their current enrollment, which is pulled nine months before their renewal date. The following size groups are required to complete a full recertification:
- All groups with one enrolled subscriber
- Small groups with more than 34 enrolled
- Large groups with fewer than 51 enrolled
Over the course of 2016, we have gradually adjusted our mailing cycle to send recertification mailings earlier in the year. They were previously sent three months prior to a group’s renewal date but are now sent nine months prior to give groups more time to complete the recertification process. We have also implemented an automated call feature for groups that have not responded to recertification materials we’ve already sent.
Importance of responding to mailings
It’s very important for employers to respond to these recertification mailings so that they retain their current coverage. (If a group does not respond to these recertification mailings, their medical coverage will be terminated upon renewal.) For groups that also have our dental coverage, it will stay active unless we receive a written request to terminate the coverage. If we receive a written request to terminate a group’s coverage prior to renewal, we are able to terminate both the medical and dental coverage.
We are allowing groups to self-report as a sole proprietor by sending a letter or email to us acknowledging that they will not qualify to renew as a small employer. Any recertification communications or questions should be sent to Recertification@bcbsri.org.