Frequently Asked Questions
Is this considered a group plan?
With respect to your group/practice, this is considered a group plan, so you have to offer the plan to all employees eligible in your practice (full-time employees working at least 30 hours a week).
What is the minimum number of enrollees per group?
If all employees decline/waive coverage, it is ok if only the employer or one employee enrolls.
Can I take my contribution out of my paycheck pre-tax?
If your employer has a section 125 (premium only plan) in place you may be able to make your employee contribution on a pre-tax basis.
What benefit Plans are offered?
In an effort to meet the needs of all the members, we are offering 3 health plans and 2 dental options. Each employer group will have the option of electing a single plan, dual option or offering all three health plans. Likewise with the dental, two plans will be offered and the employer group will determine how many they offer.
How many plans can I offer my employees?
Your group can decide to offer all benefit plans and your employees can choose, or you can offer 2 or 1 of the plans. It is up to the employer.
When do deductibles start over?
Deductibles reset every calendar year. So each January 1 each year, your deductible starts over.
How are contribution rates determined?
Rates for the AHP are based on claims and utilization of the membership as well as demographic and benefit design factors. Each year, we will review and establish rates for the next year. Each individual group will be able to determine their own employer/employee contribution rates with a minimum being 50% of the single rate.
Are there exclusions for pre-existing conditions?
There are no pre-existing condition exclusions, but rates are not final until after a medical questionnaire is completed during enrollment on all participants, and the underwriting department makes a rate recommendation. Final rates will be approved by the group prior to the effective date.
How can a group leave the plan?
You can terminate your contract with the plan with a written notice 90 days in advance of the plan renewal.