Small Group Blues Enroll - Arkansas Blue Cross and Blue Shield

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ARKANSAS BLUE CROSS AND BLUE SHIELDSMALL GROUP BLUESENROLL GROUP ADMINISTRATOR’S MANUAL• Explain all waiting periods to new applicants.• Make sure your payment reflects the total amount of your group billing. Pleasesubmit only one check for payment. Also, please write your group number and billinginvoice number on your check.• Do not add an employee’s name to your group billing or pay for an employee whosename does not appear on the billing.• Make premium payments to Arkansas Blue Cross for covered employees and theirdependents every month, in advance (before the due date).• Submit a Change Request form when changing from family to individual coverageand remit the corrected amount when the change appears on the billing.• Submit a complete application when changing from individual to family.• Remember to accurately and timely report employee and dependent eligibilitychanges and other information to Arkansas Blue Cross. If you fail to do so, yourgroup is liable to Arkansas Blue Cross for any claims paid in error on behalf of suchemployees or dependents.• Please remit Page #1 of your bill noting all adjustments to billed amount.• Retain a copy of Page #1 for your records and send original to:ARKANSAS BLUE CROSS AND BLUE SHIELDP.O. BOX 2181LITTLE ROCK, AR 72203-2181ATTN: CUSTOMER ACCOUNTS• If there is any change in your address, phone number, etc., please notify your GroupService Representative as soon as possible.• Remember, all correspondence to Arkansas Blue Cross should include your group’sname and number and, if applicable, the identification number of employees.• Make sure that the percentage of eligible employees covered by your group policystays at or above the minimum number of insured employees as specified in yourGroup Policy. If the percentage of the eligible employees becomes less than thepercentage of employee participation specified in your Group Policy, your GroupPolicy is subject to termination. Upon request, you will furnish Arkansas Blue Crosswith information regarding current participation and contribution, and if required,provide documents to validate those numbers.• Make sure that the percentage of your company contribution to employees’ premiumstays at or above the minimum percentage specified in your Group Policy. If thepercentage of contribution becomes less than the percentage of contributionSmall Group BluesEnroll R 10/25/07 3
ARKANSAS BLUE CROSS AND BLUE SHIELDSMALL GROUP BLUESENROLL GROUP ADMINISTRATOR’S MANUALspecified in your Group Policy, your Group Policy is subject to termination. (Minimumcontribution to the employee premium is fifty percent (for groups 2-50), but yourgroup may elect to contribute a greater amount.• Fulfill legal COBRA obligation (See Section 9). Please remember that ArkansasBlue Cross shall not assume your (the employer’s) obligation to provide benefitsunder COBRA if you fail to provide the required COBRA notices at the timesspecified in your Group Policy, nor shall Arkansas Blue Cross be responsible forproviding any COBRA notices to employees or dependents.• Fulfill legal HIPAA obligations. Your group agrees to indemnify and hold ArkansasBlue Cross harmless if any action or inaction of your group results in Arkansas BlueCross being charged with violating HIPAA.• Provide all employees and dependents appropriate communications and noticesfrom Arkansas Blue Cross.• The Group Policy is the legal, binding group agreement.• Guidelines will be applied as indicated in this manual. Revisions will be made aspolicies and procedures are updated.Small Group BluesEnroll R 10/25/07 4
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Small Group Blues Enroll - Arkansas Blue Cross and Blue Shield

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