Employers

Group Administrator's Manual

Group Administrator's Responsibilities

Listed below are important points to remember as you perform your duties as a group administrator. By following these guidelines, you assist us in providing you with the best service possible. Your cooperation is greatly appreciated.

Please verify the accuracy of information submitted on employee applications and change forms and ensure this information is transmitted to the company.

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Eligibility and Timelines

All permanent, full-time employees (minimum of 30 hours per week and 48 weeks per year) are eligible for group coverage. Please ask new employees to complete and sign an application form or online form for BluesEnroll groups (See "Group Coverage Guidelines").

Arkansas Blue Cross will accept applications signed, dated and received with no more than 60 days before the effective date of coverage; all other requirements for "timely" status will be observed.

Applications can be sent three ways:

  1. Emailed — quoteHIPAA@arkbluecross.com
  2. Faxed — 501-378-2926
  3. Mailed — Arkansas Blue Cross and Blue Shield
    P. O. Box 2181
    Little Rock, AR 72203-2181
    Attn: Mandated Group/HIPAA Compliance Unit

When completing the application, make sure it is completed in its entirety. Also, please make sure to write your group number on all applications as well as on change request forms.

If the new employee had prior creditable coverage (coverage without a break of 63 days) from a former insurance carrier and was issued a Certificate of Creditable Coverage (a document that proves the employee had coverage), please attach it to the application. However, this is not required.

Explain all eligibility periods to new applicants; make sure all employees understand how effective dates are assigned. Arkansas Blue Cross calculates effective dates on a calendar month basis. The Employer Group Application has been revised to offer only a "monthly" option for waiting periods.

Examples:

  • If the date of hire is June 11, and the group has a three-month waiting period, the effective date will be calculated as June 15-July 15 (first month), July 15-August 15 (second month), and August 15-September 15 (third month).

  • For first-of-month groups, the effective date would be October 1. If your group has a billing on the 15th of the month, the effective date would be September 15.

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Applications for BluesEnroll Groups Only

Arkansas Blue Cross will accept online applications transmitted no more than 60 days before the effective date of coverage; all other requirements for "timely" status will be observed.

  • Please verify the accuracy of information submitted and make sure this information is transmitted to the company.

  • Applications and changes in coverage must be communicated to the company in a timely manner in the format required by the company in order to be effective. The company shall not be responsible for any applications or changes in coverage or errors in such applications or changes if proper procedures as required by the company are not followed. The company shall be entitled to rely upon any data submitted by an employee or policyholder in online format.

  • Please obtain and maintain the documents described in the Group Coverage Guidelines to support eligibility status of employees and dependents. You shall provide these documents to the company upon request.

On advance effective dates, the online application will not be transmitted to Arkansas Blue Cross until 30 days prior to the effective date.

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Waiting Periods

Please explain all waiting periods to new applicants. If your group has special needs related to waiting periods, please contact your marketing representative or independent agent. The request will need to be faxed, mailed or emailed on your company letterhead. This documentation will be placed in your group’s file for verification of your request.

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Group Billing

Make sure your payment reflects the total amount of your group billing; submit only one check for payment. Also, please write your group number and billing invoice number on your check.

Do not add an employee's name to your group billing or pay for an employee whose name does not appear on the billing.

Make premium payments to Arkansas Blue Cross for covered employees and their dependents every month, in advance (before the due date).

Submit a change request form when changing from family to individual coverage and remit the corrected amount when the change appears on the billing. Submit a complete application when changing from individual to family.

NOTE: BluesEnroll groups do not use the change request form.

Remember to accurately and timely report employee and dependent eligibility changes and other information to Arkansas Blue Cross. If you fail to do so, your group is liable to Arkansas Blue Cross for any claims paid in error on behalf of such employees or dependents.

Please remit Page 1 of your bill, noting all adjustments to billed amount.

Please retain a copy of Page 1 for your records and send the original to:

Arkansas Blue Cross and Blue Shield
P.O. Box 3590
Little Rock, AR 72203-3590
Attn: Customer Accounts

If there is any change in your address, telephone number, etc., please notify your group service representative as soon as possible.

Remember, all correspondence to Arkansas Blue Cross should include your group's name and number and, if applicable, the ID number of any mentioned employees.

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Group Policy

The group policy is the legal, binding group agreement. Guidelines will be applied as indicated in this manual; revisions will be made as policies and procedures are updated.

  • Make sure that the percentage of eligible employees covered by your group policy stays at or above the minimum number of insured employees as specified in your group policy. If the percentage of the eligible employees covered by your group policy becomes less than the percentage of employee participation specified in your group policy, your group policy is subject to termination. Upon request, you will furnish Arkansas Blue Cross with 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' premium stays at or above the minimum percentage specified in your group policy. If the percentage of contribution becomes less than the percentage of contribution specified in your group policy, your group policy is subject to termination. (Minimum contribution to the employee premium is 50 percent (for groups 2-50), but your group may elect to contribute a greater amount.

  • As the employer, please remember to fulfill your legal COBRA obligations (See "COBRA Section"). Please remember that Arkansas Blue Cross is not responsible for providing COBRA notices to employees or dependents, and Arkansas Blue Cross will not be able to provide benefits under COBRA if you fail to provide the required COBRA notices at the times specified in your group policy to your employees and dependents.

  • Fulfill legal HIPAA obligations; your group agrees to indemnify and hold Arkansas Blue Cross harmless if any action or inaction of your group results in Arkansas Blue Cross being charged with violating HIPAA.

  • Provide all employees and dependents appropriate communications and notices from Arkansas Blue Cross.

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