Employer Resources Heavin & Associates Insurance Agency Inc.

Employer Resources

GUARANTEED ISSUE: An insurance company cannot decline an employer’s application for group medical insurance because of pre-existing health problems. They must accept all groups of 2 – 50 employees, regardless of health problems. Many of our plans even cover pre-existing conditions that your employees or dependents may have.

SENATE BILL 51: Affects small group employers from 2 – 50 employees by requiring the group health policy to end coverage at the end of the calendar month, regardless of actual termination date. Employers are required to notify the insurance company by the end of the month, or be held liable for the next month’s premium. There is a three-day grace period for employees terminating in the last seven days of a calendar month.

TEXAS HOUSE BILL 2015: Recently, insurance companies have changed their underwriting practices to comply with Texas House Bill 2015. This legislation requires an insurance company to provide a group a monthly premium versus claims report and large claim information for any single claim above $15,000.

SENATE BILL 80: This law allows insurance companies to offer a discount on their plans for employers willing to pay 100% of the cost of their employees health insurance.

HOW TO TERMINATE AN EMPLOYEE: Employers can no longer terminate an employee’s coverage directly with the insurance company by writing on their bill when submitting payment.

There are three ways to terminate an employee’s coverage:

Notify your Customer Service Representative at our Agency by phone, FAX or e-mail. Please call to confirm receipt of your notification.
Notify the insurance carrier directly by phone, FAX or online on the insurance company’s website. If you take this step, please also advise us so we may follow up on your behalf.
If you subscribe to The Compliance Office (TCO) services and have agreed to the automatic carrier notification, you may terminate your employees directly on the TCO website.

COBRA

This federal law allows for employees and dependents who lose their coverage to be offered coverage for a specified period of time. The law requires you to notify new employees of this coverage and notify them again about this coverage upon termination. There are several ways to administer COBRA, which is an employer law, including:

Through your insurance company as an administrator.
Through a Third Party Administrator, such as TCO.

DEPARTMENT OF LABOR

For more detailed information including sample notices, here’s a link to the Department of Labor.

EMPLOYER ONLINE LINKS

We encourage you to take advantage of the resources at each of the insurance company’s websites online.

Billing statements can be reviewed.
Employee coverage may be added or terminated.
Employee changes such as name, address, etc. may be processed.
Order ID cards.
Look up provider lists.
View and print Certificates of Coverage.

Please register as the employer on the links listed below, so you may access these services.

AETNA

BLUE CROSS BLUE SHIELD OF TEXAS

HUMANA

UNITED HEALTHCARE