{"id":5830,"date":"2018-02-13T11:54:27","date_gmt":"2018-02-13T16:54:27","guid":{"rendered":"https:\/\/peakinsuranceadvisors.com\/?p=5830"},"modified":"2018-02-13T12:18:40","modified_gmt":"2018-02-13T17:18:40","slug":"oxford-updates-new-york-small-group-underwriting-guidelines","status":"publish","type":"post","link":"https:\/\/peakinsuranceadvisors.com\/oxford-updates-new-york-small-group-underwriting-guidelines\/","title":{"rendered":"Oxford Updates New York Small Group Underwriting Guidelines"},"content":{"rendered":"
Oxford updates New York small group underwriting guidelines to meet DFS Guidance \u2013 We were advised of the following update from UHC Oxford regarding changes to their underwriting guidelines for new and renewing groups for coverage starting on 1\/1\/18.\u00a0 These changes are being made to comply with DFS guidance as follows:<\/p>\n
To qualify as a group eligible for coverage under Employee Retirement Income Security Act (ERISA), a group must have at least one common law employee who is both eligible for and enrolled in the coverage.\u00a0 If no \u201cemployees\u201d are covered by the plan, an employee benefit plan does not exist.<\/strong><\/p>\n As a reminder, the following individuals are not eligible employees and if enrolled, do not satisfy this requirement: Sole props must have at least one other eligible employee that also enrolls.<\/em><\/p>\n The New York Department of Financial Services (DFS) also provided additional guidance surrounding the small group annual open enrollment period.\u00a0 Here is the link to the DFS guidance:\u00a0http:\/\/dfs.ny.gov\/insurance\/health\/market-rules-guide.pdf<\/a><\/p>\n
\na.\u00a0\u00a0 \u00a0a person who does not meet the common law employee definition under Department of Labor and Internal Revenue Code rules.
\nb.\u00a0\u00a0 \u00a0a former employee who is covered through retiree benefits, COBRA or state continuation;
\nc.\u00a0\u00a0 \u00a0an employee who does not live, work or reside in the\u00a0 United States;
\nd.\u00a0\u00a0 \u00a0individual proprietors\/owners and their spouses (\u201csole proprietors\u201d or \u201cpartnerships\u201d).<\/p>\n