Renewal Process for Self-Funded Large Groups

When it comes time for renewal, we will send you all of the necessary paperwork and information. Here is what you should expect:

1. Prerenewal letter
   We will mail the prerenewal letter to the group and/or agent at least 90 days before the renewal effective date so the group can verify its information. We can mail the letter sooner if the agent or group requests.
   
2. Getting the renewal rates
   Priority Health underwriters begin working on self-funded renewal groups 60 days prior to renewal.
   
   • We typically submit each renewal quote request to three reinsurers in order to get the most favorable renewal quotes for each client. You may also request a review by other reinsurance carriers.
   • Reinsurance carriers review 10 months of utilization information when creating renewal quotes.
3. Renewal packets go out
   Your group's Priority Health representative will deliver the renewal packets to you (the agent of record) 30-45 days prior to the group's renewal. The group then has until the 15th of month prior to the effective date to make a renewal decision.
   
   The renewal packet contains:
   
   • Renewal rates and any alternate benefit designs requested
   • Utilization and other applicable reports
   • Key contacts grid
   • Renewal Verification form
4. Submitting the renewal
   After the group and/or agent confirms the renewal decision, your Priority Health representative will complete the self-funded paperwork, including fee disclosures, reinsurance contracts and any amendments/SPDAs needing signatures. He/she will coordinate the necessary paperwork and forward it to either the agent or group for signature. If forwarded to the group, the agent will receive a final signed copy for his/her records.
   
5. Member materials
   
   • Amendments and other documentation - Priority Health will review suggested language with you. Once approved, we will forward everything to the employer group for distribution to employees.
   • Plan supporting documents - Includes Certificate of Coverage, policy, Summary of Plan Benefits, schedules of copayments and deductibles, certificate riders. Mailed to group members within 30 days of renewal.
   • Member handbook - Mailed directly to members separately from the plan documentation.
   • ID Cards - If the group makes a benefit change that affects the member ID card (for example, different office visit or ER copayment), we will send new ID cards to the entire group within 7 to 10 business days after the renewal is completed.

Contact the Agent Help Line with your questions. Your group's representative will work with you closely throughout the entire process.