Renewing 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:

Prerenewal letter

We will mail the prerenewal letter to the group and/or agent at least 120 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.

Getting the renewal rates

• If Priority Health is the stop-loss carrier:
  • Priority Health underwriters begin working on self-funded renewal groups 120 days before renewal and deliver a proposal within 90 days of the renewal effective date (see below for renewal packet info).
  • We'll provide a proposal for renewing current stop-loss coverage and give the group alternate specific deductible options.
• If the group has a third-party stop-loss carrier:
  • Priority Health will give you or the group the agreed upon stop-loss reporting package.

Renewal packets go out

Your group's Priority Health representative will deliver the renewal packets to you (the agent of record) 90 days prior to the group's renewal. The group then has until 45 days before their renewal date to make a decision.

The renewal packet contains:

• ASO proposal with fees and stop-loss coverage 
• Projected claims liability 
• Key contacts grid  

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. They 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 their records.

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 schedule of copayments and deductibles and certificate riders. Mailed to group members.
• Member handbook - Mailed directly to members who have not previously received one. Only mailed to all members if the group has changed plans.
• ID cards - If the group makes a benefit change that requires a new member ID card, we will send new ID cards within 7 to 10 business days after the renewal is completed. 

Group Medicare plan renewals

Submit group Medicare renewal notices to Priority Health 60 days before the group's effective date. This ensures we will meet the Center for Medicare and Medicaid Services (CMS) requirement that we send members their Annual Notice of Change (ANOC) 15 days before their open enrollment period.