Plans for 1-50 eligible employees

Consumer engaged plans	Core plans	Group/individual plans
HealthbyChoice Incentives	PriorityHMO/PriorityEPO	PriorityMedicare
PriorityHSA	PriorityPOS
PriorityHRA	PriorityPPO

Getting a small business group on board with Priority Health

1. Complete and submit an Agent Agreement (1.48MB PDF), if you haven't already.
   
2. Request a quote by:
• Log in to your Priority Health account and use the Rate Generator tool to create a proposal (available for groups of 1-50 eligible employees).
  
  OR
• Fill out a Proposal Request Sheet (82KB PDF) and fax it to 616 957-2529
3. Complete the Small Group Application (547KB PDF), waiver and enrollment forms (the last two are located in Rate Generator).
   
• Must be done before the group can be enrolled for coverage

Call the Agent Help Line or the small business representative for your region with any questions.

Renewing a small business group

See the small group renewal process to renew a small business group's coverage.

For more information about small business groups, jump down to:

• Small business group enrollment requirements
• Eligible employees
  
• Community rating
• Billing structure

Small business group enrollment requirements
The group must:

• Be of a permanent nature and financially stable
• Have been formed for a purpose other than to secure group insurance
• Carry Worker's Compensation coverage unless not required by law
• Join or be a member of an organization recognized by Priority Health or any Chamber of Commerce in the Priority Health service area
• Sign a group agreement with Priority Health
• Not offer another employer-sponsored individual plan if it violates our underwriting criteria
  

Eligible employees

• ALL active employees who work a minimum of 30 hours per week are eligible. (A group may choose to offer coverage to employees working at least 17.5 hours per week as long as that coverage is equal to what it provides to all other employees.)
  
• Seasonal employees, directors, corporate officers, trustees, corporate lawyers, and owners or partners MUST be full-time employees to be eligible.
  
• Members who are eligible for Medicare (or any governmental benefits) will be treated as if they are enrolled in Medicare Parts A & B when Priority Health benefits are applied.

Community rating
Priority Health uses a rating methodology that complies with Reform Group law.

• Priority Health adjusts community rates based on group-specific zip code, size, Standard Industry Classification (SIC) code, age and tier mix (single/double/family).
• Priority Health offers only 3-tier rates (single/double/family) with a standard rate slope.
• Contact your region's Priority Health small business representative or visit www.osha.gov for assistance with rating an employer
  

Billing structure
Each group will be billed monthly. Priority Health accepts only one check per group for each monthly premium.

See the Billing & Payment section of this manual for more information.