Plans for 1-50 eligible employees

Consumer engaged plans	Core plans	Group/individual plans
HealthbyChoice Incentives	PriorityHMO/PriorityEPO	Priority Health Medicare plans
PriorityHSA	PriorityPOS
PriorityHRA	PriorityPPO

Getting a small business group on board with Priority Health

1. Complete and submit an Agent Agreement (883KB PDF), if you haven't already.
   
2. Create a quote by logging in to your Priority Health account and clicking Rate Generator on your Agent Center home page. Rate Generator provides immediate access to quotes 24/7 and ensures rates remain competitive.
   
   NOTE: On the rare occasion you need help with Rate Generator, download and fill out a Proposal Request Form (126KB PDF - Log-in required) and Census Form (64KB XLSM) and e-mail them to Quotes-SBD@priorityhealth.com. You'll get an automated response verifying receipt of your e-mail. In 5 to 7 business days, you'll be able to access your quote in Rate Generator.
   
   
3. Complete a small group application form, waiver and enrollment forms (these forms are also located in Rate Generator).
   
• West Region Small Group Application (833KB PDF) - Updated 11/2009
  
• East Region Small Group Application (847KB PDF) - Updated 11/2009
  
NOTE: Applications must be submitted before the group can be enrolled for coverage.

Looking for group Medicare coverage?

Here's how to enroll your group's retirees in a Priority Health Medicare group plan.

Is your group in our coverage area?

View our Michigan service area map to find out.

Call the Small Business Sales department or the your account representative with any questions.

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Renewing a small business group

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

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For more information about small business groups, go to:

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

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.)
  
• Directors, corporate officers, trustees, corporate lawyers, and owners or partners MUST be full-time employees to be eligible.
• Seasonal employees (those working less than 36 weeks per year) and 1099 employees are not 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.