Termination of coverage
- Process the termination using the online Enrollment tool. Select "Disenroll." Go to the online Enrollment tool. (You must be logged in to access the tool.)
- Be sure to provide the exact date of termination according to your termination policy and a termination reason so coverage is administered properly.
- Submit all terminations to Priority Health within 30 days of the termination date.
Note: If you disenroll an employee more than 30 days after the termination date, you must certify that you told the affected employee about their loss of coverage when they were terminated. (This ensures you and Priority Health comply with health care reform rules for rescission. Learn more.)
If you can't use the online Enrollment tool, send the completed enrollment/change form to the Enrollment department:
Email: enroll@priorityhealth.com
Fax: 616 942-5242
Mail:
Priority Health
Enrollment
P.O. Box 205
Grand Rapids, MI 49501-0205
Note: Terminating an employee's coverage does not remove that employee from our system. If you ever need to reinstate that employee, you may do so in the online Enrollment tool by following the reinstatement instructions.
Types of coverage termination
Most employer groups terminate coverage as of:
- The end of the day eligibility was lost or
- The end of the month in which eligibility was lost
Coverage termination typically occurs when:
- The employee voluntarily terminates employment
- You terminate employment
- The employee doesn't meet your plan's eligibility requirements (for example, if they don't work the appropriate number of hours)
- A dependent doesn't meet your plan's eligibility requirements (divorce, etc.)
Certificate of Creditable Coverage (COCC)
Per HIPAA requirements, Priority Health will provide a COCC for your employees (and their dependents). The COCC provides evidence regarding coverage the member had under your plan. This information is used to "waive" pre-existing condition periods. The member may request a COCC for 24 months after termination of coverage.
Contact your account manager for more information.
