Medical Mutual Of Ohio Marketplace Update

[CHUMPS FROM OXFORD]

A few questions/answers courtesy of Med Mutual.

• Q. Can non-grandfathered small group (1-49) or individual customers get an early renewal on December 1, 2013?

A. Yes. We recognize customers have valid business reasons for requesting changes to their coverage period. Just as we have in the past, we will continue to accommodate these requests.

• Q. Can non-grandfathered fully insured groups with 50 or more employees elect an early renewal?

A. No. Groups with 50 or more full-time equivalent employees will receive renewals at their regularly scheduled anniversary date.

• Q. If customers elect to renew early, what changes?

A. For small groups, December 1 becomes the permanent renewal date for customers who select this option. Note that all products a customer has with the Medical Mutual family of companies will move to this anniversary date.


For individuals changing their renewal, there will be a December 1, 2014, renewal followed by a January 1, 2015 renewal. All subsequent renewals will take place in January.

• Q. Will deductibles and benefit accumulations for individuals and group members be impacted by this change?

A. No. Deductibles and benefits will continue to accumulate on a calendar-year basis.

• Q. What is the timetable for requesting a change?

A. There are two stages of this process: requesting an early renewal illustration and the group or individual policy holder's acceptance of an early renewal offer. Any request for an early renewal illustration should be submitted by August 1, 2013. If the customer accepts the offer set forth in the illustration, Medical Mutual must receive the Renewal Date Change Request Form by October 1, 2013.

• Q. Whom should I contact to begin this process?

A. You can contact your Royal Advantage Broker or Medical Mutual sales representative to discuss your clients' options.

• Q. Will customers seeking this change be subject to underwriting?

A. Yes. Early renewals are subject to our customary renewal process and applicable rate changes in accordance with state filings. The impact of an early renewal will vary from customer to customer; therefore, early renewal may not always be the best option for a customer.

• Q. For small groups, will this renewal change trigger open enrollment?

A. Yes. As with any renewal, groups will have the ability to make benefit changes and will have a new open enrollment period.

• Q. Can a customer with a Section 125 cafeteria plan renew early?

A. Yes. However, the customer must confirm that Section 125 Cafeteria Plan documents have been amended to change the ERISA plan year.

• Q. What if, after reviewing the renewal exhibit, a customer does not want to renew early?

A. Individuals and small groups do not need to elect this change. Those not electing to renew early will receive their next regularly scheduled renewal in 2014 and will be rated in accordance with applicable federal and state regulations. For accounts requesting early renewal illustrations that do not submit the Renewal Date Change Request Form by the October 1, 2013, deadline, the current renewal date will remain as described above.



Timeline for December 1, 2013, early renewal process

• August 1: Deadline for brokers to request early renewal illustrations.
• Late August/Early September: Renewal illustrations will be released to all customers requesting December 1, 2013, early renewals. Small group illustrations will be delivered to the broker. Individual illustrations will be delivered directly to both the broker and individual.
• October 1: Deadline to accept December 1, 2013, renewal offer. This deadline will not be extended.
• November: Medical Mutual will send out the December invoice reflecting the new renewal rates. Revised Summaries of Benefits and Coverage will be provided.

 

[AllenChicago]

Customers seeking the renewal date adjustment are subject to Underwriting. Wow. That's something I've not seen before. Must be a Medical Mutual thing. Having to accept and renew everyone who applies each enrollment (or special enrollment) period will be a shock to Medical Mutual's system, won't it?