What do I need to know:

Starting with September 1, 2011 bills, small groups (2-50) will not be eligible for reinstatement if they are terminated for non-payment of their monthly premium bill.

This means if we do not receive the premium payment due by the 30th day after the due date shown on the group’s bill, the policy will be automatically terminated with no reinstatement rights. To be clear, we will no longer grant discretionary reinstatement if we do not receive payment in full by the 30th day of the group’s grace period. 

The first billing cycle to be impacted by this important change is 9/1/11. For example:

·        Small groups that don’t pay their 9/1/11 premium will be terminated on the 30th
      day of their grace period – September 30 — retroactive to the group’s “paid to”
      date of September 1, or earlier if they are in arrears. 
 
·         This 
process will apply to all bills starting 9/1/11 and thereafter.

NOTE: If a group is terminated for non-payment of premium, claims incurred after the premium “paid to” date will not be Empire’s responsibility and it will then be the member/employee responsibility to pay those provider bills.

If insufficient funds are submitted, the entire payment will be returned.  Full payment must be resubmitted by the 30th day of the grace period to avoid termination.  Notice of the insufficient funds will not be sent to customers after the 20th day of the grace period. 

What do I need to do:

·        Make sure your clients are fully aware of this critical change before it goes into effect on September 1, 2011. 

·        Continue to emphasize the importance of paying monthly bills by the payment date listed for receipt no later than 5pm on Day 30 of the grace period. There will be no extensions beyond the end of the contractual grace period, i.e., the 30th day after the due date on the group’s bill.

IMPORTANT REMINDERS:

Regardless of delivery method, payment MUST be received by 5pm on the last day of the 30 day grace period:

·        Groups can access their bills and pay them online by registering on www.empireblue.com

·        Groups can pay their bill via phone (prior to cancellation) for a $25 fee by calling the GBA Contact Center at (866) 422-2583.

·        A group can also pay their bill by mail:

Ø  Payments mailed via USPS should be sent to:

Empire HealthChoice
P.O. Box 11744
Newark, NJ  07101-4744

Ø  Payments overnighted should be sent to:

Empire HealthChoice – Attention: 11744
c/o Regulus
365 West Passaic Street, Suite 530
Rochelle Park, NJ 07662

·        If a group has billing questions they can contact the Accounts Receivable and Collections Call Center at (888) 791-3236.

·        Payments sent to other Empire offices or any other P.O. Boxes will not be accepted or processed.

 
This notice supersedes any prior notice, statement or representation made regarding small group reinstatement rights.