Savoy Associates is pleased to introduce Karen Sullivan, our Office Manager and Horizon BCBSNJ Member Maintenance Expert.

In addition to fostering a fun, family-like environment in our home office, Karen trains and manages all new account administrators on Horizon's enrollment system, stressing the importance of timeliness, diligence, and accuracy. Karen and the Member Maintenance team at Savoy Associates typically process over 1000 Horizon BCBSNJ transactions per month as a service to our brokers and their small group clients!

In this month's Expert Feature, Karen offers some tips and addresses some common misconceptions regarding your clients' Horizon BCBSNJ transactions:

The Horizon Member Maintenance Department at Savoy Associates strives daily to serve you by processing your requests rapidly and accurately.  The best way to ensure this is to send in quality application forms that contain all of the necessary information.  Take a few moments to review your clients' forms before sending them to us. If any information is missing or illegible, please confirm with the client. If necessary, have the client resubmit a complete application before sending it to Savoy.  If the application is illegible, type the information on your cover sheet for our reference.  Applications written in ball point pen transmit poorly, while those written with gel pens transmit beautifully.  These may seem like insignificant points; however, they greatly affect positive, speedy, and accurate results.

Two very common misconceptions that I would like to address are the Late Entrant and the Open Enrollment Period for NJ Small Groups:

The Late Entrant is defined by Horizon BCBSNJ as an application received more than 30 days after the subscriber's eligibility date.  Coverage for late entrants becomes effective no earlier than the date Horizon BCBSNJ receives the competed application.  Late entrants are subject to a pre-existing condition exclusion limitation, which may be reduced by prior creditable coverage if the break in coverage is no more than 90 days.  The pre-existing limitation applies to groups with 2-5 eligible employees and to late entrants in groups with 6 or more eligible employees.

The function of Open Enrollment in NJ Small Group is for employees who are already enrolled under one employer plan to switch from their present plan to another plan offered by the same employer. Paperwork must be submitted within 30 days prior to the group's anniversary date. This information can also be found in the FAQ section of our website.

When terminating small group employees, please remember that Horizon BCBSNJ terminations become effective at the stroke of midnight; i.e., at the very beginning of the day of the date selected. Therefore, the subscriber will have no coverage at all on the actual date selected.  Please always confirm the correct date with your client and have them terminate coverage the day after the employee's last day of work, etc. to ensure coverage throughout that final day.

Varying circumstances can cause enrollments and/or terminations to sometimes be unusually tricky.  If you ever have any questions concerning Horizon BCBSNJ Member Maintenance paperwork and processes, please do not hesitate to contact us. Our highly experienced team at Savoy Associates is at your service and eager to help!

And remember: An ounce of prevention is worth a pound of cure!