The Operations Department at Savoy Associates assists your Business Development Team (BDT) in completing various tasks, including the processing of new business case submissions, plan changes, BOR letters, and enrollment changes.  To help you get your Small Group transactions processed quickly and efficiently, I would like to give you some tips for submitting them to our office.

For any type of transaction, the most important thing that you can do is to submit "clean", or complete and accurate, paperwork in a timely fashion.  This is the key to securing your client’s requested effective date!

Submitting clean paperwork to us is critical.  If you want things to go smoothly, you should verify that you have all of the information that is required by the carrier and check your work for accuracy before you give it to us.

Timeliness is paramount.  Your BDT is going to do a complete "scrubbing" of your submission, i.e., a thorough review of your business transaction to be sure that it is complete, accurate, and can be processed as requested.  It will not move on to the carrier until it is clean and your team is confident that it will be approved.  You should give your BDT ample time to review your paperwork in the event that any information is missing or there are corrections that need to be made.

It is typical for our office and the carriers to receive the highest volume of business right before or on the deadline.  Therefore, if you give us your transaction at that time, you should be prepared to deal with the cluster of traffic that usually occurs.

It is a lot like leaving at 8:00 a.m. for a 9:00 a.m. business appointment, when it takes you an hour to get there.  You know you will be traveling in rush hour.  In choosing not to give yourself extra time, you are assuming there will be no traffic delays or problems with your trip.  If something goes wrong, you will likely not get to your destination on time, as you have allowed no room for error.

By waiting until the last minute, you are essentially putting your business into a traffic jam.  However, when you submit the paperwork before the traffic, you are giving yourself the opportunity to fix any issues that may come up and secure the requested effective date.  I think we can all agree that it is better in business to be prepared and punctual!

Now, I would like to expand on the types of transactions and what you can do to speed up their processing.

New Business Cases

Strive to submit a clean new business case.  The more complete and accurate your case is, the less bumps there will be on the road to the requested effective date.  Plus, you will receive expedited case processing and eligibility for the Savoy Associates Clean Case Bonus!

Use the carrier’s new business checklist and ask yourself the following questions before submitting a case:

1. Am I properly appointed with the carrier?
2. Am I licensed to do business in that state?
3. Who do I want to be paid? My agency? Myself?
4. What effective date is available based on the carrier’s guidelines and the date I am submitting this new business case to Savoy Associates?

If your submission is for AmeriHealth, EmblemHealth, Horizon BCBSNJ or Oxford Health Plans, your case will be thoroughly reviewed by your BDT before it is sent to our internal case installation department to be electronically submitted to the carrier for approval.  It is critical to have all of the required information for the case to be accepted into the carrier’s system.  As with any other submission, remember that your case could be held up by your BDT if it is missing anything.

In order to be timely with your new business cases, you should submit them at least 15 days prior to the effective date, as this will give the carrier time to send out ID cards prior to the effective date.

Plan Changes

For a plan change, 15 days prior to the effective date is ample time for processing.  However, if you submit your plan change one month prior to the effective date, the carrier will reflect the change in the next billing cycle for the group.

Broker of Record Letters

When you are about to take over a group with a Broker of Record (BOR) letter, you should always ask yourself the same questions as you did for the new business case, which are the following:

1. Am I properly appointed with the carrier?
2. Am I licensed to do business in that state?
3. Who do I want to be paid? My agency? Myself?
4. What effective date is available based on the carrier’s guidelines and the date I am submitting this BOR letter to Savoy Associates?

When you have all of the required information and are ready to have the client sign the BOR letter, please be sure you are using the format the carrier requires.  If you do not submit the BOR letter in the correct format, the carrier will decline it.  This will result in a delay in the processing of your BOR letter.

To assist you in completing a BOR letter in the correct format, we have templates on our website that we encourage you to use. The templates are listed by carrier and can be accessed at http://savoyassociates.com/rg_njsg.aspx?CatID=4.

In order to be timely with your BOR letter submissions, I recommend giving them to us 15 days prior to the last business day of the month.  This allows enough time for our BOR team to review it, for missing information to be gathered, and for the requested effective date to be secured with the carrier.

Enrollment Changes

Regardless of the type of enrollment change you are submitting - an employee addition, termination, contract type change or open enrollment change - always take care to complete the enrollment application fully and legibly.  Unfortunately, your request may not be able to be processed if our office or the carrier cannot clearly read the following:

1. Group name
2. Group number, including the subgroup the employee wants to enroll in
3. Date of hire
4. Effective date of the transaction
5. Type of transaction
6. Employee(s) information, including the name, address, date of birth, social security number, primary care physician selections, and prior coverage
7. Dependent(s) information required for an addition, including the name, address, date of birth, social security number, primary care physician selections, and prior coverage
8. Signatures of employer and employee

Remember, if our office or the carrier has to ask you for any missing information, it is delaying the transaction from being processed.

It is very important to be on top of the timeframes for enrollment changes. The majority of enrollment changes must be submitted within 30 days. Unfortunately, many are submitted right before or on the deadline. When this happens, you are not allowing any time for the collection of missing information or other possible delays which may occur in processing.

Here are some of the most common timeframes you need to be aware of:

1. New hire enrollments must be submitted within 30 days of the employee’s eligibility date.
2. Terminations must be submitted within 30 days of the requested effective date.
3. Late Enrollees will be enrolled effective the date of receipt.
4. Open Enrollment changes must be received no later than the effective date of the change.
5. A newly married member has 30 days from the date of marriage to add their spouse.
6. A member has 30 days from date of birth to add a newborn.

These are just some examples for you to review.  The world of enrollment is incredibly complex, and requires a thorough understanding of each carrier’s policies and procedures, as well as State and Federal legislation.  Please visit our website for more detailed explanations and guidelines on enrollment transactions at the following links:

Member Maintenance section in our Small Group Reference Guide (NY-NJ-PA) (http://www.savoyassociates.com/rg_njsg.aspx?CatID=3).

Frequently Asked Questions for Small Group Eligibility Requirements (NY-NJ-PA) (http://www.savoyassociates.com/faq_1.aspx?id=1).

Cleanliness and timeliness of your submissions is vital to success in this business.  It is a good idea to know your deadlines, what is required by the carrier, and to review your work before submitting it to our office.  I recommend checking www.savoyassociates.com regularly for carrier deadlines, requirements and more.

I also encourage you to contact your dedicated Business Development Team or me with any questions you might have.

Thank you in advance for being accurate, complete and on time with your submissions, and helping us to serve you better!