Quality Connection

News and Updates for Brokers
July 2017
Retro-Termination Changes

As we shared with you last month, the Prior Authorization Transparency Act amendment will impact the retro-termination of subscribers or members.

Beginning October 1, 2017:
  • Retro-terminations are no longer allowed; terminations will be effective at the end of the month in which we receive the termination notice.
  • No premium refunds will be given once payment is made for a member, coverage is provided, and the member is listed as eligible for services.
  • If the group chooses not to pay their invoice as billed (for all enrollees), in order to avoid delinquent status they must contact the Finance Department prior to the due date to request an updated invoice reflecting any terminations. Example: In June we send the July bill including Member X. Prior to the due date, the group can contact us to request an updated July invoice that does not include Member X and then pay that invoice as billed. Otherwise, an invoice may be paid as billed, and if sent with notification of termination, one month credit will be given on a future invoice.
  • A premium credit will not be provided if we receive a member termination notice in the same paid month. For example: We receive a termination notice from you on July 10 and your payment for July has been processed. The termination is effective July 31, and there will be no premium credit.

What Employers Can Do to Prepare:

  • Sign up for automatic payment at QualChoice.com and pay insurance premium statements as billed. Adjustments for the current month will be shown on the next month's statement.
  • Register for the My Account employer portal at QualChoice.com to easily manage group eligibility changes. We will no longer make changes for names struck through on billing statements.

The forms named below, available on QualChoice.com, will soon be updated to reflect these changes.

  • Product Selection & Sold Rate Form
  • Change Form
  • Termination Form

Employers will receive a letter with additional details in the next few days. 

Updated Forms
To make sure you are using current QualChoice forms, please download from the Broker Forms page at QualChoice.com each time you need to use one.
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Dr. Win Hammerly joined KATV Good Morning Arkansas to share tips on eating right and exercising to stay healthy on vacation.

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