Excellus Bluecross BlueShield logo
Login | Register | Forgot Username | Forgot Password
Program Offerings
By Phone
By Email
By Mail
Visit Us In-Person
News & Updates
Print Forms
About Us
Compliance Notices
Broker News | September 2015 | Vol. 10 No. 8
Broker News | September 2015 | Vol. 10 No. 8

Important Information for Groups That No Longer Qualify as Small Group

Some groups that are currently community rated because they are classified as small groups may no longer qualify for community rating in 2016.

Beginning in 2016, the Affordable Care Act requires companies to have common-law employees enrolled in the coverage in order to be eligible for group health insurance. Generally, a common-law employee is anyone who performs services for an employer, and receives wages, if the employer can control what will be done and how it will be done. A common-law employee does not include the sole owner of a business or a spouse of the business owner. 

We will be assisting groups that no longer qualify as small group in the following ways:

  • Notifications will be mailed to groups that no longer qualify for small group coverage within the next 30 days.
  • Brokers will be receiving a list of their impacted groups from their account consultant.
  • If a broker feels their group still qualifies for small group coverage they should contact their dedicated account manager to work with an underwriter on resolution.
  • If a group does nothing, the group’s members will be automatically enrolled in an individual market plan similar to the plan they are in now. If members wish to select an individual plan other than the one they were automatically enrolled in, they should call 1-888-576-6593.
  • Members who are Medicare eligible will not be automatically enrolled in a plan. For help selecting a plan, they can call 1-800-659-1986 or visit excellusmedicare.com.


Home     News & Updates    Print Forms    About Us    Fraud & Abuse    Glossary    Accreditations   
Language Assistance and Non-Discrimination Notice

Copyright © 2019, Excellus BlueCross BlueShield, a nonprofit independent licensee of the Blue Cross Blue Shield Association. All rights reserved. View our Web Privacy Policy for information on how we protect your privacy. Use of this site indicates your acceptance of our Terms of Use. Follow this link to view our 31 county New York State service area. You will need Internet Explorer or Google Chrome to use the secure features of this site.