More Updates to GRx Quoting Guidelines for Large Group

We’re expanding GRx quoting guidelines for fully insured large group again to let more groups qualify for the GRx rating. The renewal increase is no longer limited to 40% or less. We will use GRx regardless of the renewal increase amount. We have also expanded the participation rule to 50%.

If you have questions, contact your account executive.

GRx Quoting Information Requirements

Census

1. Population to Be Included:

• All eligible employees regardless of coverage status
• All eligible dependents regardless of coverage status

2. Format Required:

• Excel file

3. Order Required:

• Last name
• First name
• ZIP code
• Birth date, mm/dd/yyyy
• Gender M or F
• Covered Y/N

Group Information

1. Current

• Current carrier
• Current benefits
• Current and renewal rates
• Large claimants
• Nature of business

2. Size

• Large group prospects of 100 total employees or less
• Must meet 50% employee participation
• Out-of-state employees must be 30% or less of the total enrollment

Underwriting Requirements*

1. Current renewal (increase percentage is no longer a factor)

2. Must be the original increase, not a negotiated amount

3. For Illinois groups located in the following counties:

Cass, Champaign, Christian, Clark, Clay, Coles, Crawford, Cumberland, DeWitt, Douglas, Edgar, Edwards, Effingham, Fayette, Ford, Fulton, Greene, Hamilton, Henry, Iroquois, Jackson, Jasper, Jefferson, Kankakee, Knox, LaSalle, Lawrence, Livingston, Logan, Macon, Macoupin, Marion, Marshall, Mason, McDonough, McLean, Menard, Mercer, Montgomery, Morgan, Moultrie, Peoria, Piatt, Putnam, Richland, Rock Island, Sangamon, Scott, Shelby, Stark, Tazewell, Vermilion, Wabash, Wayne, White, Woodford

*Health Alliance will rerun groups post-sale with enrollment census to verify changes in risk. Groups may be subject to re-rating.