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Health Plan Transactions
The following information is provided by Group Benefits Strategies (GBS), SMHG’s Central Benefits Administrator
Please check forms for completeness:
• Date of hire for new effectives
• Effective date
• Termination date
• Group Number MUST be on forms
• Date(s) of birth
• PCP for HMO’s
• Subscriber signature (new effectives, changes, voluntary cancellations)
• Legible handwriting
2. Late enrollees may enroll for coverage during open enrollment or at the time of a qualifying event. When enrolling someone off anniversary, the effective date should be the date of the qualifying event. The health documentation when adding someone off anniversary.
• Loss of coverage documentation
• Adoption/placement papers for an adopted dependent
• Court order for legal guardianship
• Divorce decree when necessary
• Additional information as requested by the health plan
There is a time restriction when enrolling someone due to a qualifying event. The enrollee should notify you within 30 days of the qualifying event. The health plans allow 60 days from the date of the qualifying event for the transaction to be processed.
Wash rule in effect as of 4/20/2023.
If effective date is the 1st to the 15th of the month the group is charged for the entire month. If the effective date is the 16th to the end of the month the group is not charged for the month.
If the cancel date is from the 1st to the 15th of the month the group is not charged for the month. If the cancel date is from the 16th to the end of the month the group is charged for the entire month.
Cancel dates: We use the last day of coverage for the cancel date.