12/08/2011
December submission deadline for new micro groups approaching
This is a reminder that all new micro groups (1 to 4) must be submitted no later than 5 p.m. (Pacific Time) on the 15th of the month immediately preceding the effective date. All required forms must be completed and submitted to us by the published deadline, without exception. Incomplete or inaccurate information will delay the effective date of the group's coverage. If additional information is required, we need to receive it by the 20th of the month immediately preceding the effective date; otherwise, the proposed effective date will be moved to the following month.
The following information and forms are required:
- Group Master Application
- Applications for Enrollment/Change or Enrollment Spreadsheet
- Waiver forms
- Affidavit of Qualifying Domestic Partnership (if applicable)
- Affidavit of Qualifying Incapacitated Dependent Eligibility (if applicable)
- Tax Forms and other business verification documentation
Please refer to our Micro Group Employer Documentation Requirements for more information about documentation required for groups of 1 to 4.
To expedite submission of a new micro group, please email the completed forms and documentation to us. If you have questions or need help, please talk to your Regence Sales contact.
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