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Premium Administration

Premium payment may be sent to us as follows:

• Direct from the employer, using our remittance form
• From the TPA, using our form or the TPA's

Premium payments are due on the first of the month. The premium statement should be included with the payment.

Customized statements are permitted, provided they include:

• Month for which payment being made is applicable
• Group name and policy number
• Listing of rates being remitted (must document whether or not rates are on a gross or net basis)
• Enrollment counts for the month being remitted (adjustments must be documented)
• Calculation of total monthly premium

Change of premium rates

We may change premium rates on any of the following dates:

• When the policyholder's plan or policy is amended
• When the policyholder adds or deletes a subsidiary, affiliated company or division
• When an increase or decrease in the number of covered units (persons) exceeds 10 percent of those from the prior month or 10 percent over any period of 12 consecutive months
• When the premium taxes or state assessments, payable by us, increase (but only to the extent of the increase)
• When we assume any policy administration previously performed by the policyholder or TPA
• When any policy change is required to comply with state or federal law

Premium adjustments

Additions, terminations and coverage changes frequently necessitate premium adjustments. Adjustments should be attached to the premium report.

Information submitted must document all adjustments, including the month during which the adjustment occurred. Premium adjustments and supporting documentation should be submitted no later than 60 days after the policy period ends.

Incorrect or underpayment of premium

Incorrect premium amounts or number of covered units (persons) for a policy period must be reported within 60 days after the policy period ends.

Lapse process

If we do not receive premiums by the 20th day following the end of the grace period a lapse letter is mailed to the employer, with a copy to the TPA. Coverage terminates retroactively to the date through which premium is paid.

If the policy terminates for any reason, the employer is liable for all premiums to the date of termination.

Contact Us

For more information about our premium administration or TPA Stop Loss products, submit a request.