• Underwriting Guidelines

    Small Employer Groups (2 - 99 employees)

    Minimum Size

    The Alaska-headquartered employer must average 2 to 99 employees on payroll with at least one "eligible employee" enrolled on the health plan.

    Development of Rates

    Rates will be issued based on group demographics and information received on the Alaska Group Enrollment Application and Health Survey. All applicants will be accepted.

    Enrollment Requirements

    Health Statements are required for each enrollee at the time of enrollment.

    Employee and Dependent Definitions 

    An eligible employee meets the following requirements: 

    • Regularly works at least 30 hours per week
    • Is listed on the employer's regular payroll
    • Is actively at work at the employer's regular place of business or other location to which employee is required to travel to perform the regular duties of employment
    • Has met employer's applicable probationary period
    • Resides or works in a Premera Blue Cross Blue Shield of Alaska approved service area
    • Is not covered by a collective bargaining agreement
    • Is covered by Workers' Compensation subject to verification, as required by law (24-hour coverage is available for owners, partners and executive officers when noted at the time of enrollment)

    When both spouses/partners of the same family are employed by the same employer and are eligible for coverage, both are required to enroll as Subscribers, rather than one enrolling as a Subscriber and the other as a spouse/partner. Dependents may enroll with either spouse but not with both.

    An eligible dependent meets the following requirements: 

    • An employee's lawful spouse, unless legally separated who is not an eligible employee, not on active duty in the armed forces and resides in an approved service area
    • An employee's child or the child of the employee's lawful spouse, including a legally adopted child or stepchild who is not an eligible employee, who resides in an approved service area and is under age 26
    • A Domestic Partner and the domestic partner’s children, provided the group has elected to include Domestic Partner coverage

    Contribution for Groups of 2 - 99 employees

    • Employers are required to contribute 75 percent of the employee cost
    • Employers are not required to contribute to the dependent cost

    Participation

    Groups of 2 - 3 Employees

    • 100 percent of eligible employees are required to enroll
    • Dependent participation is optional

    Groups of 4 - 99 Employees

    • A minimum of 75 percent of the eligible employees is required to enroll. If the employer contributes 100 percent of the employee cost, 100 percent participation of eligible employees is required
    • Dependent participation is optional. If the employer contributes 100 percent of the dependent cost, 100 percent participation of eligible dependents is required

    Groups of 20 - 99 Employees

    • May include dual choice when combining an HSA and a non-HSA product. $1,000 maximum difference between deductibles
    • A minimum of five employees need to be enrolled on each plan by the group’s first renewal date when dual choice is selected

    Eligible Participation Exclusions: Employees with other verifiable medical coverage are considered eligible participant exclusions and do not count against the employee participation requirement.

    For more information, contact your sales representative.

    Off-Anniversary Changes

    Off-anniversary changes may be made a minimum of six months (or greater) from the group’s renewal date and are subject to additional surcharges.

    Benefit changes requested after the group’s renewal agreement has been submitted and processed are subject to underwriting approval and additional surcharges.

    About Enrollment

    Completed enrollment materials need to be received in our office by the 20th of the month. If materials are not received until the 25th or later, the group needs to sign a form indicating they understand that enrollment activities will not be completed by the first of the month. If the completed materials are not received prior to the first of the month, the effective date will be delayed until the 15th of the month, or the first of the following month. Completed enrollment materials are defines as follows:

    • Completed Master Application & Benefit Selection Worksheet
    • Final Rates issued by Premera Blue Cross Blue Shield of Alaska and accepted by the group
    • Enrollment forms or the enrollment spreadsheet
    • Alaska Employer’s Quarterly Report (if applicable) or other required group verification
    • First month’s premium
    • Life Master Application (if applicable)
    • Life enrollment forms (if applicable)
    • First month’s life premium (if applicable) in a separate check