Jun 25, 2021

• Small Group

• NY-DOWNSTATE
• NY-UPSTATE

New ARP state continuation changes for groups with less than 20 employees

In late May, we told you and your Small Group employers about requirements involving individuals who are on state health continuation because they lost group health coverage because of termination of employment or reduction in hours. The American Rescue Plan provides these individuals with a 100% premium subsidy for continuation from April 1 through September 30, 2021.

Some details about these requirements for groups with less than 20 employees have changed since then.

• Employers must send the alternative model notice and summary to each Assistance Eligible Individual (AEI) as soon as employees become eligible.
• The notice includes a Request for Treatment as an Assistance Eligible Individual form that the employee must sign and return to their employer.
• The employer must then complete the employer portion of the form and add the group name and number to the top. The employer must then send a copy of the completed form to SmallGroupE&BSupport@anthem.com. They do not need to submit an Employee Change Form for Small Groups as we originally told you.
• We will stop billing for members once we have received the completed forms. Employers need to continue to pay for any other employees listed on their invoice.
• Empire is responsible for filing for the subsidy. We will credit the employer’s account for any premiums paid for eligible employees.
• Employers are also required to send the Subsidy Expiration Notice to the eligible employees 15 to 45 days before their subsidy expires to inform them.
   

Please contact your sales representative if you have any questions.