Policies

Policies 2016-12-28T12:23:07+00:00

These policies are for insurance plans offered through the Health Connector. From time to time, our policies may change, so check back often.

Please note that if you need a copy of a policy document, call Customer Service at 1-877-623-6765 or TTY: 1-877-623-7773 during normal business hours. Support is available in all languages.

 

Policy Groups:

  • Common Policies (for both individuals and families and small businesses)
  • Non-group Policies (for individuals and families only)
  • Small-group Policies (for small businesses only)

 

Common Policies

Non-Group Small Group Dental
Number Type Title ConnectorCare + Advance Premium Tax Credit Advance Premium Tax Credit Health Connector Plan Business Express Business Select Business Choice
CM-1 Eligibility Domestic Partner Eligibility
CM-2 Enrollment Enrollee Age-Out
CM-3 Payment Premium Billing and Payments
CM-4 Payment Refunds
CM-5 Miscellaneous Nondiscrimination

 

Non-Group Policies

Number Type Title ConnectorCare + Advance Premium Tax Credit Advance Premium Tax Credit Health Connector Plan Dental
NG-1A Eligibility Eligibility for Individual/Family Plan
NG-1B Eligibility Eligibility for Federal and State Financial Support for Individual/Family Plan
NG-1C Eligibility Rules for American Indians/Alaska Natives (Indians)
NG-1D Eligibility Eligibility for Catastrophic Plans
NG-1E Eligibility Mid-Year Life Events or Qualifying Events
NG-1F Eligibility This policy has been consolidated. See policy NG-1E above.
NG-2 Eligibility Redetermination During the Benefit Year
NG-3 Enrollment Enrollment in Individual/Family Plan
NG-3A Enrollment Dependent Eligibility and Verification
NG-4 Enrollment Open Enrollment Period For Individual/Family
NG-5A Enrollment Enrollment Timelines
NG-5B Enrollment Coverage Effective Dates
NG-6A Enrollment Termination of Coverage – Voluntary
NG-6B Enrollment Termination of Coverage – Non-Payment of Premium
NG-7 Enrollment Renewal of Coverage
NG-8 Rating Premium Rating and Re-Rating – Qualified Health Plans
NG-9 Rating Rating and Re-Rating – Qualified Dental Plans
NG-10 Payment Left over APTC applied to QDP
NG-11 Payment Waiver or Reduction of Premium
NG-12 Misc. Undeliverable Mail

 

Small Group Policies

 

Number Type Title Business Express Business Select Business Choice Dental
SB-1A Eligibility Employer Group Eligibility and Verification
SB-1B Eligibility Employee Eligibility and Verification
SB-1C Eligibility Dependent Eligibility and Verification
SB-1D Eligibility Mid-Year Life Events or Qualifying Events
SB-2 Eligibility Consolidated Omnibus Budget Reconciliation Act (COBRA) /Mini-COBRA
SB-3 Eligibility Service Area
SB-4A Eligibility Employer Contribution Requirements
SB-4B Eligibility Participation Requirements
SB-5A Enrollment Employer Enrollment
SB-5B Enrollment Employee Enrollment
SB-6A Enrollment Enrollment Timelines
SB-6B Enrollment Coverage Effective Dates
SB-7 Enrollment Annual Employee Election Period
SB-10 Enrollment Renewal of Coverage
SB-11A Enrollment Employer Group Termination of Coverage – Non-Payment
SB-11B Enrollment Employer Group Termination of Coverage – Voluntary
SB-11C Enrollment Employee Additions and Termination of Coverage
SB-12 Enrollment Reinstatement of Coverage
SB-13 Enrollment Broker
SB-15 Rating Rating and Re-Rating – Qualified Health Plans
SB-16 Rating Rating and Re-Rating – Qualified Dental Plans
SB-17 Misc. Nondiscrimination
SB-18 Misc. TEFRA Medicare Secondary Payer (MSP) Documentation
SB-20 Wellness Wellness Track Eligible Employers and Employees
SB-21 Wellness Wellness Track Rebate Requirements
SB-22 Wellness Wellness Track Term
SB-23 Wellness Wellness Track Rebate Payment
SB-24 Wellness Wellness Track Employer Group Termination and Reinstatement
SB-25 Wellness Wellness Track Voluntary Termination
SB-26 Wellness Wellness Track Appeal