Frequently asked questions

When does new business have to be submitted to Health First Health Plans?
All new business cases must be submitted by the 20th of the month preceding the requested effective date of coverage. If the 20th of the month falls on a holiday or weekend, then the case is due the last business day before the 20th of the month.

What do you do with incomplete case submissions?
HFHP expects brokers to submit clean and complete cases. This includes every question answered in the group application, employee enrollment forms, health status questionnaires (for small groups) and acceptable tax documentation. If anything is missing and/or incomplete, the case will be returned to the broker. All resubmissions are subject to the cutoff date described above.

What is acceptable tax documentation for groups of two or more?
HFHP will accept quarterly wage and tax forms for the previous filing period or UCT-6 forms plus a participation verification form for those employees listed on the 941 or UCT-6 and no longer employed or newly hired employees. In addition to the 941 or the UCT-6, HFHP requires a copy of the occupational license and a check for the first month's premium (drawn on a legitimate business account).

Will HFHP accept businesses that are filed as an sub-chapter S corporation?
Yes, with a copy of the previous year's tax filing and any applicable K1s. If there are any employees in addition to the shareholders, HFHP requires the documentation listed in question three as well.

Does HFHP require updated tax documentation periodically?
HFHP requires updated documentation upon the group renewal to verify the group still meets the definition of small employer group according to state law and that participation requirements continue to be met.

What is HFHP's participation requirement?
HFHP requires 70% of all eligible employees participate in the group plan. Any employee covered under another employer group plan may waive coverage under HFHP and will not count towards the participation requirement. HFHP requires proof of other coverage with a copy of the other coverage's ID card.

When is HFHP's cut-off date for premiums to be included in commission payment?
Brokers will be paid commissions on all premiums received and posted by the last day of the month for commission payment in the following month. For example, all premiums posted by December 31 will be included in the commissions paid in January.

How will brokers know a client has not paid premium?
Brokers receive a commission statement that includes premiums by month paid. The statement will show the last month premiums were posted.

Does HFHP notify brokers if a group has changed the agent of record?
HFHP will notify brokers via the commission statement with a notation next to the group "Agent of Record Change."