INSURANCE DIVISION FAQS

Q: Can my employees enroll anytime during the year?

A: If an employee refuses benefits when hired, he/she may not enroll until the next open enrollment effective January 1, unless he/she has a qualifying event, such as marriage or loss of coverage. If electing Life or Short-term Disability, a completed Evidence of Insurability form will be required.

Q: When can my employees add dependents or change coverage?

A: Unless there is a qualifying event, such as marriage, birth, or loss of coverage, changes and/or additions are not allowed until open enrollment effective January 1.

Q: How does an enrollee change his/her PCP?

A: Enrollees should call Harvard Pilgrim at the phone number listed on the back of their ID cards.

Q: Who do I notify when an employee has a mailing address change?

A: You or your employee should call NHADA toll free at 800-852-3372.

Q: At what age should children be enrolled with Dental coverage?

A: On the first of month following the child's second birthday.

Q: When do I notify NHADA that an employee has terminated?

A: You should submit a Notice of Termination of Coverage form to NHADA as soon as possible. NHADA suggests within 48 hours.

Q: What happens if I submit a late Termination Notice?

A: If NHADA receives notification of termination either too late to comply with federal law or too late to notify appropriate carriers prior to their submittal deadlines, coverage for the terminated employee will end on the last day of the month that notification is received, and the group will be responsible for any premium due.

Q: Does the enrollee automatically get 30 days' extended insurance coverage if he/she terminates employment?

A: NO - He/She must elect COBRA for continued coverage.

Q: When will COBRA begin?

A: Once COBRA is elected and premium payment is received by NHADA, coverage will be reinstated effective the first of the month following the last day of group coverage.