Underwriting Options

Preliminary Underwriting Checklist – Overview – Click on the icons located at the top center of the page to access the preliminary underwriting page. Or, click on the button in each checklist section. After you complete all of the check list items the status will change to completed. The Submit for Preliminary Underwriting button will be enabled so you can press it to submit the request.

Preliminary Request – Settings

Click on the settings icon, to change the default proposal settings below:

  • Underwriting Effective Date
  • Group Email Distribution List
  • Fee Agreement (PEPM)
  • Coordination of Benefits
  • Medical Tracking Year
  • Rate Guarantee
  • Stop Loss Limit

Then press the save & continue button

Group Email Distribution List

Recipients can receive email notifications for all underwriting status updates, or only Success emails (when rates are released and/or the group is installed). If the preference is set to None, the recipient will not receive any email notifications about the status of the group. To add a user to the list select the Email Preference. Enter First Name, Last Name, Email Address press + to add the user to the list. Then press update to save the changes.

Employer Information

Enter the following information:

  • Counting Methodology: Average Total Number of Employees (ATNE) 
  • Current Insurance Carrier
  • Choose type of plan is self-funded or fully funded
  • Tax ID/EIN
  • Domestic Partner Coverage Agent
  • Agent Information, you can choose a different agent from the list
  • Agent National Producer Number (NPN) if you do not know the NPN, click on the Lookup NPN link to find the NPN

Press the save & continue button.

Texas House Bill 2015 (HB2015): Claims Reports

In Texas only, Benefitter enables groups to submit prior claims reports to replace or supplement IMQ/Census underwriting. This claims report step comes between Employer Information and Census/IMQ. You can always choose to skip claims reports and proceed directly to IMQs.  If you select NO for the claims report, choose a reason from the list of values. Benefitter verifies that your claims reports cover the required criteria.

Claims Report – Upload

Benefitter verifies that your claims reports cover the required criteria:

12 consecutive months that conclude within 120 days of the requested effective date. Both Tier 1 (Premium vs Claims) and Tier 2 (Large Claims). If a single document does not meet these criteria, you can upload multiple reports. Choose the report tier, report begin date from the calendar or enter the dates, then press submit.

Claims Report – Employee Select

You will be asked to verify which people on the company census are not included in the most recent claims report. Benefitter will then determine whether some or all employees will need to fill out individual medical questionnaires.