About commercial groups

The following questions pertain to our standard contracts only. Some employer groups have negotiated other terms.

1. When does HFHP send out premium bills?
Premium billing statements go out around the 15th of the month prior to the due date.

2. When is premium due and when is it considered late?
Premiums are due on the 1st of every month. For example, January premiums are due by December 31. Premiums are considered late if they have not been received by the 1st.

3. Is there a grace period beyond the premium due date?
The State of Florida HMO statutes allow for a 10 day grace period after the premium due date. HFHP considers premiums late if they are received after the 1st of the month.

4. When will HFHP terminate a contract for nonpayment of premium?
If we do not receive the premium by the end of the grace period, the contract will be automatically terminated and the effective date of the termination will be retroactive back to the last day premiums were paid in full.

5. How should employers notify HFHP of changes to enrollment?
Any newly eligible employee should complete an Enrollment Application prior to the eligibility date and the employer should send the form to the HFHP Enrollment Department at:

Health First Health Plans
Enrollment and Billing Department
6450 US Highway 1
Rockledge, FL 32955
Attn: Enrollment

Terminations and changes to existing enrollments should be submitted to the same address on an Enrollment Change form. This includes family additions.

6. Can an employer terminate an employee directly on the premium remittance?
We highly encourage employers to terminate employees or dependents on an Enrollment Change form and send it to us. We will accept terminations directly on the bill only if the termination date is included.

7. What is the maximum credit given for retroactive adjustments?
HFHP will credit back one month from the date of receipt of the notification only. This is why we prefer to obtain termination information on an Enrollment Change form to avoid untimely notices for credit purposes.

8. When are new employees effective?
Each employer group determines what the waiting period will be before new employees are effective on the plan. The waiting period is listing in the contract.

9. Can the waiting period be changed?
Yes, you may change your waiting period on your plan's anniversary date. The new waiting period will become effective on the plan anniversary date, and will apply to employees hired after that date. Retroactive changes or changes during the plan year are not permissible.

10. What is the minimum contribution required by the employer?
HFHP requires a minimum of 50% of the employee only rate be contributed by the employer.

About Medicare groups

1. What are the enrollment time frame requirements?

• Initial Election Period - When someone first becomes eligible for Medicare, they can enroll in Health First Medicare Plan up to 90 days in advance of their effective date with Medicare.
• Group Open Enrollment Period - This is determined by the specific employer group and can be several months prior to the effective date. The application must be signed and dated prior to the effective date of coverage and HFHP must receive this application no later that 90 days after the effective date. To avoid unnecessary processing delays and issues, it is beneficial to forward applications in advance of the effective date.

All other enrollments must be signed, dated and received at HFHP by the close of business the last business day of the month immediately preceding the effective date of coverage.

2. When are premiums due?
Premiums are due the 1st of the month for the following month's coverage. If premiums are not received by the end of the month after the due date, all members will be transferred to individual Medicare Plans and billed directly.