February 17, 2016

April 2016 Small Group Renewal Paperwork Due March 1

Blue Cross and Blue Shield of Texas (BCBSTX) small groups (1- 50) that are renewing April 2016 must return any required paperwork by March 1, 2016.  Forms included with 2016 renewals include:

2016 Forms for Small Group Renewals

Form	Description	Due Date for April 2016 Renewals	Default Action if Form is not Received
Composite Rate Billing Method Declaration Form	Required for groups electing Composite billing	Tuesday, March 1, 2016	Age billing will apply.*
BPA for Amendment	Required for groups that want to make benefit plan changes or other types of changes		Changes will not apply at the time of the effective renewal date.
Grandfathered Health Plan Certification Form Important: Rate Table, Signature and Contribution Information pages (up to three separate pages) are required.	Required to renew the group’s grandfathered plan(s) – if applicable		The grandfathered plan will be moved to the closest ACA metallic plan at time of renewal.

*The Composite Rate Billing Method Declaration Form with the BPA for Amendment (if applicable) must be received together or age billing will apply.

New! Composite Billing
April 2016 renewal exhibits include composite billing, in addition to individual age rate billing for the Affordable Care Act (ACA)/Metallic plans (medical and dental). Composite billing tiers include: Employee Only (EO), Employee + Spouse (ES), Employee + Children (EC) and Employee + Family (Spouse with children) (EF).

Paperwork Requirement for Composite Billing:

• To receive composite billing, the group must complete and submit the Composite Rate Billing Method Declaration Form to BCBSTX 30 days in advance of the effective renewal date. If the form is not submitted (together with the BPA for Amendment if applicable), age billing will apply.

New! 2016 BPA for Amendment form
The Small Group Benefit Program Application (BPA for Amendment) – only required if the renewing group is making a plan change – has been updated for 2016 and available to download from the BCBSTX website. The 2016 BPA for new business is also available in the Forms Finder section.

Paperwork Requirements for Grandfathered Plans:

• Grandfathered Health Plan Certification form (including Rate Table, Signature and Contribution Information pages)

Important: Groups renewing their grandfathered plans in April must submit the Grandfathered Health Plan Certification form 30 days in advance of the effective renewal date. If the Grandfathered Health Plan Certification form (including Rate Table, Signature and Contribution Information pages) for groups renewing in April is not submitted by the deadline, the grandfathered plan will be moved to the closest ACA metallic plan at time of renewal.

Change to Renewal Process for 2016 EGI Process that includes MSP Forms
As a reminder, BCBSTX will no longer require small groups to complete the Employer Group Information (EGI) form, including Medicare Secondary Payer (MSP) information, at the time of renewal. Please note, the EGI form is still required as part of the new group documentation. Although the EGI form should not be submitted for renewing groups, it is required for new group submissions.

New Small Group Business Paperwork Deadlines
As a reminder, paperwork deadlines for new small group business are different from small group renewals. BCBSTX recommends submitting new, small group paperwork at least two weeks prior to the group's requested effective date. If paperwork is received after the group's requested effective date, the group may risk having their effective date moved to a future time.

For more information, contact your Texas Small Group Account Management Unit at 877-239-5582 or via fax at 972-907-3631.