PREMIUM ACCOUNTING
SLG Benefits provides a Premium and Enrollment Statement to each
Policyholder for the purpose of calculating all premium payments.
PREMIUM PAYMENTS
Premium payments are due on the first of the month.
Payment should be submitted along with the Premium and Enrollment
Worksheet. Customized worksheets are permitted, as long as the
worksheet includes the following information:
- Month for which payment being made is applicable
- Group name and Policy number
- Listing of rates being remitted (must document whether or not
rates are on a gross or net basis)
- Enrollment counts for the month being remitted (adjustments must
be documented)
- Calculation of total monthly premium
All premium payments should be made payable to SLG Benefits and Insurance, LLC & sent care of:
SLG Benefits and Insurance, LLC
9 Atlantic Avenue
Marblehead, MA 01945
LATE PREMIUM
A premium is considered past due if not received by
the end of the Grace Period established in the Policy (normally 31
days) and may result in SLG Benefits making appropriate contact to
determine the delay. SLG Benefits intends to notify all Producers of
Policyholders whose premiums have not been received by the 10th of the
following month. Our notice informs the Producer, which is also deemed
to be notice to the Policyholder, that premium has not been received
and that termination or a voiding of the Policy may take place without
further notice.
Premiums received after the 10th are considered late payments. Any
extensions for receipt of payment are granted at the sole discretion
of SLG Benefits. We reserve the right to cease extensions past the
grace period at anytime and without prior written notice.
It is the Policyholder's responsibility to make certain that premiums
are paid. We request that you do not rely upon the expectation of
receiving premium late notices in order to trigger payment of
premiums. Coverage may be rescinded or terminated whether or not the
late premium notice mentioned above is sent or received. Prior premium
payment delay shall not constitute waiver by the insurance company
and may not be used to create any release of responsibility for timely
submission of current and future premium payments.
If any of these procedures are in conflict with any state law or
regulation, we will adjust our procedures to conform with the state
requirement accordingly.
PREMIUM VARIANCE
All policies are on a self-bill basis. We do not
send billing statements and it is the Policyholder's responsibility to
pay the monthly premium in a timely manner. If the premium paid does
not match the actual amount due, we will send a notice of variance. We
will allow the variance to be credited or the additional payment be
made in the following month's billing statement.
Since the premium received by SLG Benefits for the first month of
coverage is estimated, please allow for premium reconciliation between
the estimate and the actual earned first month's premium. This can be
adjusted when submitting the second month's payment. If final rates
are not established by the time the second month's premium is due, an
estimated amount is still required to be paid on time, with
reconciliation occurring in the third month.
ENROLLMENT STANDARDS
Under certain circumstances, at the discretion of
SLG Benefits, a given monthly premium total may be revised due to
enrollment fluctuations. Premium revisions shall not be permitted that
are based on enrollment adjustments in excess of ninety-days (90) from
the first of the month in which SLG Benefits receives a request for
premium revision.
Back charges or credits of more than 90 days for any employee must
have supporting documentation that explains the delay in change
notification. SLG Benefits will approve or disapprove these
adjustments on a case-by-case basis. Please note that timely reporting
is important for you and the client's protection.
Enrollment changes of more than 10% from the effective date of
coverage must be reported to SLG Benefits immediately. SLG Benefits
has the right to change rates and/or factors in order to adjust for
significant changes in plan participation. No action will be taken
without notifying the TPA or Producer.
We will accept a no loss/no gain procedure on additions and
terminations for a month. This means, if a group is completing their
billing on the 15th of the month for the following month:
- We will count all additions made between the 1st and the 15th of
the month. Any additions made from the 16th to the end of the month
will not be accounted for in that month and will be reflected in the
following month’s remittance.
-
We will count all deletions made between the 1st
and 15th of the month. Any deletions made from the 16th to the end
of the month will not be accounted for in that month and will be
reflected in the following month’s remittance.
This does not mean that the Plan Sponsor will not
add or delete the individuals from the plan if it occurs after the
15th. It should list these individuals on the census for the next
month, but a pro-rating for the short period is not necessary.
This philosophy mirrors running a census on the 15th of the month and
reporting based off that census. It relies on the fact that most
groups have a normal ebb and flow to additions and terminations and
they will generally balance out. We do not pro-rate any premiums, so
this is our recommended procedure.
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