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Small Group Underwriting Healthy NY Form And Annual Group Information Form WebTool Updates

Small Group Underwriting form updates are rolling out as outlined below. Impacted lines of business include Small Group Medical, Dental, Vision and Healthy NY.

Healthy NY (HNY) Group Size Information
Going forward, Underwriting will begin collecting group size information on all HNY renewal groups to comply with Federal COBRA reporting requirements. Below the new process is outlined for renewal HNY groups:

  • HNY Recertification (Renewals)
    The HNY Recertification Form will include a new supplemental page with two group size questions to collect total employee and full-time equivalent employee data.

    Ownership question has been added to collect current ownership information. This is required to ensure we have current ownership information on file to determine that the group has common law employees enrolled.

    *Instruction reference documents will be posted soon to external sites for assistance in completing the new form

We encourage groups to begin providing their group size information as soon as possible. We will require HNY renewal groups to use the new version of the form starting with July 1st renewals.

Share this Healthy NY form with your employer groups:

HNY Supplemental Group Size (PDF)

Annual Group Information Form (AGIF) Updates
The AGIF form and accompanying online AGIF WebTool have been updated to reflect the changes below. Updated AGIF instructions are available online as a reference for how to complete the form.

  • Section 2: Minor language updates to reduce inaccurate responses and increase the number of AGIF that are approved with no reach out
  • Section 3:
    • Added question for groups to indicate if they offer a vision product through the Health Plan, and if so, to indicate the employer contribution to vision
    • Medicare questions have been removed resulting in a shorter overall form. We will now use information collected in Section 2, Question 2 to identify groups that may have a size change that will impact Medicare primacy.
  • Signature Section: Added legal language notifying groups that The Health Plan is reporting on their behalf for CAA Rx reporting.

Share the newly updated AGIF forms and AGIF WebTool Instructions with your groups:

Updated AGIF Form (PDF)

AGIF WebTool Instructions (PDF)

The anticipated date for these AGIF and online AGIF WebTool changes is Friday, March 31, 2023.

Questions on these changes can be directed to a member of the Small Group Underwriting team.


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