Payment Deferral Requests for May Must be Submitted by June 10, 2020
(Available for fully insured groups with CareFirst medical coverage)
During this challenging time, CareFirst is committed to ensuring our employer groups’ policies are not cancelled for nonpayment of premiums. Employer groups who are experiencing difficulties making their payments can follow the steps below to apply for payment deferral.
- Employers with more than 200 employees - contact your Broker or CareFirst Account Executive directly to request payment deferral.
- Employers with less than 200 employees - log in to the Employer portal, navigate to Billing and click the link for premium deferral. Alternatively, you can contact your broker to submit your request.
- Complete all the form fields, being sure to select the payment deferral month(s).
- Once your request has been submitted, it will be considered final for the requested period and cannot be modified online. You can only submit one request for deferral.
If you receive your bill from a third-party administrator (also called a TPA or FSP), you must request this deferral through that third-party biller. If your group’s premium is billed by the DC Health Link, visit the DCHL website for more information.
Individuals and employer groups can request to defer payments for up to two months (April/May) or one month (May) and will be billed for those payments, which would be broken out over the remaining months of 2020.
For every month(s) that is deferred, that total premium would be divided by the remaining number of months in 2020.
Requests to defer April and May are due by May 10, 2020. Deferral requests for May only are due by June 10, 2020.
One Month Deferment Example: If a May premium of $14,000 is deferred, you would divide by 7 months (June through December) resulting in the monthly deferral premium being $2,000. The new amount—regular monthly premium + the monthly deferral premium—would be due with the June payment and continue through the remainder of 2020.
Two Months Deferment Example: If both April ($12,000) and May ($13,000) premiums are being deferred, you would divide by 7 months (June through December) resulting in the monthly deferral premium being $3,571.43. The new amount—regular monthly premium + the monthly deferral premium—would be due with the June payment and continue through the remainder of 2020.
The deferral is available to both Individuals and groups who are paid in full up to the month prior to the deferral period.
Example: If deferring March/April, the individual or group must be paid through February.
Example: If deferring April/May, the individual or group must be paid through March.
- Does not apply for individuals who receive subsidies
- Does not apply to DC SHOP groups (including the dental/vision only groups that accompany small groups that have medical under a separate group ID)
- Does not apply to standalone products (dental, vision)
- Does not apply to ASO self-funded groups, administrative fees or claims invoices
- Individuals/Groups must be paid to date before requested deferral dates
Yes, deferred premiums are limited to the months above and must be consecutive.
You can choose between deferring the premium for one month (May) or two months (April and May). Requests to defer April and May are due by May 10, 2020. Deferral requests for May only are due by June 10, 2020.
After the 60-day deferment, premium payments will resume and the scheduled periodic payment for the deferral will be added. Both will need to remain current to avoid cancellation.
An online submission will be available next week on the CareFirst website that individuals/employer groups can use to submit a request for payment deferral. Groups may also reach out to their broker, full-service provider or CareFirst representative.
Brokers should contact their General Producer (GP) for help in submitting deferral request for groups and can also contact Broker Services area and or their CareFirst Representative for help.
For groups administered through an FSP, brokers should ask the client to provide a written request outlining which months they want to defer their CareFirst premium (March/April or April/May) and they understand the deferred premium amount will be divided among the remaining months in 2020 which will be payable along with regular monthly premiums.
CareFirst will send an acknowledgement letter to direct billed groups and individuals once their request for deferral is processed and approved. This letter will outline the payment plan rules, installment plan payments that are due, etc. We are working on finalizing that letter.
If a group terminates before 12/31/2020, as long as they abide by the payment plan rules, the group would have through 12/31/2020 to complete their deferred payment plan. CareFirst may pursue all options to recover any delinquent amounts, including the deferred dollars.
COBRA participants are not receiving additional grace periods for their payments past the 30-day payment grace period required by law. CareFirst should continue to receive updates to paid-through dates and notice of terminations timely. Standard contractual retroactivity policies continue to apply.
Most groups under 50 do not differentiate active employees from COBRA participants. When a COBRA distinction has been requested upon initial setup, it is accommodated. Generally, there is no clear tracking for under 50 groups.
No. The current enrollment file process should remain as-is.
Yes, documentation of business rules will be provided to each FSP.
The arrears notification will not be sent during the deferral of payment period but will be sent when the regular premium cycles begin.
The group will be directed back to the FSP.