Members Employers Providers Brokers GENERAL UNDERWRITING GUIDELINES Business Verification For all small group (6-50 employees) prospects and for renewal groups, proof of eligibility is required. Employer Contribution HMO/POS/PPO Large Group (Greater than 50 employees) The employer contribution must be at least 50% of the individual and the family rates, or 70% of eligible employees must participate in company sponsored health benefits AND the employer must contribute at least 25% toward the individual and family rates. HMO/POS/PPO Small Group (less than 50 employees) The employer contribution must be at least 50% of the individual rate. A minimum dollar value equal to 100% of the individual rate must be contributed towards the family premium. Participation Guidelines 1-5 Employees - 100 % of all employees in Health New England's enrollment area must enroll. 6-10 Employees - 75 % of all employees in Health New England's enrollment area must enroll. 11-50 Employees - Greater of 8 or 50% of employees n Health New England's enrollment area must enroll. 51+ Employees - 50 % of all employees in Health New England's enrollment area must enroll. Enrollment Area Requirements HMO/POS/PPO At least 70% of the eligible and participating subscribers must live within the HNE enrollment area. HNE only markets within its service area. Health New England One Monarch Place, Suite 1500 Springfield, MA 01144 - 1500 Hours of Operation: 8:00 a.m. - 5:00 p.m. Member Services Hours: 8:00 a.m. - 6:00 p.m. Monday - Friday Walk-In Hours: Due to COVID-19, we are not accepting walk-ins at this time. Contact Member Services Direct Line: (413) 787-4004 Toll Free: (800) 310-2835 TTY: 711 Privacy & Disclaimer Statement Notice of Privacy Practices Interoperability APIs HNE Associates Copyright © 2021 Health New England, Inc. All Rights Reserved Members Employers Brokers Providers Interoperability APIs