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Plan Administrator - MBA - Payment Requirements
Maintaining Eligibility – Detailed monthly billing statements for the next month’s premium are sent out to all companies before the end of each month. The Trust’s contractual payment due date is the first day of the billed month. In order to maintain current eligibility for employees, full payment must be received by the Trust on or before the 15th day of the billed month.
Delinquent Eligibility Status – A company’s eligibility for the month will be delinquent if full payment is not received by the 15th. Delinquent eligibility status results in claim payment delays and other difficulties for employees, their medical providers, and the insurance carriers.
Retroactive Cancellation – If full payment for the month is not received within 45 days of the payment due date, the company will be retroactively cancelled back to the last day of the month in which full payment was received. Any partial monthly payments will be refunded at that time.
Insufficient Funds – Payments returned to the Trust Administrator for any reason must be replaced with guaranteed funds (i.e. cashier’s check, money order or cash) within 5 working days of being notified by the Administrator. A $20 fee will be assessed on all returned drafts.
Example of billing cycle using coverage for the month of January:
- Billing statement mailed: approximately December 20-22.
- Contractual payment due: January 1.
- Current eligibility cutoff date: January 15. (To avoid delinquent eligibility status, full payment must be received on or before the 15th day of the month.)
- Cancellation date: February 15. (To avoid retroactive cancellation of coverage, full payment for January eligibility must be received on or before February 15th.)
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