It is Coventry Health Care's policy to only provide medical coverage for months that have been paid for by the employer group. When payment has not been received, we move quickly to collect on past due accounts, and if unsuccessful, terminate medical coverage. Here is a brief overview of how we do this.
Each month, the Group Administration Department conducts a review of employer groups that have not paid their current month's premium. Any employer group who has not paid at least 70% of their premium billed is targeted for collection. Amounts under $100 are excluded from the collection process. If no payment is received, the collection process begins.
1st of the month - premiums are due. The group has a 31-day grace period to make payment.
15th of the month - premium reminder letters are sent. Groups have until the end of the month to make payment. Two telephone or one person-to-person contact is made by Collections if no payment is received.
5th of the second month - groups with unpaid prior month premiums are sent to the Collections Supervisor and Manager for approval to terminate. Notice of cancellation letters are sent to groups approved for termination.
15th of the second month - final demand letters are sent to termed groups for unpaid premiums. Any group who does not remit payment at this point is sent to an outside collections agency after 10 days.
Reinstatement of Coverage
Reinstatement is issued on an exception basis only. Groups who have been terminated for non-payment of premiums are not guaranteed reinstatement based on subsequent receipt of payment.
All reinstatements must be requested in writing to the collector. Once payment in full through the current month and a written request is received, the collector will fill out a Collection Exception Form and forward this for Southern Health approval. All reinstatements are processed without lapse of coverage.
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