For groups of 2-50 Employees:
Employers need to fax the age and sex demographics of a group to (205) 939-1748. Click here to download the Quote Request Form. These may also be mailed to the attention of the Small Group Sales Department at:
Viva Health, Inc.
Attention: Ronnetta Underwood
417 20th Street North, Suite 1100
Birmingham, AL 35203
If there are any questions, please call Ronnetta Underwood at (205) 558-7599.
For groups of 50 + Employees:
Please contact Clay Harrison at (205) 558-7416 in order to obtain a quote.
Small Group Underwriting Guidelines
These guidelines are used in the underwriting of groups with 2 to 50 employees to whom Viva Health will be offered on an exclusive basis. These groups are subject to review of individual medical underwriting questionnaires. Effective July 1,1997, HIPAA required that small groups of 2 to 50 employees be subject to guarantee issue. While HIPAA does not prohibit the use of health conditions in establishing premiums, Reg. 116 does establish guidelines within which premiums may be adjusted for the group as a whole on the basis of health conditions.
Eligibility Requirements: (eligible groups must meet the following characteristics)
- Have been in business for at least 3 months.
- Meet Viva Health's minimum participation requirements.
- Meet Viva Health's minimum employer contribution requirements.
Provide proof of employer-employee relationship in the form of one of the following:
- State of Alabama Quarterly Contribution & Wage Report (pages 1 and 2).
- Payroll records on all employees showing regular FICA withholdings
- W-2 forms on all employees reflecting wages subject to FICA withholding
- Employer groups of no less than 2 and no more than 50 employees.
- The group must be physically situated within the small group product service area.
- Regulation 116 defines employer groups as any person, firm, corporation, partnership, association, political subdivision, or self-employed individual.
- All full time employees, as defined by the employer, who work a minimum of 30 hours per week are eligible for coverage. At the employer's discretion, this may be reduced with the minimum being 17 1/2 hours per week as long as the eligibility criterion is applied uniformly to every employee of the defined group.
- Partners, sole proprietors, corporate officers or owners, and independent contractors of the employer-defined group are eligible for coverage provided they devote a minimum of 30 hours per week to the business applying for coverage and there are at least two employees applying for whom FICA taxes are being withheld. These are individuals for whom there is usually no true employer-employee relationship, i.e. the employer does not withhold taxes, FICA, etc. on behalf of the worker, and their wages are reported on a 1099 Form. At the discretion of Underwriting, the 1099 employees may be offered coverage, primarily for groups of 10 workers or less. For such cases, the guideline will be a W-2 employee for every 1099 worker covered.
- Under Reg. 116, Viva Health is not required to offer coverage to an employee, when the employee does not work or reside within the carrier's established geographic service area.
Large Group Underwriting Guidelines
Please contact Clay Harrison at (205) 558-7416 or by email at firstname.lastname@example.org