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Small business service tips

Adding or losing employees

Call your account manager or our Small Business Account Management Support Team at 800-790-4661, option 3 at least 90 days before your group’s anniversary date to avoid delays.

Broker of record changes

A broker of record (BOR) is the broker authorized to represent a client’s decisions on health plan coverage. As a BOR, you may receive copies of the communications we send to your clients, including quotes, notifications, and policy information. The BOR can receive compensation from Kaiser Permanente and designate additional payee brokers.

From time to time, one of your clients may wish to add, change, or remove a BOR. Here are some frequently asked questions regarding that process — and also, helpful tips for serving them.


1. Who is authorized to make a broker of record (BOR) change?

A BOR change request must be made through a letter signed by the contract signer or an interested party authorized to make contract changes at your client’s company.

If the identified interested party will be given authority to make changes on behalf of the client, be sure your client checks the box on the Contact Change form. Otherwise, the interested party will not have authority to add a BOR.

Important: If the BOR change request letter hasn’t been properly signed, we’ll return it to your client for correction. This will cause a processing delay.


2. How does a client add, change, or remove a BOR?

Tell your client to:

  • Submit a BOR change request on client letterhead.
  • Make sure the request is signed by an authorized representative of the client, and include his or her printed name and title.
  • Include your broker identification number and your name as the agent of record.
  • Include the effective date of the BOR change. Future-dated requests are acceptable, but we can’t honor backdated requests. Requests dated after the first of the month will have an effective date for the following month at the earliest.

  • Send the request to our Small Business Account Management Support Team — preferably by email to amt@kp.org. You can also fax it to 800-369-8010.


3. How long does it take to process a BOR change?

It typically takes between 48 and 72 hours.


4. A BOR change is taking more than 72 hours to process. Why?

If a request isn’t processed within 3 days, it’s likely because some required materials weren’t received or because the request was backdated. Please consult with the Account Management Support Team to determine whether your client should resubmit the request.

 

5. When is the BOR change effective?

The effective date depends on the date we receive the request. Complete paperwork must be received by the fifth business day of a month for the change to be effective on the first of that month. A BOR request letter (including all necessary information) received after the fifth business day of a month will be effective the following month.

For example, if a properly submitted change request is received on December 3, it will have an effective date of December 1. However, if a change request is submitted on December 3, but it is incomplete and updated information isn’t received until December 10, then the change will have an effective date of January 1.


6. Why is a previous broker still appearing on correspondence?

It could be a timing issue. For example, if we hadn’t yet processed the BOR change request at the time of a renewal. It could also be because the request:

  • Wasn’t received
  • Is incomplete
  • Hasn’t yet been forwarded to the proper department

Always keep proof of delivery (email or fax confirmation) to show the date Kaiser Permanente received the request letter. This can affect the effective date.


7. Why am I no longer the BOR for a particular group?

This is usually because a BOR change was processed at the group’s request. We send a courtesy notice when we process a BOR request, but processing delays will delay the notice. Remind your clients to inform a broker if he or she has been replaced. If you think a BOR change was made in error, please contact the Account Management Support Team.


8. Why wasn’t I notified of a BOR change?

A notification letter is typically sent on the day any BOR change is processed. For future-dated small business BOR changes, a letter is typically sent within one week of the processing date. If you didn’t receive a letter, please contact the Account Management Support Team.


9. I’m part of a firm that has purchased (or been purchased by) another firm. How do mergers, acquisitions, and book of business transfers affect the BOR?

For questions about mergers and acquisitions, contact Broker Compensation Services at 800-440-2323. We need a letter that:

  • Explicitly notifies us of the sale
  • Tells us which groups are to be moved to the new owner
  • Includes the effective date
  • Is signed by the selling and buying brokers

We cannot always accommodate requested effective dates. If a group has paid its premiums in advance and the selling broker has already received commission, the effective date will be the first day of the coverage period that hasn’t yet generated a commission payment for that group. Based on commission payment activity, different groups in the same book of business might have different effective dates.


10. When does a BOR change show up online?

Once a change has been processed, it should show up online right away. If the BOR change was completed for a future effective date, the change shouldn’t show up online until that date.


11. What if a group isn’t commissionable?

There are situations in which brokered groups might not be commissionable. If you’d like to make a particular group commissionable, contact your small group sales executive.


12. Can I split commissions on a particular group with another broker?

Yes, splits can be established on a BOR request, or in a letter from the current broker. Please email your request on your company letterhead to amt@kp.org. Make sure it’s signed by the authorized representative of the group. Include the printed name alongside the signature.


13. Why am I not being paid commissions on a BOR change I submitted weeks or months ago?

If you aren’t receiving commissions on a BOR change, it may be because the paperwork:

  • Is in the system but hasn’t been processed yet
  • Isn’t in the system or is incomplete

Please contact the Account Management Support Team to check on the status of your BOR change request.


14. How do I submit a "BOR" change request letter?

To make sure your BOR letter gets processed in a timely manner:

  • Submit the letter on client letterhead with a signature from an authorized representative.
  • Include your Broker Identification number (BID) and your name as the agent of record.
  • Submit the letter before the fifth business day of the month for the change to be effective on the first of that month.
  • Send the letter to the Account Management Support Team via fax or email (preferred):

Please allow up to 72 hours to receive an acknowledgement of receipt from AMT. Check your spam folder for this email. For additional assistance, call the Account Management Support Team 800-790-4661, option 3.

Cal-COBRA information for employees who lose coverage

When your clients’ employees are no longer covered, it’s easy to have Cal-COBRA packets sent directly to them. Just write “Please send Cal-COBRA packets” at the top of the Subscriber Termination and Transfer form. Be sure to confirm the correct member mailing address is on file with us prior to submitting the form.

California Service Center email best practices

To make sure your request is processed efficiently, follow these guidelines when you email a request to our Small Business Services California Service Center1.

Include a clear subject line

The subject line should include your client’s:

  • Company name
  • Purchaser identification (PID) number 
  • Request

Subject line example:

ABC company-123456-subscriber termination request

Use recommended attachment formats

Use these file formats for attachments: .doc, .docx, .xls, .xlsx, .pdf, .bmp, .txt, .tif, .tiff, .jpg, .jpeg.

Don’t use: .gif, .mpg, .rar, .avi, .wmv.

Don’t include important information in body of email

Only the attachments included in your emails will be processed. Any requests made in the body of an email won’t be addressed.

Don't send password-protected attachments

They can't be opened or processed.

Email the right team

Remember to submit enrollment applications, account change forms, and member terminations2 to our California Service Center.

For other types of requests, go to our contact us page or download our quick reference guide.

1 The California Service Center’s e-mail box is unmonitored. It cannot reply to questions and can only accept forms. If you would like to include specific instructions or notes with the application, be sure to include them as an attachment and not in the body of the e-mail.

2 Terminations must be received in the month of the subscriber or group termination.

COBRA reporting

Under the federal Consolidated Omnibus Budget Reconciliation Act (COBRA), employees and their families can continue to get group health coverage for a period of time after the employee no longer works for the company. Your client’s employees and their families may qualify for COBRA coverage in these situations:

  • Voluntary or involuntary job loss
  • Reduction in hours worked
  • Divorce from the covered employee
  • Death of the covered employee

For more information on COBRA, please see the “COBRA regulations” section of the “Government guidelines” page.

 

1. How do my clients know who’s enrolled in COBRA?

Only clients with active COBRA members, will receive a Billed Federal COBRA Activity Report from Kaiser Permanente listing current COBRA members for that month.

The report also lists former employees who:

  • have missed COBRA payments
  • are being terminated from COBRA, either for nonpayment, or because they’ve reached the maximum period of COBRA continuation coverage

 

2. Who receives my clients’ COBRA activity report?

The person at a company who’s been specified as the contract signer will automatically receive the report.

 

3. What if my clients want someone other than the contract signer to receive the report?

To have the activity report sent to someone else at a company, ask your client to contact our Small Business Account Management Support Team at 1-800-790-4661, option 3.

 

4. Who can answer questions about the COBRA activity report?

Contact our California Service Center at 1-800-790-4661, option 1.

Separating 1 regional contract into 2

If your clients’ small business has locations in Northern and Southern California, and the non-headquarters region has at least 13 Kaiser Permanente subscribers, the group may need to separate its contract. This will give each location its own contract and customer identification number (CID).

To help make this transition easier, we’ve simplified our process:

  • Groups only need to separate at their renewal — not midyear.
  • Kaiser Permanente will separate and renew the group. Any members affected by the separation will get a new ID card.
  • Only groups that offer Kaiser Permanente Insurance Company (KPIC) plans (PPO) need to sign and submit a prepopulated Employer Application. For these groups, your Account Manager or a Small Business Account Management Support Team representative will reach out to help you with the process. If a group doesn't offer a PPO plan, no action is needed.

What if my clients’ group uses Electronic Data Interchange (EDI) to send files?

After separating their group, they must update their EDI file with the employees from each region. We recommend making updates by the end of their renewal month.

What if my clients’ group uses online account services?

The group with the original contract will need to add the new location on online account services by filling out our Online Account Services User ID Request Form. Be sure to include the CID of the group with the original contract and the new CID of the other region. After making the updates, they’ll be able to access both regions from one account.

How many bills will my clients get?

Your clients’ group may receive a bill for each contract. Billing may take 1 to 2 months to catch up after the separation. Until that happens, they may see a credit or retro charges on their bills. We recommend they pay as billed.

If my client offers one or more grandfathered plans, will the risk adjustment factor stay the same after the separation?

Yes, the grandfathered risk adjustment factor stays the same for both groups if your clients offer one or more grandfathered plans.

Do my clients’ employees’ deductible and out-of-pocket accumulations follow them if they’re moving to the new location?

Yes. After the member is transferred, we’ll transfer all deductible and out-of-pocket accumulations. This process can take 30 days or more to complete after the group’s renewal date.

Why do affected members receive a Certificate of Creditable Coverage letter?

Affected members who are terminated from the contract for the headquartered location must be mailed a Certificate of Creditable Coverage letter, but they can disregard the letter because they were immediately enrolled in the new group located in the opposite region.

How long does it take to separate a group?

It takes about 4 weeks, not including the time it takes to transfer any deductible or out-of-pocket accumulations.

Please contact your account manager or our Small Business Account Management Support Team at 800-790-4661, option 3.

Terminating a small group contract

How do I help a small group terminate their contract with Kaiser Permanente?

Contact our Account Management Support team at 800-790-4611, option 3, Monday through Friday, 8:30 a.m to 5 p.m Pacific time to assist you with this request.

Who's responsible for stopping autopay?

If your client pays their premium through autopay, it's their responsibility to turn it off once all premium owed has been paid. If you or your clients have questions on how to stop autopay, please call the California Service Center at 800-790-4661, option 1.

Can my client request reinstatement of their contract later?

Yes, your client can request reinstatement of their contract within 60 days of their termination date without lapse in coverage and without needing to go back through the underwriting process.

Can I use a Declination of Coverage form to request termination of a small group contract?

No. The Declination of Coverage form is for employees who want to decline group health coverage with Kaiser Permanente.

New member ID cards

Your clients’ employees will get new ID cards only when they:

  • Become new Kaiser Permanente members.
  • Switch to a plan that uses another type of card (for example, from small business coverage to Medicare coverage).
  • Have a gap in coverage that’s 396 days or more.
  • Lose their card and ask for a replacement through Member Services1.

1 Most members can also access their digital ID card through kp.org or the Kaiser Permanente app. This option is not available for Northern California, Medicare members, and some out-of-area plans.

Updating an email or physical address

There are several ways to update your client's email or physical address changes.

1. Your client's authorized signer must send an email to amt@kp.org and do the following:

email address change must indicate "Email address change request" in the subject line and the body of email to include the Group ID number, first name, last name, and new email address.
physical address change must indicate "Physical address change request" in the subject line and the body of the email to include the Group ID number and specify which type of address change note here:
  • Physical location (California address — no P.O. boxes or purchased addresses)
  • Billing address (where we’ll mail billing statements)
  • Mailing address (where we’ll mail contract and renewal information)
  • Physical, billing, and mailing address (if they’re all are the same)
2. Complete the Customer Address or Name Change Request form and fax to 800-369-8010. Separate forms are required for each individual address change.

3. Call us at 800-790-4661, option 3.
 

If you have any other questions, please contact your account manager or call our Small Business Account Management Support Team at 800-790-4661, option 3.