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Underwriting Guidelines

Small business groups must meet these underwriting guidelines in order to apply for our group health products. Please review and adhere to these guidelines.

1. A qualified small business group must have a minimum of two eligible employees.
2. All employees who work 24 or more hours per week are eligible for coverage.
3. 75% of the eligible employees must apply for coverage. Eligible employees with other comprehensive health insurance not applying are not considered in this percentage application (i.e. spouse coverage, Indian, VA and Medicare)
4. Those employees not applying for coverage must complete a declination application. Current health insurance information should be noted on the declination application where applicable.
5. The employer must have employed at least two or more eligible employees within the state of Oklahoma on at least 50% of its working days during the preceding calendar quarter.
6. The employee must agree to pay a minimum of 50% of the employee only (single) rate.
7. All applications, contracts and relative documents must be complete and submitted prior to requested effective date for timely processing.
8. Company must be headquartered in the state of Oklahoma.

Other requirements

• Sole proprietorships, partnerships, Limited Liability Companies (LLC), farms, churches, etc. may not have to file OESC reports with the state. In these cases, legal documents must be provided verifying the existence of the legal entity. Three months of payroll records, schedule C filing, schedule F filing or other tax records will be required to verify ownership and/or employer/employee relationship.
• Limited Liability Companies must provide the names and addresses of past and present managers and members. Declination applications for current managers and members not applying for coverage are required. Current health insurance should be noted on the declination application where applicable.
• Additional information may be requested from time to time.

Note: These requirements are subject to change.

For more information about Blue Cross and Blue Shield of Oklahoma group health plans, call 1-800-281-0446 or e-mail our marketing department.