Mid-Market Underwriting Guidelines for Brokers (Groups of 51-99)

Transcription

1 Mid-Market Underwriting Guidelines fr Brkers (Grups f 51-99) Independence Blue Crss Underwriting Department Applies t grups effective r renewing n r after 1/1/2014 This dcument is fr infrmatinal purpses nly and is nt intended t be all inclusive. Independence Blue Crss (IBC) reserves the right t change these underwriting guidelines withut ntice as IBC, within its sle discretin, believes necessary t cmply with federal and/r state law r as required by federal and/ r state regulatry agencies. IBC has the sle discretin and final authrity t interpret the scpe and applicatin f the underwriting guidelines. These guidelines supersede any previusly released guidelines. Page 1

2 Cntents Eligibility and enrllment requirements... 4 IBC/Keystne Health Plan East (KHPE) service area... 4 Grup lcatin requirements... 4 Grup participatin requirements (eligible emplyees)... 4 Emplyer cntributin requirement... 4 Cverage Classes... 4 Emplyee eligibility... 5 Dependent eligibility... 5 Dmestic partner (DP) cverage... 5 Changes in emplyee r dependent eligibility criteria... 5 COBRA... 6 Emplyer eligibility... 6 Cmmn wnership affiliatin (tw r mre cmpanies affiliated r assciated)... 7 Prduct fferings grups f Mandated benefits... 9 Dwngrading benefit plans ff anniversary date... 9 High deductible health plans (HDHPs), including HSA-qualified HDHPs... 9 Health Reimbursement Accunt (HRA) Health Spending Accunt (HSA) Blue Slutins Chice Defined Cntributin Prducts Rating infrmatin Prspective rating Definitin Eligibility fr Prspective Rating Methdlgy Affiliatin grups (multi-emplyer affiliatins) Definitin and requirements Rate qute submissin Dcumentatin required when submitting a rate qute request Situatins requiring rate qute submissin thrugh IBC accunt executive Pst-sale submissin requirements Pst-sale enrllment requirements P a g e

3 Grup terminatins and reinstatements Terminatin prcess Terms and cnditins upn terminatin f cverage Reinstatement f cverage P a g e

4 Mid-Market Underwriting guidelines (grups f 51-99) Independence Blue Crss (IBC) reserves the right t change these underwriting guidelines withut ntice as IBC, within its sle discretin, believes necessary r t cmply with federal and/r state law r as required by federal and/r state regulatry agencies. IBC has the sle discretin and final authrity t interpret the scpe and applicatin f the underwriting guidelines. Please nte: The guidelines listed in this dcument are internal plicies and are nt intended t be a descriptin r summary f applicable laws. These guidelines are applicable t new and renewing custmers. IBC reserves the right t apply rate adjustments fr new business custmers nt in cmpliance with the Underwriting Guidelines. Renewing custmers nt in cmpliance with the Underwriting Guidelines may be subject t rating adjustments r pssible terminatin f the grup cntract. This applies t pre r pst sale and renewal business. Eligibility and enrllment requirements IBC/Keystne Health Plan East (KHPE) service area Grup lcatin requirements Grup participatin requirements (eligible emplyees) Emplyer cntributin requirement Cverage Classes 4 P a g e Greater Philadelphia five cunty area: Philadelphia, Bucks, Mntgmery, Chester, and Delaware. Cntiguus Cunties (cunties that brder the five cunties): Warren, Nrthamptn, Lehigh, Berks, Hunterdn, Lancaster, Mercer, Burlingtn, Camden, Glucester, Salem, New Castle, and Cecil. The grup must be lcated within the Greater Philadelphia five-cunty area, as defined abve. Grup members wh live in nn-cntiguus cunties and have HMO/POS cverage must be cvered under and issued bklets by an affiliate f IBC. Grup members enrlling in HMO/POS cverage must reside within the IBC service area. Minimum 75 percent participatin Valid waivers: - Emplyees with grup cverage thrugh IBC subsidiaries (cverage thrugh an individual direct pay plan is nt a valid waiver), Medicare r Medicaid, Veteran r ther gvernment issued cverage; - Emplyees cvered thrugh their spuse; - Emplyees cvered as an eligible dependent t age 26, in accrdance with federal Patient Prtectin and Affrdable Care Act. Fr grups cvering retirees, 100 percent participatin is required fr retired emplyees and the grup must cnsist f a minimum f 75 percent active emplyees. Retiree-nly grups will nt be accepted. Participatin audits: IBC reserves the right t perfrm peridic audits t assure cntinued cmpliance with the abve requirements. Fr cntributry plan fferings, emplyers must cntribute a minimum f 25 percent f the calculated grss mnthly premium r 75 percent f the single-tier rate fr each plan ffered. Definitin: Distinct categries (classes) within the grup, where these classes will receive different levels f health care cverage. Classes must be determined by cnditins relating t emplyment; must be clearly identifiable; and must exist fr purpses ther than insurance risk (fr example, unin/nn-unin, salaried/hurly, full time/part time). Excluding a class within a grup frm cverage is nt permitted. Existing grups may nt split int multiple grups t btain multiple benefit levels. Qualifier: Subject t the abve cnditins, IBC will cmply with the cverage classificatins requested by the emplyer, but apprval f such request is nt a representatin by IBC t the emplyer that the requested classificatins cmply with applicable laws/regulatins. The emplyer shuld cnsult with its wn legal

5 Emplyee eligibility Dependent eligibility Dmestic partner (DP) cverage Changes in emplyee r dependent eligibility criteria cunsel r tax advisr t determine if the cverage classificatin is permissible under applicable laws/regulatins. Eligible emplyees include all active emplyees and wners r partners actively engaged in the business wh: - are deemed benefit-eligible accrding t the emplyer; and - meet all requirements as defined in the carrier s plan dcuments and fulfilled any authrized waiting perid requirements; and - wrk at least 25 hurs per week; and - reside r wrk in the applicable service area. - In accrdance with the PPACA laws, emplyee prbatinary perids cannt exceed 90 calendar days. Off-cycle adds: Emplyees wh initially waive cverage because they are cvered under a spuse s medical plan may be added ff-cycle t the grup s benefit plan upn the ccurrence f a life event (fr example, spuse s emplyment is terminated). Emplyee s spuse (if bth husband and wife wrk fr the same cmpany, they may enrll tgether r separately.) Dependent children f the emplyee (natural, adpted, under legal guardianship r curt-rdered custdy), as defined in plan dcuments and in accrdance with state and federal laws, are eligible fr cverage up t age 26. At emplyer s request, medical cverage fr dependent children may be extended t age 30, if the dependent child meets the fllwing criteria (Pennsylvania State Law): - Is nt married and has n dependents (need nt be a full-time student); - Is a resident f the Cmmnwealth f PA r enrlled as a full-time student in an institutin f higher educatin; - Is nt prvided cverage under any ther grup r individual health plan, including eligibility fr any gvernment health care benefits prgram. Overage handicapped dependent children wh, in the judgment f IBC, are incapable f self-supprt due t mental r physical incapacitatin (cverage will terminate upn marriage f the dependent) Individuals cannt be cvered as an emplyee and dependent under the same plan, nr may children be eligible fr cverage thrugh bth parents and be cvered by bth under the same plan. Dmestic partners, nly if the emplyer elects this designatin at cntract effective r renewal date (See dmestic partner cverage criteria belw.) Dependents must enrll in the same benefit ptin as the emplyee. DP cverage may nly be added r remved n grup s anniversary date. Must be ffered by all in-frce carriers in rder t add t the IBC/KHPE cverage. Must be added t all grups within an affiliatin. Must be added t all lines f business separate grup numbers nt permitted. Dmestic partners cannt be cvered retractively. Definitin: Emplyer-initiated requests t change grup s eligibility criteria: Fr example, changing minimum hurs wrked requirement fr eligibility (must meet guidelines listed fr minimum hurs wrked requirement); changing dependent eligibility frm age 26 t age 30, etc. Changes in eligibility criteria may nly be made n grup s anniversary date and with at least 120 days prir ntificatin t Underwriting. (Please nte that changes t eligibility may affect premiums.) Requests fr ff-anniversary changes will require Underwriting review and apprval. Changes may nt be made n a retractive basis. 5 P a g e

6 COBRA Emplyer eligibility COBRA cverage will be extended in accrdance with the federal law. Emplyers with 20 r mre emplyees (full- r part-time) are eligible t ffer COBRA cverage. The number f COBRA enrllees is limited t 10% f the grup enrllment. COBRA members are nt t be included fr purpse f cunting emplyees t determine the size f the grup. Once the grup size has been established, and it is cnfirmed that the law is applicable t the grup, COBRA members can be included fr cverage subject t the nrmal underwriting guidelines. An emplyer must emply n average at least 51 full-time emplyees, including fulltime equivalents (FTEs) n business days during the preceding calendar year. All persns treated as a single emplyer under specified sectins f Sectin 414 f the Internal Revenue Service Cde shall be treated as ne emplyer. Grup applicants nt meeting this definitin f an emplyer are nt eligible fr cverage under the Mid-Market Emplyer prgrams, but may be eligible fr cverage under the Small Emplyer prgram refer t the Small Grup Underwriting Guidelines manual. Organizatins must nt be frmed slely fr the purpse f btaining health cverage. 6 P a g e

7 Cmmn wnership affiliatin (tw r mre cmpanies affiliated r assciated) Emplyers wh have mre than ne business with different tax identificatin numbers (TINs) may be eligible t enrll as ne grup if all f the fllwing criteria are met (cmbined arrangements will nt be quted until sufficient prf f wnership is prvided, as utlined belw): - One wner has cntrlling interest f all business t be included; and, - Prvides prf f wnership (acceptable prf includes cpies f IRS Frms 851, Schedule K-1, SS4 Applicatin fr Emplyer ID, r latest federal tax return all businesses filed under ne cmbined tax return must be enrlled as ne grup); and, - Prvides UC2A Emplyer s Quarterly Reprt f Wages fr each entity and cmbined census with all eligible emplyees frm all entities; and, - Must have cmmn plicymaker legally authrized t make benefits decisins fr the cmbined business; and, - Prvides letter frm emplyer indicating desire t cmbine the cmmnly wned entities Subject t underwriting review and apprval n a case-specific basis. Once cmmn wnership is established, and premium rates have been prvided, the grups are required t be rated as an affiliatin and must accept the premium rates as presented. Cmmn wnership grups may later be separated fr grup cverage nly when based n verifiable legitimate business reasns. 7 P a g e

8 Prduct fferings grups f (New Business: eligible enrllees; Existing Business: enrlled cntracts) Benefit plans available: Blue Slutins fr Mid-Market Emplyers prtfli (with r withut a Drug Rider and Visin plan/rider) - Flexibility t chse frm several Select Drug and Basic Drug plan ptins. - Emplyers may nt ffer same medical plan with different drug, dental and/r visin ptins. - If Drug plans are ffered, they must be ffered with all medical plans. Exceptin: If ne ptin is HSA-qualified HDHP with integrated drug, ther nn-hsa qualified plans nt required t include drug. HSA-qualified high-deductible plans - with integrated drug Nte: Existing custmers withut drug benefit may retain their current plan. Keystne Health Plan East Dental and Visin Riders (available nly with an IBC r Keystne medical plan) Freestanding Dental Plan (UCCI) Freestanding IBC Visin Plan Must be ffered alngside a medical plan Biennial/ annual benefit ptins (standard: biennial) Nte: Vluntary Davis Visin plan is nt available t grups f 2 t 99. Quting Plicy: Maximum 3 ttal packages t include three medical ptins with tw drug riders and ne visin. Grup size: Existing grups with nn-blue Slutins PPO, HMO r POS plans may retain existing PPO, HMO, r POS plans but any benefit change will be Blue Slutins Prducts. 8 P a g e

9 Mandated benefits Dwngrading benefit plans ff anniversary date High deductible health plans (HDHPs), including HSA-qualified HDHPs 9 P a g e Definitin: Benefits that are required t cver the treatment f specific health cnditins, certain types f healthcare prviders, and sme categries f dependents, such as children t a certain age. Health care benefits may be mandated by state and/r federal law. Examples f mandated benefits and hw implemented fr IBC health benefit plans: - Autism benefit Pennsylvania State mandate effective July 1, 2009: Applied t existing grups with 51 r mre enrlled cntracts and is required fr new and existing grups with 51+ ttal cmmercial emplyees. - Mental Health and Substance Abuse Parity benefit federal mandate effective Octber 15, 2009: Applied t existing grups with 51 r mre enrlled cntracts and is required fr new/existing grups with 51+ ttal cmmercial emplyees. - Ntes: A cmmercial emplyee includes any nn-medicare emplyee, including seasnal and/r part-time emplyees. Off-anniversary dwngrades are permitted using the fllwing guidelines: - All changes must be cmpleted 180 days prir t anniversary. - Limit f ne ff-anniversary and ne n-anniversary dwngrade per cntract year. - Off anniversary benefit changes must be submitted t Underwriting 75days (r mre) in advance f the benefit change effective date. - All requests subject t underwriting apprval. Definitin: - HDHP Any plan with an in-netwrk deductible f $500 Single/$1,000 Family r higher - HSA-Qualified HDHP Plans must fllw prescribed federal guidelines and requirements, which are updated annually by the IRS. Guidelines fr funding deductibles Emplyers are nt allwed t: - Fund mre than 50% f the emplyee/family deductible csts t an HRA r HSA; - prvide a supplemental benefits plan that augments the cre health insurance plan; - pay mre than 50 percent f emplyee/family deductible csts thrugh an allwance r claims payment; r, - prvide any cmbinatin f the abve that causes the ttal amunt funded t be greater than 50 percent f the emplyee/family deductible. When the HSA-qualified HDHP is ffered ff-cycle, the full annual deductible will apply t the shrtened perid there is n deductible carryver t the next cntract year. An HSA-qualified HDHP may be ffered alng with ther prducts, up t the maximum plan fferings (dual plan ptins) fr the size f grup. HSA-qualified HDHPs: Health Savings Accunt (HSA) regulatins have distinct requirements fr prescriptin drug cverage. Federal requirements fr HSAqualified HDHPs d nt allw a separate prescriptin drug prgram (r rider) t prvide benefits befre the HDHP annual deductible is satisfied; therefre, if a plan prvides any prescriptin drug benefit befre the annual deductible is met (except in the case f preventive drugs), it is nt a qualifying HDHP fr a Health Savings Accunt. If the emplyer grup has a prescriptin drug prgram thrugh anther carrier, the grup may request IBC t cmbine the Rx claims with the IBC medical plan claims. Such requests are subject t underwriting review, and if apprved, an additinal administrative fee will apply fr this service. If an HDHP prduct is ffered ff cycle, the full annual deductible will apply t

10 10 P a g e the shrtened perid there is n deductible carryver t the next cntract year. An HDHP r HSA-qualified HDHP may be ffered alng with ther prducts, as lng as the maximum number f prduct fferings is nt exceeded.

11 Health Reimbursement Accunt (HRA) Health Spending Accunt (HSA) Blue Slutins Chice Defined Cntributin Prducts Available t grups f enrllees (existing business) r eligible emplyees (new business). May be ffered nly: - On grup s anniversary date; - with a Flex Deductible medical plan ptin (prescriptin drug plan selectin will fllw high-deductible plan rules); Emplyer funding t the HRA cannt exceed 50 percent f the annual emplyee/family deductible. Only ne HRA ptin per custmer Debit card ptin nt available Available t grups f enrllees (existing business) r eligible emplyees (new business). Available nly with a federally qualified high deductible health plan (HDHP) with integrated prescriptin drug benefit. Emplyers adding r changing t an HSA-qualified plan with a cntract year benefit perid may change anniversary date, which wuld apply t all prducts. Defined Cntributin Overview: - Fr defined cntributin prducts emplyers cntribute a defined amunt twards the emplyees premium. The emplyee is respnsible t pay the remainder f the premium after the emplyer cntributin. - The emplyer can ffer multiple defined cntributin prducts frm the defined cntributin prduct prtfli t its emplyees. Maximum Prduct Offerings: - Maximum f 5 defined cntributin prducts Defined Cntributin Prduct Guidelines: - Emplyers may chse frm several Select Drug and Basic Drug plan ptins. - If the emplyer decides t ffer Visin, Drug, r Dental cverage with defined cntributin prducts, Visin, Drug, r Dental must be ffered with all defined cntributin prducts ffered by the emplyer. - Emplyers may nt ffer the same defined cntributin prduct with different drug, dental and/r visin prducts. - Defined cntributin prducts cannt be cmbined with cverage ptins frm nn-defined cntributin prducts. Emplyer Cntributin Requirement: - Fr cntributry plan fferings, emplyers must cntribute a minimum f 25 percent f the lwest cst ptin s grss mnthly premium r 75 percent f the single tier rate f the lwest cst ptin ffered. Off-Cycle Benefit Changes: - Upgrades and dwngrades t defined cntributin prducts will be allwed nly n anniversary. Nte: Other than the specific guidelines fr defined cntributin prducts described in this sectin, the Mid-Market Grup Underwriting Guidelines generally apply t defined cntributin prducts. 11 P a g e

12 Rating infrmatin Prspective rating Definitin Eligibility fr Prspective Rating Methdlgy Fully-insured, experience rating prgram Emplyer pays a fixed premium rate t IBC, and IBC assumes the entire claim risk fr the cvered services. N surplus/deficit determinatin An emplyer must emply n average at least 51 full-time emplyees, including fulltime equivalents (FTEs) n business days during the preceding calendar year. Standard rating methd fr grups 51 r mre based n ttal number f emplyees fr new business, grups f 51 r mre renewing cverage will retain the rating methd 12 P a g e

13 Affiliatin grups (multi-emplyer affiliatins) Definitin and requirements Rate qute submissin Dcumentatin required when submitting a rate qute request Grups f 51 r mre that meet specific requirements, may be eligible t jin an affiliatin. See Large Grup underwriting guidelines fr affiliatin requirements. Incmplete submissins may impact ur ability t evaluate the grup applicatin and prvide a cmpetitive prpsal. Subject t applicable state and federal laws, IBC reserves the right t pend qute requests. Such a decisin will nt be based in any way n the medical cnditin f the grup s members. This sectin is nt inclusive f all underwriting requirements, additinal requirements may apply. Existing business emplyers with emplyees: Requested plan design If adding new cntracts ttaling mre than 10 percent f existing ppulatin, refer t new business grup requirements utlined belw New business emplyers with 51 t 99 emplyees: Marketing strategy and grup/brker expectatins (if applicable) Is prspect a previus IBC custmer (if s, prvide details) Name f existing insurance carrier Brker and/r cnsultant infrmatin Five-year carrier histry Length f time with current carrier Summary f current plan design (surce dcumentatin) Current renewal, including premium rates (surce dcumentatin) Three-year rate histry (if available) Emplyee cntributin by plan design and rating tier (percentage r dllar value) Claims infrmatin: - Twelve t 24 mnths f prir claims data (minimum f 12 mnths mature experience) - Experience perid shuld be defined (specify incurred and paid perids) - Specify any benefit changes made within each experience perid prvided - Medical claims brken ut by inpatient, utpatient, and prfessinal claim categries - Medical claims brken ut by facility and zip cde - Enrllment fr each mnth f the experience perid - Shck claims infrmatin (individual claims in excess f $50,000) - Diagnsis and prgnsis fr excess claims - Prescriptin drug claims data t include: - Script cunt - Break-ut by generic, brand and nn-frmulary, as well as retail and mail rder Rate infrmatin: - Current and renewal rates (surce dcuments) - Histrical rate increases fr last three-year perid - Current financial arrangement - Brker cmmissins (if applicable) Detailed census in spreadsheet frmat must include the fllwing: Emplyee name Page 13

14 Date f birth (MM/DD/YYYY) Current plan design indicatr(fr example, emplyee Jhn De is enrlled in HMO high ptin plan) Zip cde f current residence Emplyee gender Cverage status (enrllment by cverage tier) Waivers (eligible emplyees nt electing cverage because they are cvered under anther plan) Opt-uts (eligible emplyees nt electing cverage and wh are nt cvered under anther plan) New hire infrmatin: date hired r date eligible fr cverage if emplyees are in a prbatinary perid COBRA subscribers and expiratin date Additinal required infrmatin (where applicable): Request fr prpsal (RFP) with all attachments Cmpeting carrier infrmatin (if available) Unin agreement (if applicable) Situatins requiring rate qute submissin thrugh IBC accunt executive Prf f Business Dcumentatin(applicable when additinal infrmatin is needed t prve that a grup is an eligible business) The fllwing dcumentatin must be prvided fr cnsideratin: Mst recent UC2-A r Business license (nt a prfessinal license). If nt available, a cpy f the partnership agreement, articles f rganizatin, r articles f incrpratin; and, - Emplyer identificatin number/federal tax ID number; and, - Quarterly Wage and Tax Statement. If nt available, when will ne be filed; and, - Letter frm Certified Public Accuntant (n CPA s letterhead) listing the names f all emplyees (full- and part-time), number f hurs wrked each week, dates f hire, weekly salary, and cnfirmatin f establishment f payrll recrds. Existing business: A change in anniversary date - Dcumentatin Required: Letter frm emplyer (n custmer letterhead) A material change in the census (fr example, purchasing a new entity) - Dcumentatin Required: Prf f cmmn wnership (see Cmmn Ownership rules under Eligibility Requirements sectin f this dcument - Requires apprval by Underwriting Nn-standard requests nt viewable as alternatives t renewals n ROAM New business: All requests fr emplyers with emplyees 14 P a g e

15 Pst-sale submissin requirements Pst-sale enrllment requirements Dcuments required with grup submissin Rates quted are cnditinal pending receipt, review and acceptance f the standard submissin requirements. Pst-Sale enrllment requirements shuld be sent t underwriting management fr review. Rates are based n final enrllment IBC reserves the right t re-evaluate rates quted if final enrlled cntracts vary by ten percent, plus r minus. The fllwing dcumentatin must be prvided fr cnsideratin: Applicatin fr New Emplyer Health Benefits (frnt and back) Universal Enrllment Frms (ne fr each emplyee enrlling) Rate Qute First mnth s premium check(s) Mst recent PA UC2A Frm (Unemplyment Cmpensatin Tax Frm) Emplyers that d nt have/file a UC2A because they are a newly frmed cmpany, family-wned business, r a nn-prfit entity, must prvide ne prf f business and ne prf f emplyment frm the list belw. Dcumentatin shuld cnfirm that the business is active and the lcatin f the business: Prf f business: (prvide ne) Current business license (nt a prfessinal license) Crprate Tax Frm (Frm 1120) Partnership agreement, articles f rganizatin r articles f incrpratin Official dcument with Emplyer Identificatin Number/federal tax ID number Federal Frm 990 r IRS Exemptin letter (fr nn-prfit entities) AND: Prf f emplyment: (prvide ne) Payrll recrd (Paychex, ADP, etc.) W-2 fr all emplyees IBC Eligibility Frm fr Owners/Partners cmpleted and signed by each wner/partner (requires tax dcumentatin) Letter frm Certified Public Accuntant listing the names f all emplyees (full and part time), number f hurs wrked each week, dates f hire and weekly salary. Page 15

16 Grup terminatins and reinstatements Terminatin prcess Any terminatins will be in cmpliance with the federal Patient Prtectin and Affrdable Care Act. Grup may terminate cverage n cntract anniversary date, with at least 30 days advance written ntice t IBC. IBC may terminate the grup s cverage fr nnpayment f premium, upn written ntice, effective the last day f the 30-day grace perid. IBC reserves the right t terminate a grup s cverage ff-anniversary if the grup fails t meet IBC s underwriting guidelines, including but nt limited t minimum participatin requirements. Terms and cnditins upn terminatin f cverage Reinstatement f cverage The grup is respnsible fr all due but unpaid premiums and any accrued deficits. When active grup is terminated, all COBRA grups, retiree grups, and Medicare grups (including Medicare Advantage grups) must als be terminated COBRA-nly, retireenly, r Medicare-nly grups are nt allwed. Grups terminating t purchase individual cverage will nt be eligible fr grup cverage fr 12 mnths frm the date f terminatin f the grup cverage. Grups cancelling traditinal Blue Crss Hspitalizatin r Blue Shield Medical/Surgical cverage must als cancel the Majr Medical prgram. Applies t grups terminated frm cverage due t nnpayment f premium. Reinstatement must ccur within 60 days f the effective date f cancellatin. Must be retractive t the cancellatin date. Grups that have been terminated fr nn-payment by IBC will nt be eligible t reapply until: (1) All utstanding financial balances are paid in full; and (2) the grup makes payment f six mnths f premium in advance f issuance f health benefits plan. Prir IBC Medical claims infrmatin (medical lss rati) subject t review alng with infrmatin prvided n the emplyee applicatin and included in the verall assessment f the grup. Fr frmer IBC grups reapplying fr cverage, determinatin f grup status will be based n the fllwing criteria: Grups returning within 12 mnths f terminatin will be deemed renewal business; Grups returning mre than 12 mnths fllwing terminatin will be deemed new business. IBC reserves the right t assess a reinstatement fee fr administrative services. Upn satisfactin f the abve cnditins, IBC Underwriting will review the case and make a final determinatin whether r nt t apprve reinstatement and applicable rate level. Limit f ne reinstatement per year. 16 P a g e