Group Transmittal Sheet Template Page 2

Monthly Billing Procedures

New Enrollees have effective dates on the first of the month. Terminations are effective

as of the last day of the month.

Invoices will be sent by the 20th of the month for the following month's coverage. If you

are billed for a subscriber who is being terminated, please pay the invoice as is and note

the change on the transmittal form. Credit will be given to you on the following month's

invoice.

This form along with an enrollment card should be used to inform us of new subscribers,

coverage changes, (single to family, etc.) and Plan type changes (Comprehensive to

Reimbursement, etc.). Terminations should also be noted on the form. Forms can be

faxed to the attention of our Enrollment Department at 516-227-0582.

If you have any questions about an invoice, please call us at 1-800-468-0608.

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Parent category: Legal