Health New England will require all submissions to be received by HNE at least 10 business days prior to the first of the month the group is to become effective. If the required information is not received and completed within that timeframe, the group will be re-rated and effective for the following month. Your New Business Account Executive will advise you of any effective date or rate changes.

The information required for new business is as follows:

• Signed group application
• Domestic Partner Rider (if applicable)
• Domestic Partner Affidavits (if applicable)
• Completed Enrollment Forms for all enrollment subscribers
• Deposit Check equal to first month premium
• Payroll records or other appropriate documentation* to verify group and subscriber eligibility

*HNE reserves the right to request any additional information necessary to verify employer and/or employee and/or dependent eligibility.

If you have any questions regarding the submission requirements, please contact your New Business Account Executive.