Northwest Employers Trust

UNDERWRITING GUIDELINES & PLAN PROVISIONS
 
Minimum Full-time Employee Status: 20 hours per week
Minimum Contribution Level:

75% of the employee rate and 0% of the Dependent rate.  Discounts are factored into rate calculations based on higher employer contribution levels for employees and dependents.
Eligible Dependents: Under age 25 and primarily dependent on the employee for support.
Minimum Participation: 75% of all eligible (not covered by another plan) employees must participate.
Pre-Existing Condition Provision: 3 months free of treatment or 3 months consecutive months of coverage.  For transplant benefits an individual must have been covered for 6 consecutive months.  Credit for pre-existing conditions will be provided for members with “creditable prior coverage” as defined by HIPAA.  No credit is provided for transplants.
Residency Requirement: Groups must be headquartered in Washington State.
Ineligible Group & Employees: Part-time employees are not eligible.  1099 employees are not eligible. See Restricted Industries.
Domestic Partners: Are eligible.  Affidavit available in forms section.
No Prior Coverage: Qualification for a business with no prior coverage is considered on a case by case basis. 
'Class out' groups Must be at least 10 covered employees for a one "class" group.
Must be at least 25 covered employees for a two "class" group.