Eligibility
Cards are sent to the print shop only once eligibility is verified during onboarding.
For guaranteed timely delivery of member ID cards by the plan start date, eligibility must be verified by the 15th of the month at the latest.
For 1/1 groups, eligibility must be verified by December 10th for guaranteed delivery of member ID cards by the plan start date.
Contracts
During onboarding, the SPD will be assigned to the designated signatory for the group.
The person assigned to sign the SPD will receive reminder emails every week to sign the contract.
If the contract is not signed within 30 days, Yuzu will send one final reminder to the group that services will cease if the contract is not immediately signed.
Plan Selections
All plan selections are expected to be final when uploaded into the Yuzu portal.
If there are changes post upload, PDs must notify Yuzu or risk benefit disruptions.
For renewal groups, if any plan selections change upon renewal it is expected that this will take place 30 days before the renewal goes live and that Yuzu will be notified of this change by the group or broker.
Failure to alert us of a plan change before you verify eligibility and trigger card printing will result in a card re-print fee being applied.
New Group Notification
Net-new groups must be uploaded into the Yuzu portal at least 5 days prior to the plan start date. Any late uploads must be alerted to the Yuzu team and will be handled on a case-by-case basis.
If portal to-do’s are not finalized at least 10 days before the plan start date, Yuzu may be unable to finalize the plan by the first day of coverage and RX/medical coverage may be delayed and backdated.
Accumulator Periods
If a group decides to run on a calendar year accumulation period, all accumulators must be loaded within 20 days after plan’s start date.
For renewal groups on calendar year accumulators, all benefits must stay the same year over year for accumulators to port over automatically.
If there are any benefit changes, the group must manually load accumulators.
Stop Loss Implementation
Groups must complete their stop loss onboarding and have valid stop loss contracts and configurations in the Yuzu portal for go-live date.
Stop loss vendors must receive all required information from the groups and have them active in their system within 30 days following the group’s start date.
Failure to provide all necessary information will delay stop loss activation and will result in suspension of services.
Direct Contracts
Direct contracts are added during launch, not after. Plans run from the start either with or without these contracts in place, and net new contracts only apply to new claims. No claims reprocessing for late contract adds.