Insurance Companies

Insurance companies, also known as “issuers,” can use the information and resources below to prepare for Open Enrollment (OE) and help serve Georgians throughout the Plan Year (PY).

Georgia Access works with insurance companies to offer Qualified Health Plans (QHPs), including Stand-Alone Dental plans (SADPs), to consumers in the individual and small group markets. Insurance companies participating in Georgia Access are licensed by the Office of Commissioner of Insurance and Safety Fire (OCI) and have plan management and back-end enrollment responsibilities.

Insurance companies may also play a role as Enhanced Direct Enrollment (EDE) partners, facilitating consumer enrollment into QHPs. More information about EDE partners can be found here: Enhanced Direct Enrollment Partners.                                

Resources

Georgia Access PY 2025 QHP Application Instructions for Issuers (Updated July 26, 2024.)

• This resource provides the timeline and instructions for issuers intending to sell Affordable Care Act (ACA)-compliant plans on Georgia Access for PY 2025, including:
  • Individual market health plans and SADPs seeking on-Exchange QHP certification.
  • Small group plans seeking on-Exchange QHP certification, known as Small Business Health Options Program (SHOP) plans.
  • Off-Exchange SADPs seeking QHP certification.

External Links

• System for Electronic Rates & Forms Filing (SERFF): All insurance companies must have access to this system to submit and revise plan data. Plan certification decisions are also recorded in SERFF.
• OCI Regulatory Filings Website: All insurance companies and their products are regulated and reviewed by OCI. More information on forms and processes for filing is located on this site.
• The public can search forms submitted to Georgia Access, including Transparency In Coverage Templates, on the SERFF Public Access webpage.

User Fee Information for PY 2025

Georgia finalized a user fee rate of 2.5% of premium for PY 2025.

User Fee Payments

Insurance companies may follow the steps below to retrieve their user fee invoices and submit payments for PY 2024 and PY 2025.

• Log into Vertafore’s Pay State Invoice using your Business Account ID# (i.e., Sircon subscriber number) and email/username.
  • Select “Get Help Signing In” for assistance accessing your account.
• Arrange for payment via Automated Clearing House (ACH) by providing your bank with the Payment Processor and the ACH payment ID (located on the Georgia Access User Fee Invoice letter).
• If there is an open invoice status, select “Pay State Invoices” to process payment.
  • Online payment is the only payment method accepted.
  • Invoices must be paid in full via Vertafore’s Pay State Invoice service.

For questions about Sircon accounts or the payment service:

• Fill out a Contact Support form at https://sirconwalkup.vertafore.com/apex/sc_ContactSupport.
• Call 877-876-4430.

For questions about Georgia Access invoices:

• Call 404-656-2070 or 800-656-2298.
• Email intake@georgiaaccess.ga.gov.