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Insurance Companies

Welcome to Georgia Access! 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.

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 an Enhanced Direct Enrollment (EDE) Partner, facilitating consumer enrollment into QHPs. More information about EDE Partners is here: Enhanced Direct Enrollment Partners.

Resources

  • Georgia Access PY 2025 QHP Application Instructions for Issuers (Updated June 17, 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 stand-alone dental plans (SADPs) seeking on-Exchange qualified health plan (QHP) certification.
      • Small group plans seeking on-Exchange QHP certification, known as Small Business Health Options Program (SHOP) plans.
      • Off-Exchange stand-alone dental plans (SADPs) seeking QHP certification.
    • This resource may be updated based on the final Notice of Benefit & Payment Parameters (NBPP) and other guidance once released by CMS.

External Links

User Fee Information for PY 2024

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

  • 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:

For questions about Georgia Access invoices:

User Fee Information for PY 2025

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