Univera Healthcare logo
Login | Register | Forgot Username | Forgot Password
By Phone
By Email
By Mail
Visit Us In-Person
News and Updates
Print Forms
About Us
Compliance Notices
Employer News | July, 29 2014
Employer News | July, 29 2014

Annual Group Information Form (AGIF) Renewal Certification Due August 5, 2014

Due to various state and federal regulations, Univera Healthcare is required to obtain certain information regarding groups. As a result, groups will need to complete the Annual Group Information Form (AGIF) Renewal Certification. The forms are now available on Univera on Demand. The updated form must be returned by August 5, 2014.

Community-rated groups will be receiving a notice, including the AGIF Renewal Certification web link, that can be used to submit their form. The notice will be distributed via email or postal service mail (if no email address is on file). Experienced-rated groups will receive the AGIF, along with applicable renewal paperwork, through their dedicated sales consultants. Groups that have not submitted an AGIF within the past two years, or that have been flagged for audit (e.g. verifying group eligibility, company location – Cede, etc.), will be receiving the AGIF Long Form.

Community-Rated Groups - Annual Group Information Form Notification

  • The AGIF notification will be emailed directly to insured groups for which Univera Healthcare has a current email address on file. Instructions will be included to complete the interactive form and submit it online.
  • The AGIF paper notification will be mailed directly to insured groups for which Univera Healthcare does not have an email address on file. Instructions will be included to complete the interactive form and submit it online.
  • Groups are encouraged to go to the AGIF website for submission, whether the notification was received electronically or by postal service mail.
  • The notification will include a phone number to request a paper form for any group who does not want to complete and submit the form online.
  • The forms must be completed and signed by the authorized group representative. The broker cannot complete and sign the form on the group’s behalf.
  • Groups that submit their AGIF Renewal Certification via the AGIF website and prior to October 1, 2014 will have their forms reviewed within 60 days of receipt.

Experience-Rated Groups - Annual Group Information Form Notification

Large groups can obtain the new AGIF through Univera on Demand. Groups and brokers will submit the completed AGIF with renewal paperwork to their dedicated sales consultants.  Renewal quotes for group accounts with fewer than 1,000 enrolled contracts with not be released without a completed AGIF.

Waiver of Group Coverage

As a reminder, please use the most recent waiver form which was revised in December 2013. Please be sure to replace any old forms you have on file with this newest version. The form is also available through Univera on Demand.


home     news & updates     print forms     about us     fraud & abuse     glossary     accreditations   
Language Assistance and Non-Discrimination Notice

Copyright © 2019, Univera Healthcare, an Excellus company. View our Web Privacy Policy for information on how we protect your privacy. Use of this site indicates your acceptance of our Terms of Use. You will need Internet Explorer or Google Chrome to use the secure features of this site.