Insurance Agent Forum

[Dowejonez]

Have a couple of retired school teachers I'd like to write. If you leave an association plan (no Rx) do they have to let you back exactly as you were, against the plan rules for leaving a group like this?

I'm sure there is no advantage from her association unless there are other benefits available which she isn't aware of. She just has a standard BC BS sup. from them, same as mine, but you know how it is when you are told you can never go back.

If I can't find someone with their group to talk to I will want to read it in CMS guidelines. That is unless someone on here knows.

[djs]

Short answer - no.

Longer answer - they may not be able to get out without a qualifying event, and will not get back in without a qualifying event (marriage, divorce, job change resulting in loss of other coverage, etc) or open enrollment.

Here's what concerns me about your question.... if she is looking for RX coverage, what happened? Can she be written individually to start with? She chose a plan without it, now wants it.... this is a redflag. I may be reading to much into this, but I would ask.....

Dan

[Dowejonez]

The teachers group from the year she retired is Health only. In a way I don't trust the info I'll get from whomever administers the group plan as it may be in their interest to keep the group as large as they can. Another half a dozen phone calls tomorrow.

It feels like it takes three times as many phone calls to what one call did 10 years ago. And everyone has the auto/multiple extension choice messages that I usually forget to listen to in the beginning and have to "press the #sign to hear menu again" and maybe "again".

Well ...I've been trying to use the effing Rx engine all evening and am giving up. Haven't seen it this busy since year 1.