Insurance Agent Forum

[Dave020]

I wanted to make sure that CA agents selling IFP plans are aware of a problem with the Anthem BC attestation form required (in some form) under the new law, AB 2569.

The law requires agents selling plans to attest to the accuracy and truthfulness of answers on IFP applications submitted by clients and prospective clients.

All carriers except Anthem Blue Cross have either created an attestation form or are currently using the attestation that is on their IFP applications. In those cases, all attestations include the option for the agent to state that agent did not assist or help the applicant answer the questions on the application.

Now comes Anthem BC. Their attestation form has the following verbiage with NO OPTION to opt out for applicants who submit randomly online in the middle of the night.

"A new law became effective January 1, 2009, AB 2569, which requires all agents/brokers to submit an attestation with each submitted application. As an agent/representative who is submitting this application to Anthem Blue Cross/Anthem Blue Cross Life and Health Insurance Company, you have the duty to assist the applicant in providing answers to health questions accurately and completely." (emphasis mine).

Now, hold on, I have a duty to help them answer the questions? That is exactly what they did not want us to do after the Health Net settlement. And exactly how do I help them answer questions when they are doing an online application form directly on my agent connect site at 3 AM? I guess we need to be 24/7 in order to comply with this?

There's more:

"To the best of my knowledge, the information on this application is complete and accurate. I explained to the applicant, in easy-to-understand language, the risk of the applicant providing inaccurate information and the applicant understood the explanation."

?? Now, since the applicant can go to agent connect, do planfinder and apply online without me knowing about it until the application has actually been submitted, at which time it is locked and cannot be altered by the applicant, exactly when did I have the opportunity to explain anything? If they lied, they lied and it's too late to fix it. How can an agent attest to this after-the-fact??

And the last section:

"If you state, as an agent, any material information that you know to be false, you are subject to a civil penalty up to $10,000 as authorized under California Health and Safety Code 1389.8(c)."

So, if the applicant did it by him/herself online without consulting me and submitted erroneous information on the application, and I sign the attestation saying that I explained not to do it before they did it (???), even though I never heard of them until after they did it, I am submitting a false attestation which is false material information which now subjects me to a potential $10,000 freaking fine?!

Simply, Blue Shield CA has a nice form, and you can check a nice block that says the following:

"I did not assist the applicant/applicants in any way in completing or submitting this application. All information was completed by the applicant(s) with no assistance or advice from me."

Gee, is that so hard to add, Anthem? I posted this not so much because of the form, but because Anthem is working very hard NOT TO change this form.

I don't see how any agent with agent connect and planfinder can not get in trouble with the Anthem attestation form. You can call them later and go over it, but once that submit button got hit, those answers, truth or not are locked into the system for eternity.

I showed my Blue Shield RSM the Anthem Attestation form the other day over coffee. She is still laughing.

[djs]

When they sent me this notice, I had the same concern. Didn't bother me a whole lot though, I've only ever sold 1 Blue Cross policy where I wasn't significantly involved in the sale. Even the 1 I knew about, I had emailed the link to do the application, just they took about 6 months to actually apply.

This attestation form basically prevents unattended sales. No more simply put up a website and they will come. Can't do it with this form.

Dan

[Dave020]

They are saying that e-health is using this same form. I wonder how they are doing it? Does e-health stop process at their end before submission, or can you submit direct to the carrier via e-health.

You are right, this pretty much shuts down the agent connect/planfinder program they gave us.

I suggested that they consider implementing a technology whereby the applicant submits to agent who then reviews the application before final submission. I doubt they will do that.

[dave74]

Thanks for posting that Dave!

[GreenSky]

What's just as bad is that not only is agent notified to submit the form, but the same information along with a copy of the form goes to the applicant. So now the applicant must wonder why his new agent is so incompetent that he needs to be reminded to submit a form.

I was just told that the underwriters will get to applications submitted on 1/13 sometime in the 1st week of Feb. Add to that incompetency the issue that they now have to match the damn form faxed to them and everything gets put on hold. Today (1/28) I was told I needed to fax the form for my 1/13 submission. I faxed it on 1/20. After 15 minutes they found it.

Blue Cross is starting to make CMS look efficient!

Rick

[Dave020]

As an aside, Anthem is laying off 1500 nationwide.

My RSM told me that Anthem has admitted that they "screwed up" with this form and are going to fix it. I'll believe that when I see it. Most likely they will wait until new applications are printed. In the meantime he suggested adding a caveat statement onto the form for those online direct applicants using a statement similiar to the one on the Blue Shield form. Then e-mail it to him to forward.

[elisag2a]

Good info, I just submitted an application the other day and they called wanting the form. Very interesting, I'm gonna let the prinicpal of our firm sign it, she makes more than I do