Policy Amendments Effective January 1, 2008

*STIBROKER@AUSTIN.RR.COM* · 01-07-2008, 06:48 PM

It is about freaking time....

The Texas 80th Regular Legislative Session has now concluded. As a result of all the bills passed, only two will impact individual health products. A brief description of these bills, along with necessary action, is provided below.
HB 1919 - This bill expands the existing mandated benefit for treatment of Acquired Brain Injury (ABI) to include outpatient day treatment services or other equivalent post-acute care treatment services.
Outpatient day treatment service and other post-acute care treatment services had been covered under the existing ABI benefit provisions. In order to completely comply with the new law, amendments have been developed to expand and include these services into the definition of ABI.
HB 2548 - Currently, members receive pre-existing credit for prior group, government or church coverage when purchasing an individual health policy. [COLOR=Red]This bill provides the same credit for an individual policy and now allows the member to transfer credit from one individual policy to another[/COLOR].

Expat · 01-07-2008, 06:53 PM

BCBS has been doing this since last Feb. However they have no problem in declining an application if they don't like the pre-exist.

*STIBROKER@AUSTIN.RR.COM* · 01-07-2008, 07:10 PM

Who do you think sent me this.....Aetna has been doing it longer....now its about time Unicare step up to the plate.....now that could mean more rescinded policy's in the first 2 years......

Originally Posted by Expat

BCBS has been doing this since last Feb. However they have no problem in declining an application if they don't like the pre-exist.

TXINSURANCE · 01-07-2008, 07:28 PM

A little dirty secret of the bill is SHORT TERM is cretible.

Look it up.

This could extend someones "63 days" for a long time.

*STIBROKER@AUSTIN.RR.COM* · 01-07-2008, 07:34 PM

Yea but who wants to get cancer on stm......

Originally Posted by TXINSURANCE

A little dirty secret of the bill is SHORT TERM is cretible.

Look it up.

This could extend someones "63 days" for a long time.

TXINSURANCE · 01-07-2008, 09:18 PM

yea but who wants to get cancer on stm......

No one, but here is the scenerio...

Client calls you 60 days into their 63 day window.

Unicare goes out 4 days on effective dates.

BCBS does not lock in effective dates

Write a 30 day STM and their 63 day window starts over...

Or a client is held in u/w too long, and gets declined... slip in a 30 day temp and their 63 days starts when the temp runs out.

Sounds to good to be true but it is buried that STM is creditable, good luck trying to explain it to a carrier.