Insurance Agent Forum

[Dave020]

Ok, I talked to someone I know at BS CA who has been doing Blue for ages and here is what she told me:

When someone moves to CA from another Blue state and has a Blue plan, they are offered what is knows as an "interplan" which is the Blue state-to-state GI plan. When they come to CA the "J-wire" from the original Blue Carrier must be sent to both Blue Cross CA and Blue Shield CA since they are separate out here. The new resident then has the choice as to which Blue Interplan to elect. These are special GI plans not available through agents or to the general public except in these cases. They are similar to conversion plans.

When a BS CA or BC CA client moves to another Blue state, either of the CA Blues must send the "J-wire" to the new blue advising arrival of the insured and insured's desire to purchase an interplan in the new state.

Now, she said she knew of no specific mandate that interplans must be offered, but in all of her years of working with BS CA, she has never seen a situation where another Blue did not offer an interplan.

You might contact new Blue and ask, specifically, about their Interplan.

Dave
The David Fluker Health Insurance Agency - Gilroy, California - Serving California Residents Since 1995

[salpro22]

Originally Posted by Dave020

Ok, I talked to someone I know at BS CA who has been doing Blue for ages and here is what she told me:

When someone moves to CA from another Blue state and has a Blue plan, they are offered what is knows as an "interplan" which is the Blue state-to-state GI plan. When they come to CA the "J-wire" from the original Blue Carrier must be sent to both Blue Cross CA and Blue Shield CA since they are separate out here. The new resident then has the choice as to which Blue Interplan to elect. These are special GI plans not available through agents or to the general public except in these cases. They are similar to conversion plans.

When a BS CA or BC CA client moves to another Blue state, either of the CA Blues must send the "J-wire" to the new blue advising arrival of the insured and insured's desire to purchase an interplan in the new state.

Now, she said she knew of no specific mandate that interplans must be offered, but in all of her years of working with BS CA, she has never seen a situation where another Blue did not offer an interplan.

You might contact new Blue and ask, specifically, about their Interplan.

Dave
The David Fluker Health Insurance Agency - Gilroy, California - Serving California Residents Since 1995

I thought J-Wire was a band????? Hmmmm, what a shame....

[Dave020]

To follow up on my last post, I think that it is important to utilize the "power of Blue" to get this done.

I think if you or I or the client ask about it, we may get an incorrect answer. When the client requests the "J-wire" from the originating Blue carrier to the new Blue carrier, I suspect that communication carries some weight whether by mandate or by agreement.

When a Blue tells another Blue to send interplan materials out to a new resident who is eligible, it gets done. If we or the client ask for it, it may or may not.

Dave

[Dave020]

Here is an interesting link that talks about the Interplan Tranfer blue to blue.

Google Answers: Blue Cross individual conversion plans in California

I found this part quite interesting:

History 1948-1995
The Western Conference of Prepaid Medical Service Plans

By 1954, the plans developed and adopted an Interplan Transfer
Agreement. Several years later, the Blue Shield organization concluded
A similar Agreement among its member plans.

***** This paper refers to the existence of an Interplan Transfer
Agreement among the Blue Shield plans. I was not able to find a
Specific reference to this agreement on the Blue Cross/Blue Shield
Association website but I found many references from various Blue
Cross/Blue Shield plans that imply and confirm their existence. The
General rule seems to be that if you move and are covered by a Blue
Cross/Blue Shield health plan you can ask for a transfer of your
Coverage to the new Blue Cross/Blue Shield provider in you new
Location. This provider many have different coverage rules than the
Provider in your old location. Your question seems to ask about
Individual (rather than group) coverage to be continued in California
From another state.

[Dave020]

More interesting reading on interplan transfers

Western Conference History

[Dave020]

And, according to this document, participation in the interplan transfer programs is a requirement to belong to the BCBS Association.

Handbook of Health Care Accounting and Finance - Google Book Search

[somarco]

The September 1948 meeting in Reno, Nevada was organizational in nature. Participants discussed the common needs of the plans, the necessity of such an organization, and how to proceed. They concluded that it was not necessary to form any "hard and fast" organization that might become a burden on any individual plan, but the organization should rather be on a cooperative basis.

Sounds like something Mario Puzo would write.

Seriously, maybe this is indigenous to CA. I have run into folks who moved here from other states, contacted BX about a transfer and were sent a standard application which would be underwritten. Ran into a lady two weeks ago. Moved here from WV and has emphysema. She told me she was going to keep her current plan and transfer it to the GA plan.

Wish I could remember her name. I might just call her back in a few months and see what happened.

[Dave020]

According to the last link I put up, it is a requirement to provide interplan transfers to be a member of the BCBSA.

Did those people you talked to have their Blue contact the new Blue directly to request an interplan transfer, or did they just contact the new Blue themselves. If I call them, they will send me a standard app thinking I want to apply for coverage. As I mentioned above, I think that it is important to let home blue do the work of talking to new blue.

If I have time, I may call all 39 Blues and get the status of their interplan transfer plans. Afraid I'd end up on hold too long and burn the day.

It's not a CA thing, I have had clients get interplan transfers in Tenn, Texas, Nevada and Washington state. Pricey and not as good as an individual plan, but better than nothing.

[Dave020]

This from the General Accounting Office 1994:

"Inter-Plan Transfer Agreement -
This program establishes a mechanism for transferring the membership of subscribers who move permanently to an area served by another Blues plans. Under the program, continuity of coverage is provided to subscribers through requirements that all plans offer certain minimum benefits and limits on the nature and extent of coverage restrictions (such as pre-existing conditions clauses) that plans may impose"

http://archive.gao.gov/t2pbat3/151562.pdf (page 33)

[newmindfashion]

Dave020,
Sorry for the delay in acknowledging your efforts on this issue. Thank you for the research. What's your experience with costs on these interplan transfers? Because I'm experiencing ignorance of any interplan transfers with the two blues on my end, I'm wondering if its worth pursuing for my customer if the costs of these plans are typically beyond afordable.

[Dave020]

Generally expensive, sometimes prohibitively. Usually a form of conversion plan may have some benefit restrictions.

[bluemarlin08]

BC of Tennessee is standing strong on their statement that inter-plan transfers to be done without evidence defaults to BC GI plans, period, of the state transferring to.

[newmindfashion]

Indeed. And, if the state being trasnferred to does not have a GI plan, then too bad.

That's what I'm getting in general.

[Dave020]

Blue - I've done a couple of inter-plan transfers between CA and TN, both ways, and they have gone relatively smoothly. Good reciprocation between those two Blues (three technically since CA has seperate BC and BS companies).

New - what does the original Blue say about this? Are they going to notify new Blue to request inter-plan transfer? New state Blue does not offer any individual conversion plans?

Dave

[bluemarlin08]

Dave,
So are you saying you have been involved with Tennessee BC cases that were transferred to a CA BC non GI plan without evidence of insurability? If so, I"m confused why the Tennessee BC is so adanebt, and trust me I have spoken to several of the supervisors and they are all reading the sane script????? I don't want to mislead my clients, what would you suggest to get the right answer, if you have actually done the transfer?

[bluemarlin08]

Adanebt

I meant adament, sorry!

[Dave020]

Originally Posted by bluemarlin08

Dave,
So are you saying you have been involved with Tennessee BC cases that were transferred to a CA BC non GI plan without evidence of insurability? If so, I"m confused why the Tennessee BC is so adanebt, and trust me I have spoken to several of the supervisors and they are all reading the sane script????? I don't want to mislead my clients, what would you suggest to get the right answer, if you have actually done the transfer?

Sorry if I was not clear, the inter-plan transfers have all been to GI plans - usually these are the same or similar to the GI individual conversion plans they offer people coming off of group/COBRA. Coming to CA, it goes to either Blue Cross or Blue Shield and they offer GI plans if requested. Same back to Tenn, offer is a GI conversion plan, they may have a special "inter-plan" available.

Dave

[bluemarlin08]

That is how I understand it, thanks! So, if a prospect expects to change states in the future, it might be better to go with a PPO that is accepted without having to show insurability!

[schealthagent]

With BCBS of South Carolina, you are able to move to any other state and maintain your coverage - the only thing that changes is the doctors that you see (as long as they are in the BC and or BS network.) I have been told this by everyone from member services, marketing reps & the president of on of the largest GA's in the state. Several of my clients have moved, filed change of address and had no problems. It might be due to the higher rates that members seem to pay here versus other states.

Marc

[Dave020]

Each Blue likely has its own rules regarding residency. Both CA Blues require residence in CA at least 1/2 of each year. If someone changes state of residence permanently, they cannot remain on either CA Blue.