Portability of individual BC/BS plans

[newmindfashion]

This topic was on an older thread but couldn't find it. A couple of you had mentioned something about portability of BCBS individual plans.

Does the Blue Cross Blue Shield Association have a guaranteed issue program set up that automatically accepts customers moving from one BCBS state to another that may not be insurable on an individual basis in the new state?

I have a customer that had a minor malignant cancer diagnosis that is moving from one BCBS state with an HMO to another. This customer would not be able to get approved into the Blue Cross in their new state of residence. The new Blue Cross state is telling me no guaranteed issue program exists.

Is there anything else to this story regarding member states of the BCBS Association?

 

[Crabcake Johnny]

In MD for indie Blue Cross HMO plans if you move out of the service area you need to submit a new app subject to underwriting.

 

[somarco]

Each BX plan is operated independent of the other regardless of parentage. When an individually insured policyholder leaves the service area they have 60 or 90 days to apply for new coverage. Doesn't matter if they are crossing state lines or not.

They cannot port coverage once they move outside of the service area by the issuing BX plan.

 

[Crabcake Johnny]

Which is a huge flaw for Blue Cross. With GR, Assurant, World and others you're free to move in any state where they offer coverage and you simply pay the adjusted rate. No underwriting.

 

[newmindfashion]

My understanding is the same as you guys. However, one of our west coast brethern posted something about a guaranteed issue plan as part of being a BCBS Association member state.

FL for example, will accept other BCBS members on a non-underwritten basis if they move there as long as they apply for a plan that is not superior to their present coverage. Someone in BCBS of FL told me that.

 

[Guest]

Which is a huge flaw for Blue Cross. With GR, Assurant, World and others you're free to move in any state where they offer coverage and you simply pay the adjusted rate. No underwriting.

From my Aetna rep this morning....

....as long as the person moves to a state with an Aetna Individual Plan they can select the most comparable plan and pricing in that state with no health underwriting.

If they want to move to a richer plan, it would require health
underwriting. I have attached a map of where we are and the states that are opening.


Deborah Springer
Account Executive
Aetna Northern CA Individual Markets

HTH

Al

 

[Crabcake Johnny]

Interesting and that would have to be true since Aetna's benefits are different based on the state. Assurant and GR don't pull that kind of junk - Max Plan is the same benefits (barring additional mandated bene's) in every state and Copay Select is the same in every state.

For example, if you take an Aetna plan and move to MD there's now an immediate maternity benefit.

One more strike against Aetna.

 

[Dave020]

I think with Blue it varies by state depending on what they offer in that state. Both CA Blues will take other state Blue new residents on a conversion plan (special) GI, all other plans require underwriting with one caveat...Blue Cross CA under Anthem has a deal with Nevada and Colorado to offer same or closest match coverage GI with those states. It may expand depending on what Indianapolis wants to do.

FL sounds about right, same or lesser coverage ok for GI, upgrade we want to look at you first.

Since there may be states where Blue does not offer conversion coverage, it may that those association members cannot provide a same or lesser benefit plan GI so they refrain from offering any GI coverage since all would be considered an upgrade.

The main problem is that BCBS Association simply refers you to the member in the state you desire and you have to contact them.

 

[somarco]

Nothing interesting about Aetna. If you want to change to a richer plan with any carrier you must go through underwriting.

Had a lady earlier this year move to FL. She was able to find a plan that was similar to her GA plan and no underwriting. Rates were higher, but no underwriting.

Sounds like a plus to me rather than a strike against Aetna.

BX and several other carriers offer conversion plans, assigned risk plans or risk pool if you are entering the state with creditable coverage and no carrier options. That is not the same thing as portability.

We have Anthem/Wellpoint in GA and there are no reciprocal agreements for portability.

 

[Dave020]

We have Anthem/Wellpoint in GA and there are no reciprocal agreements for portability.

I am hoping that Anthem/Wellpoint will continue to open up more states and eventually get them all in reciprocation. Currently only CA, NV and CO have the reciprocation agreement. How many states does Anthem/Wellpoint have currently?