Blue Cross of Florida questions

[MikeLentini]

Just what we need on this forum. Another one who knows it all. And there is NO CHANCE of you nailing her. She has too much class. I stand by my statement. We are not bc florida agents because they're all captive. I gave info from when I was with them for a short time. Only the carrier can tell you exactly at this moment how it works. It can change at anytime. Your question was so open, I thought you were a consumer. What a surprise when you exposed yourself as you are.

Gevalt! I felt the same way about you. another middle aged Jewish gentleman in a red convertible living in S. Florida.
LOL what a cliche. MAYBE SPS?

What Chutzpeh you have.
Actually, how can you classify me as a "know it all" when I came here to ask some questions that I clearly "don't know" the answer to.

I called BCBS and after 35 minutes on hold, LAQUISHA answered and she wouldn't give me any info unless I was an insured with BCBS.

Thank you for everyone else for the accurant information.

L'chei-im!!

 

[Dave020]

However, if a person is living in FL and has BCBS and moves to another State, the policy they have is NOT portable. The client has to re-apply with the BCBS in the new State and is not guaranteed acceptance. If they contracted a declinable condition, they will not be acceptable for coverage.

This is incorrect. There is no portability of the existing policy, however BCBS Association membership requires that all Blue plans in all states offer existing Blue subscribers a GI plan when they move to that state. It is called an "interplan transfer" and they must take on the subscriber on a GI basis. In most states the Blue will offer one of its individual conversion plans as the option on interplan transfer.

So a subscriber in CA on Blue (either one) moving to FL can either apply for underwritten coverage or, if declinable, request the home CA Blue send a J-wire to BCBS FL advising them to send out information for GI enrollment to the subscriber as soon as they arrive in FL.

Also, currenty 11 Anthem Blue states offer full reciprocal coverage for those moving, so they are GI to closest match to plan they had in original state. These are called "relocation plans" and effect the following states (currently):

California
Colorado
Nevada
Wisconsin
Missouri
Indiana
Ohio
Kentucky
Georgia
Virginia
Connecticut
New Hampshire

 

[indmedins]

This is incorrect. There is no portability of the existing policy, however BCBS Association membership requires that all Blue plans in all states offer existing Blue subscribers a GI plan when they move to that state. It is called an "interplan transfer" and they must take on the subscriber on a GI basis. In most states the Blue will offer one of its individual conversion plans as the option on interplan transfer.

So a subscriber in CA on Blue (either one) moving to FL can either apply for underwritten coverage or, if declinable, request the home CA Blue send a J-wire to BCBS FL advising them to send out information for GI enrollment to the subscriber as soon as they arrive in FL.

Also, currently 11 Anthem Blue states offer full reciprocal coverage for those moving, so they are GI to closest match to plan they had in original state. These are called "relocation plans" and effect the following states (currently):

California
Colorado
Nevada
Wisconsin
Missouri
Indiana
Ohio
Kentucky
Georgia
Virginia
Connecticut
New Hampshire

Dave, sounds like you sell the Blues, so I am sure you know what you are talking about. But, all I can tell you is a family member of mine got denied BCBSFL coming from Empire Blue Cross and NO GI was offered or any mention of a J-wire. Seems to me the average person moving might not know about this GI or J-wire. A good agent as you seem to be would have informed my family member and saved grief. I was not in the business at that time and just know what I experienced and do appreciate the info you provided.

Perhaps if she was told by BCBS to call Empire and request a GI plan, she would have attained coverage. But, BCBS is NOT portable and you will be denied in the individual market if you move and are uninsurable. As you know, their underwriting is very tight with BCBS and can take months to get a decision. She found a major medical plan just as good as BCBSFL, no riders and at a fair premium.

 

[Crabcake Johnny]

I really don't care what BX says or even what's in their written policy.

I have dealt with 5 clients just within the past year who were moving from on state to another with BX plans are ALL were told they were ass out.

We tried to cite all programs of portability but when it came to sh*i or get off the pot BX bottom-lined each one and said their plans were NOT portable and there was NO GI option.

My most recent fiasco was a lady in DE who was told she could indeed move to MD and move her plan. It was back-and-forth for week - each BX rep giving her a completely different story.

When I called and bottom-lined the BX manager he assured me that was no way she could make the move and still be insured by BX.

The ONLY way, based on a conversation I had with a BX manager, that someone can get a GI BX plan is if they are HIPPA eligible - expiring Cobra.

Sorry.

I also dealt with a client who was technically OON while seeking treatment in another state - had BX and was told she could still see a BX doctor.

Poppycock.

She was balanced billed - we three-way called Carefirst who said that although they can indeed seek treatment OON with another BX provider they are STILL subject to balance billing.

Please watch what the evil empire tells you or your clients.

 

[TXINSURANCE]

Dave is correct however you wouldn't want to go that route first because a fully underwritten option is far less money.

Those GI plans from one BCBS to another cost an arm and a leg - I have seen rates as high as several thousand dollars. The application and inquiry process they will try to disqualify with trick questions as well.

The process can be very upsetting...

Quick story someone was offered this GI coverage from one BCBS to BCBS TX. They declined the GI offer as it was over $1500/mo. They are completely uninsurable in Texas with all companies.

They applied with the Texas High Risk Pool - who also declined them - because "they had other coverage offered but decided not to elect it..." In other words they were penalized for even asking about BCBS inter association GI and it disqualified them for the Texas Pool via a trick question.

This is the type of stuff that needs addressed before the government does a hostile take over or re build, as it is completely unacceptable.

 

[Dave020]

You'd rather get opinions from agents than talk to the carrier.

I agree to a degree with you on this, however it has been demonstrated through this forum in the last year or so that sometimes the carrier is not the best place to get information.

Another agent on this forum sometime back was looking for information about what turned out to be an interplan transfer. BCBSFL was clueless until pressed with information I provided and reluctantly agreed that they were actually required to provide an interplan transfer (who would have thought that their license status with the Association had some rules attached to it LOL).

I have found that generally the information available from carriers is only as good as what they are willing to cop to, especially when it comes to reciprocation and GI issues.

So, sometimes the forum is a good place to ask questions, at least IMO. I have learned quite a few things here as well.

 

[Dave020]

Dave is correct however you wouldn't want to go that route first because a fully underwritten option is far less money.

Those GI plans from one BCBS to another cost an arm and a leg - I have seen rates as high as several thousand dollars. The application and inquiry process they will try to disqualify with trick questions as well.

The process can be very upsetting...

Quick story someone was offered this GI coverage from one BCBS to BCBS TX. They declined the GI offer as it was over $1500/mo. They are completely uninsurable in Texas with all companies.

They applied with the Texas High Risk Pool - who also declined them - because "they had other coverage offered but decided not to elect it..." In other words they were penalized for even asking about BCBS inter association GI and it disqualified them for the Texas Pool via a trick question.

This is the type of stuff that needs addressed before the government does a hostile take over or re build, as it is completely unacceptable.

This is one instance where MRMIP in CA beats the TX pool, MRMIP allows for both declines and any policy premium priced above the MRMIP level. Here, they could have gotten into the pool based on the premium.

 

[Crabcake Johnny]

It's been my experience that calling BX in situations like this is difficult.

Phone are staffed by low-paid and uninformed employees who don't know what's available or how anything works.

All I know is people coming from Anthem to Carefirst or Carefirst to Anthem are screwed.

 

[Dave020]

Dave, sounds like you sell the Blues, so I am sure you know what you are talking about. But, all I can tell you is a family member of mine got denied BCBSFL coming from Empire Blue Cross and NO GI was offered or any mention of a J-wire. Seems to me the average person moving might not know about this GI or J-wire. A good agent as you seem to be would have informed my family member and saved grief. I was not in the business at that time and just know what I experienced and do appreciate the info you provided.

Perhaps if she was told by BCBS to call Empire and request a GI plan, she would have attained coverage. But, BCBS is NOT portable and you will be denied in the individual market if you move and are uninsurable. As you know, their underwriting is very tight with BCBS and can take months to get a decision. She found a major medical plan just as good as BCBSFL, no riders and at a fair premium.

I was referring to the part about not being able to obtain coverage, sorry if I wasn't clear on that. I did mention that you were right that the policy was not portable.

BCBSFL is notorious for claiming no interplan transfer option, yet in the past when pressed have copped to having to allow it onto a conversion plan.

Again, the Association requires it, it is not optional by licensee.

 

[indmedins]

My whole point, from what I experienced, was there was no mention of GI or J-wire by BCBSFL. Just a you are denied, have a nice day. A savvy BCBS agent would have been able to help, but the price is outrageous for GI anyway, plus some people are not a decline with another carrier as per my family member.