So we have a client that moved from IL to FL. They had an individual BCBS IL policy, so logically they cancelled it once they got to Florida (and prior to contacting us).
The BCBS IL policy is set to expire 7/31.
2 weeks ago, we submitted a UHC off exchange application in FL with backup documentation showing previous and current address as well as the BCBS IL cancellation showing the 7/31/2016 cancellation date.
UHC is telling us that the client does not qualify for a SEP because they cancelled their insurance on their own.
I called last week and requested it to be reopened and explained the situation. The person on the phone understood the situation and sent it over to be re-opened. Since then I've been calling every other day to check on the status of the 'reopening' and they've just said "no update yet". Today they said it won't be reopened because the client does not qualify for a SEP. I was able to leave a voicemail with a supervisor who will hopefully call me back today.
The rep said the client should have contacted the carrier and requested an address update. Then the carrier would have told them that their plan isn't available in FL and would have sent a cancellation letter stating that.
Anyone else run into a situation like this? Any suggestions? Advice?
What do you do when common sense is thrown out the window???
Thanks in advance
The BCBS IL policy is set to expire 7/31.
2 weeks ago, we submitted a UHC off exchange application in FL with backup documentation showing previous and current address as well as the BCBS IL cancellation showing the 7/31/2016 cancellation date.
UHC is telling us that the client does not qualify for a SEP because they cancelled their insurance on their own.
I called last week and requested it to be reopened and explained the situation. The person on the phone understood the situation and sent it over to be re-opened. Since then I've been calling every other day to check on the status of the 'reopening' and they've just said "no update yet". Today they said it won't be reopened because the client does not qualify for a SEP. I was able to leave a voicemail with a supervisor who will hopefully call me back today.
The rep said the client should have contacted the carrier and requested an address update. Then the carrier would have told them that their plan isn't available in FL and would have sent a cancellation letter stating that.
Anyone else run into a situation like this? Any suggestions? Advice?
What do you do when common sense is thrown out the window???
Thanks in advance