I have a client who wants health insurance coverage on their daughter, whom is 23 and is in college. She is still claimed as a dependent of theirs. My problem is that she goes to college in Louisiana. So even though she is a dependent of her parents in Texas she lives and goes to college in Louisiana, can I write her if I'm not licensed in Louisiana?
Dependents
- Thread starter Golddoor
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I'd check with you local Blue and see if you can write her in Texas (I would think it would be no problem since that is her legal residence).That way she can use "Blue Card" to access care in LA while she is in school and covered under TX Blue coverage.Just a thought!Davewww.davefluker.com
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Thanks Dave. I guess your the only one who wants to reply.
Im not appointed by Blue and not planning on it since Im not a big fan of theirs. Are they the only company that offers out of state coverage?- 1,926
I would be carefull writing blue, when she leaves college, she may move to another state and there can be complications if her health changes. I would go with someone that has a nationwide network, PHCS or UHC.
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Blue has mandatory reciprocation in all fifty states, it is a part of the Blue Cross Blue Shield association requirements. I have not found that UHC nor PHCS will write individual conversion to California from other states, nor will Aetna nor Cigna. Dave
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Recently I was talking with my Blue Cross rep explaining that I have a client that was planning to purchase an individual BC policy here in Tennessee and was planning to retire in Washington state in 2 years and they would still be under age 65. Th agent explained to me that if the client moves their residence to another state, that after 6 months residence they must either apply for a BC policy in Washington, with new underwriting and pre ex period, or, if they had a change in health, they could qualify for a HIPPA policy. As explained to me, although there is reciprocity in all states, if residence is changed the above scenario takes place. Talking with the PHCS folks, they tell me that a policy bought in Tennessee can be taken to Washington, regardless of changes in health and the policy is transferrable.
Are my sources incorrect? Appreciate any direction for clarification on this matter.
Are my sources incorrect? Appreciate any direction for clarification on this matter.
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I am speaking individual to individual coverage, so HIPAA is out unless they are coming off of group. When you are on a Blue plan and move to another state, you notify your Blue carrier in your home state of the move. They generate a "J-wire", I believe it is called a J-4 wire informing Blue in the new state of your arrival and eligibility. Once you get to the new state, you contact the new Blue and reference the J-4 and they allow you to enroll in a conversion plan automatically as required by the BCBS Association. No residency waiting period applies, no other requirements except, of course, health issues that would preclude buying a standard plan.Blue Cross CA just announced that they are now offering full underwritten reciprocation with Nevada and Colorado - not a conversion plan, but a plan as close to the existing CA plan as possible, and visa versa. Eventually Wellpoint/Anthem will offer this in all of their states.Anyway, yes Blue Association requires mandatory conversion coverage be available to anyone moving to another association state. Are there any states without an association member? I used to think Hawaii, but they do have an association member also.Dave
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No residency waiting period applies, no other requirements except, of course, health issues that would preclude buying a standard plan.
What if there have been changes in health in the applicant from when they were first issued the policy in their current state, and the move to the new state? If they had a standard plan and now have cancer or heart disease are they automatically converted in the same UW status as the previous policy? Thanks for the help, I really need to understand this because I am getting conflicting info.
What if there have been changes in health in the applicant from when they were first issued the policy in their current state, and the move to the new state? If they had a standard plan and now have cancer or heart disease are they automatically converted in the same UW status as the previous policy? Thanks for the help, I really need to understand this because I am getting conflicting info.
- 3,384
That is an issue and why they usually defer to a conversion plan option in the new state. Basically it works like this, when someone moves and wants to stay on Blue in the new state (or has to for health reasons), Blue will do the J Wire and new Blue must by rule take them on the conversion plan in the new state. Now, conversion plans can be pricey and also may have some benefit limitations compared to the old plan in the old state, but it is guaranteed issue individual coverage with Blue as required by the association.In the states currently reciprocating under Wellpoint (CA, CO and NV), they cannot use health as a factor on the matching plan they have to offer - this rule is a Wellpoint/Anthem thing, not an association thing. In that case even with health changes they still have to match as close to the original plan as is available at the same pricing level they had in the other state. I guess they figure WP/Anthem is on the hook no matter which of the three states you are in if you get sick, so it comes from the same funding whether CA, CO or NV.
