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INDIVIDUAL
INSURANCE |
Q: |
Does The Cason
Group have any Individual Disability Carriers? |
A: |
No, we do not
currently have individual disability. |
Q: |
Do Individual Carriers do
agent of record changes? |
A: |
The only way
to change agents of record for an Individual policy is
for the individual to go back through underwriting. This
may also be done when an individual is upgrading benefits. |
Q: |
What companies will do a pre-screen? |
A: |
American Republic, Shenandoah Life and West Coast
Life will do a pre-screen. BlueCross BlueShield of South Carolina and
BlueChoice for Kids will not. |
Q: |
Do I have to be appointed
with an Individual Carrier in order to obtain a quote?
|
A: |
The only carrier
you must be appointed with prior to obtaining a quote
is BlueCross BlueShield of South Carolina. |
Q: |
What do I do with an individual
who is uninsurable? |
A: |
BlueCross BlueShield of South Carolina is an administrator of the SC Health Insurance
Pool (SCHIP.) Agents are not paid commissions on these
policies so applicants must contact BlueCross BlueShield of South Carolina directly at 803-264-6401. |
Q: |
Can applications be faxed?
|
A: |
BlueCross BlueShield of South Carolina, and West Coast Life will accept
faxed applications. |
Q: |
Do Individual policies give
credit for continuous coverage? |
A: |
Individual underwriting
considers pre-existing conditions whether or not the applicant
has had continuous coverage. Conditions may be covered,
excluded, or rated-up. |
Q: |
What companies will do a list
bill for individuals? |
A: |
All of our individual
carriers will do a list bill except for Humana in NC. Please check with us for
the requirements. |
Q: |
Do Individual Carriers rate-up
for tobacco use? |
A: |
Some carriers
rate-up 10-20% for tobacco use. BlueCross BlueShield of South Carolina
does not
rate-up for tobacco-use. |
Q: |
How long does it take to get an application approved? |
A: |
Each individual
is different. Some approvals take one to two weeks while
others may take one to two months. Applications may be
held up in underwriting for various reasons such as waiting
on medical records. |
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GROUP QUESTIONS |
Q: |
When will groups get their cards? |
A: |
Typically it
is 7-14 business days from the date of the acceptance
letter, not the effective date. |
Q: |
Will The Cason Group check the status of a claim for me? |
A: |
We are glad
to. However, we will always need a HIPAA authorization
form filled out by the member in question designating
the agent and The Cason Group account service representative
and authorizing The Cason Group account representative
to receive any PHI. Providing this information upfront
saves time. |
Q: |
How do I add an employee/dependent? |
A: |
Each carrier
has a form that a member needs to complete. However, if
an employee is not a new hire and newly eligible, a qualifying
event must have occurred to have the new member added
without penalty. This excludes groups with an open enrollment
period. |
Q: |
How will a service be covered? |
A: |
In order to
best determine coverage provided for a service, specific
information is necessary since many procedures and drugs
have subtleties. For example, if the strength of the drug
or a CPT code (procedure code from the provider) is provided,
a more accurate answer can be given. |
Q: |
Do I have
to send enrollment/change forms to The Cason Group? |
A: |
It's up to you.
We will be glad to forward the forms to the appropriate
carrier and keep a fax confirmation on record for five
years past a group termination. Or if you choose to send
it to the carrier yourself, be sure to keep a dated fax
confirmation. |
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