Effective Dates from October 1, 2010 forward
Those who submit, or have postmarked, an application and payment between the 1st and 15th of any given month will be assigned an effective date of the 1st of the following month. For example, if an applicant sends in the application and payment on October 12, 2010, the earliest effective date they can have is November 1, 2010.
Those who submit or have postmarked an application and payment after the 15th of the month, will be assigned an effective date of the 1st of the second following month. For example, if an applicant has the application and payment postmarked on October 25, 2010, the earliest effective date they can have December 1, 2010.
Please note: The applicant's option to request an effective date was removed from the application. We recommend applicants apply 30-60 days before the end of coverage to avoid a lapse in coverage.
Is this where such restrictive working came from?
See also Small Group AB 1672
Anthem has a newer rule regarding HIPAA start dates when the application is rolled over from a decline through underwriting.
The new rule is that the premium authorization for the underwritten application must be authorized verbally or in writing to be applied to the HIPAA rollover, it?s not automatic anymore.
The bigger issue is that when the app rolls over from decline to HIPAA, Anthem no longer allows the premium date of the original application to count towards the premium submission for the HIPAA rollover. As an example, someone borderline HIPAA with COBRA expiration of 10/31 applying 10/5 for Smart Sense and declined 10/15 the rollover would be after 10/15 so even if the premium rollover is authorized by note or letter, the open of the HIPAA app is considered after 10/15 and thus the start date is pushed to 12/1 and they gap a month. There is no workaround for this situation.
If the COBRA expiration is closer than 60 days and they are a possible decline and HIPAA, I believe it best with Anthem at this point to write it HIPAA first then try underwriting later.
My RSM told me yesterday that this has been an unannounced procedure for well over six months. But he also told me that you could preserve the premium submission date by adding a note in the additional comments section of the online app or with a paper application indicating that it is OK to use the same premium payment method for HIPAA.
Today, Support told me that was not true and that the HIPAA rollover application would only be considered ?received? when the HIPAA unit opens the HIPAA app (new ID #). That is the point where the premium rollover authorization from the original IFP app gets date-credited.
It used to be lock in from the date of the IFP application including credit for premium submitted but Support told me they changed it Sept 2010.
From a friendly competitor
Click on image to enlarge
Blue Cross HIPAA Brochure
Please note that premium or authorization, sent in with a standard application, does NOT count for HIPAA!
Sample request for HIPAA payment
More detail on effective dates
To try to insure there is no lapse in coverage the client will need to obtain all required documents prior to the end date of their current coverage. Blue Cross email dated 6/1/2010
Evidence of Coverage EOC
hmo saver
select hmo 25
basic ppo 1000
ppo share 5000
PPO Share $1,500
Addendum
        
Blue Cross information on DMHC Website
Evidence of Coverage
effective date
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