| Individual |
| When can the applicant have the policy effective? |
| When can I cancel a policy?
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| Is this policy still active? |
| If a father/mother who lives in Iowa needs to provide coverage for their child who lives out of state, is the child eligible? |
| Does the applicant have to send in premium with the application? |
| Who is eligible for a HIPIowa state mandate policy?
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| How do I remove a dependent/spouse? |
| How do I add a dependent/spouse? |
| How much is the monthly premium? |
| Can I fax in a copy of the app to speed up the process?
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| What is Medicare? |
| When should someone purchase Medicare supplement coverage |
| Is there a waiting period for pre-existing conditions with Medicare supplement plans? |
| What happens if the insured is out of Iowa and needs medical treatment? |
| What is medical underwriting?
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| What is the status of an application? |
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| Individual |
| Question: When can the applicant have the policy effective?
Answer: The day after the application is signed (as long as they don’t have a current Wellmark policy in force), up to sixty (60) days from the signature date (i.e. application is signed August 23rd, they can have it effective October 23rd). If the individual currently has a policy with Wellmark, the policy would take effect the 1st of the month following the signature date (i.e. application is signed August 15th, September 1st would be the effective date) |
| Question: When can I cancel a policy?
Answer: A policy must be cancelled on the first of the month following the signed, written notice (i.e. Receive request to cancel August 8th, the effective date of cancellation would be September 1st)
i. If proof of group coverage, Wellmark will honor an odd cancel date if that is when the group coverage starts.
ii. To cancel for the next month, notice must be into Wellmark no later than the last day of the month prior (i.e. Want cancellation to be effective September 1st; request must be in by August 31st).
If the cancellation request is received after the requested cancel date, there must be proof of group coverage. An individual has forty-five (45) days from the requested cancel date to prove group coverage (i.e. If individual wants a cancellation effective date of September 1st, they have until October 15th to prove group coverage was effective September 1). |
| Question: Is this policy still active?
Answer: You need to call GBL at (515) 453-8207 ext. 408 or (800) 640-7382 ext. 408 and provide the policy holders SSN. We will be able to tell you if this policy is still active or if it’s to late to have the policy reinstated. If it’s not to late, GBL will provide you the necessary information in order to reinstate the policy. Wellmark usually requires two months worth of premium. |
| Question: If a father/mother who lives in Iowa needs to provide coverage for their child who lives out of state, is the child eligible?
Answer: If the child’s permanent address is not considered Iowa, than the answer is no. If the dependent is a student whose permanent address is still considered Iowa, then they are eligible, but they must sign the application and the address listed on the application must be their Iowa address. |
| Question: Does the applicant have to send in premium with the application?
Answer: If it is a Wellmark direct pay application or a med supp app, they Don’t need to send in any money. If it is a short term app, they must send a check for at least one month worth of premium along with the application. |
| Question: Who is eligible for a HIPIowa state mandate policy?
Answer: There are several factors that can make someone eligible for the HIPIowa plan. Please refer to page 2 of the application or you can call GBL @ (515) 453-8207 ext 408 or (800) 640-7382 ext 408 for further clarification. |
| Question: How do I remove a dependent/spouse?
Answer: In order to remove a dependent or spouse an application must be completely filled out, excluding the health questions. If the individual being removed is the applicant, there must be a qualifying event for them to be removed (i.e. group coverage, Medicare eligibility, divorce, etc.) |
| Question: How do I add a dependent/spouse?
Answer: If it is a qualifying event, they have thirty-one (31) days to add them to the plan from the date of the event without going through underwriting (i.e. marriage, birth, change in dependent status, etc). If it is not a qualifying event, then they have to answer health questions (i.e. loss of coverage, moving from coverage area, etc) |
| Question: How much is the monthly premium?
Answer: The premium is almost always what is listed in the premium book; the only exception is if a rate up is applied. A rate up occurs with weight and/or high blood pressure situations and is only applied to the person being given the rate up. You can call GBL at (515) 453-8207 ext 408 or (800) 640-7382 ext 408, give us the policy holders SSN and we will look it up for you. |
| Question: Can I fax in a copy of the app to speed up the process?
Answer: No – Wellmark will not accept a faxed coy of an individual application unless it was mailed over one week ago and they still haven’t received it. If this happens, GBL will fax a copy with the name of the Wellmark representative that Okayed it. |
| Question: What is Medicare?
Answer: Medicare is a federal health insurance program for people age 65 or older, people of any age with permanent kidney failure and certain disable people under age 65. There are two parts of Medicare; Part A (hospital insurance) and Part B (medical insurance). |
| Question: When should someone purchase Medicare supplement coverage
Answer: State and federal law guarantee individuals are eligible to purchase any Medicare supplement plan they wish, regardless of their health condition, if they do so during a six month guaranteed enrollment period. This period begins the first day of the month they are age 65 and enrolled in Medicare Part B (medical insurance). It is a good idea to purchase Medicare supplement coverage during this guaranteed period. |
| Question: Is there a waiting period for pre-existing conditions with Medicare supplement plans?
Answer: With some insurance companies, they can wait up to six months before their Medicare supplement plans cover pre-existing health conditions. With Wellmark Blue Cross and Blue Shield of Iowa Senior Blue coverage, they are covered immediately – their benefits begin on the first day of coverage, including inpatient care. |
| Question: What happens if the insured is out of Iowa and needs medical treatment?
Answer: They can visit a Blue Cross and Blue Shield provider anywhere in the United States. The claim will be sent to the Blue Cross and Blue Shield plan where they received services and are paid through the Bluecard program. The client can obtain a list of participating providers by calling 1-800-810-2583 or by visiting www.bcbs.com. |
| Question: What is medical underwriting?
Answer: Medical underwriting is the process of a trained professional reviewing the client’s and/or client’s family’s health history; an underwriter may need to ask them to obtain additional medical records. Once all the necessary medical information is received, they will be notified of Wellmark’s decision to either (1) accept the application, (2) accept the application if they agree to sign a condition amendment(s) or pay substantial rates or (3) deny the application based on certain medial conditions and/or failure to return needed documentation.
*If the health of anyone on the application changes between the date you sign the application and the date the coverage goes into effect, Wellmark Blue Cross and Blue Shields underwriting department needs to be notified in writing.
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| Question: What is the status of an application?
Answer: Check the wellmark website, www.wellmark.com, under the agent/broker corner or call GBL @ (515) 453-8702 or (800) 640-7382 (you will need the social security number of the individual you are calling about) |
