BlueCross BlueShield coming to the USVI

My agency is one of the selected agencies appointed by Blue Cross Blue Shield of the VI. We have been actively presenting alternative BCBS group health insurance quotes to our existing business clients for the past few weeks and the rates are coming in cheaper than their current policies.

At this time Blue Cross Blue Shield of the VI is not offering individual health insurance coverage. However, in my meeting with Mr. Haedo the topic was discussed and may be a possibility in the future.

We can provide a group health insurance quotation through our website at www.InsuranceVI.com or call us at (340) 332-1579.

Carl Gotts
Gotts Insurance Associates
www.InsuranceVI.com

Carl, are these policies available in the States?

At this time Blue Cross Blue Shield of the VI is not offering individual health insurance coverage. However, in my meeting with Mr. Haedo the topic was discussed and may be a possibility in the future.

The article does say that individual policies aren't yet available but will be offered in the not too distant future. If the premiums are affordable this would be a tremendous boon for thousands of residents who are stuck without any kind of insurance.

Dear MS411,

Blue Cross Blue Shield differs from other insurance carriers you may be familiar with in that it is more like a franchise. That is why every Blue Cross Blue Shield you have ever heard of has a geographic designation attached to it. For example; BCBS of South Florida, Empire State BCBS, BCBS of the USVI, etc.

Mr. Haedo has the BCBS of the VI franchise, for lack of a better term. So to answer your question "Are these policies available in the states?" Yes, but they would be unrelated to the BCBS of the VI company we have here. Although there are usually reciprocal agreements between the BCBS affiliates should emergency treatments be necessary while you are off island and in another coverage area. The companies themselves are considered different and independent business entities.

Individual health insurance coverage still remains unavailable in the territory, but hopefully it will be a policy we can offer in the near future. Carl

How many employees to be considered a "group"

Pia

How many employees to be considered a "group"

Pia

The BCBS agent is quoted in the article as saying, "“I see a lot of employers who weren’t able to offer benefits that are now saying, ‘I want to do right by my employees,’“Haedo said. He said most small businesses are in the range of two to 10 employees."

Two or more full time employees, working 30 or more hours per week, are required.

In addition, there must be a 75% participation of all eligible employees. For example, if your company has ten full time employees, eight would have to participate.

However, if any of your staff members had verifiable coverage elsewhere, for example they were covered under their spouse's group health plan as a dependent or are over the age of 65 and covered under Medicare parts A & B, then they would be exempt and we would not need to include them in that equation.

The document generally submitted to the insurance carrier for verification is the VIESA Form or more commonly referred to as the Quarterly Wage & Tax Statement.

Carl. Can the staff member be married or related or are there restrictions on that?

Pre-existing conditions? Will coverage/ insurance be denied to those with specific pre-existing conditions such as autoimmune (SLE, MS etc) , oncological conditions, etc?

General pre-existing conditions such as cardiology, respiratory, etc.? BCBS's position regarding the host of generalized pre-existing conditions?

Carl, thanks for taking the time to answer our questions. It's good getting answers from a qualified professional. At some point, it would be interesting to me to see if eventually more people do become covered. I think expanded coverage will help the hospitals.

Dear kimd,
Yes, we can consider a husband and wife as the two employees as long as they meet the requirements I described previously. Both have to be full time employees working a minimum of 30 hours or more per week. This is usually where all of the husband and wife groups I insure start laughing hysterically because as independent business owners, they regularly work two to three times that number of hours each week.

Dear swans,
The rules on pre-existing conditions are changing with the passage of Health Care Reform. Currently insurance carriers cannot consider any pre-existing condition for dependent children under the age of 19 years old.

The Guaranteed Availability of Insurance Clause in the legislation for all insureds will be implemented on January 1, 2013.

This will require guaranteed issue and renewability of health insurance regardless of health status and allow rating variations based only on age, geographic area, family composition, and tobacco use in the individual and the small group market and the Exchanges.

To correct my post from yesterday where I mistyped 2013. The Guaranteed Availability of Insurance Clause of the Health Care Reform Law will be fully implemented on January 1, 2014 not 2013.

Dang, Carlstx. You really got my hopes up when I read the title. Since lack of individual health insurance is the only thing keeping us from becoming full-time residents now, is there anything we can do to help "persuade" them to offer that type of plan? I know there are others in the same boat we are. Or does it just come down to demographics and profitability?

HealthCare International offers individual healthcare insurance in the USVI. See this recent thread: https://www.vimovingcenter.com/talk/read.php?4,185065