IBC Flash

December 26, 2007

Announcing New Field Underwriting Guidelines for Individual HMO

We’re writing to inform you that the new Field Underwriting Guide is now available. The field guide is a reference tool designed to assist you with the application process for our Individual Medically Underwritten Products. It provides you with a range of potential decisions based on the presence or history of the more common medical conditions seen in underwriting. 

It is not a comprehensive list of all medical conditions or histories that applicants may have. Numerous factors can influence the final underwriting decision, and IBC reserves the right to request additional information, assign the final Contract Risk Category, or decline coverage.

The guide provides you with the possible underwriting outcomes for the following categories:

• Contract Risk Category (CRC) 1 (standard risk)

• Contract Risk Category (CRC) 3 (substandard 1)

• Contract Risk Category (CRC) 5 (substandard 2)

These categories represent the possible final risk assessment for an individual.  If a member is applying for a family contract, a husband/wife contract, or a parent/child contract, the final category may fall anywhere within the five Contract Risk Categories. 

Download the Field Underwriting Guide.

The Field Underwriting Guide can also be found in the Individual Broker’s Tool Kit available through ROAM.

Independence Blue Cross offers products directly, through its subsidiaries Keystone Health Plan East and QCC Insurance Company, and with Highmark Blue Shield. Independent licensees of the Blue Cross and Blue Shield Association.