It appears that there are quite a lot of Anthem Blue Cross CA Subscribers who are eligible for both Serencsa and Feller-Freed settlement options. Because this is causing quite a bit of confusion and because it is very important not to use these settlement options out of order, I wanted to clarify things for those who are dual-eligible for both Serencsa and Feller-Freed.
As always, if you have questions or need assistance contact your personal Anthem Blue Cross agent/broker first. If you don't know who your agent/broker is, you can contact Anthem Blue Cross membership at 800-333-0912 and they will tell you who your agent is and how to get hold of him/her. Those who are house accounts (direct sale) and wish to work with me need to provide me with an Agent of Record change request letter (I can send the text) before we initiate any plan changes.
How is a subscriber eligible for both Serencsa and Feller-Freed at the same time?
Some subscribers have dual eligibility for both the Serencsa and Feller-Freed settlements. This happened to anyone who was on one of the four closed PPO Share plans in September, 2009 (500 Share, 1000 Share, 1500 Share, 2500 Share). Any Anthem subscriber who was on one of the four Share PPO plans at that time is eligible under the Feller-Freed Settlement.
When those plans closed, many subscribers moved to open PPO plans registered with the CDI (CA Dept of Insurance). SmartSense seems to have been the most popular as well as the PPO Share 5000 CDI-registered version. Any subscriber who received Feller-Freed eligibility and subsequently moved to a CDI-registered PPO plan between September 2009 and September 23. 2010 also became eligible for the Serencsa-Lichtman Settlement benefit. Serencsa settlement beneficiaries are those who were enrolled in CDI-registered PPO plans with Anthem Blue Cross on or prior to September 23, 2010 and are still enrolled in the closed plan.
Simply put:
*I was on one of the four Share PPO plans in September 2009 = Feller-Freed
*I moved to an open CDI PPO Plan after the Share Plan closed but before 9/23/2010 = Serencsa
If I am eligible for both Serencsa and Feller-Freed, what are my options to change plans?
The key is to make sure that you use the most appropriate settlement option for plan changes and in the proper order. Under Serencsa, you can move to any open CDI-registered PPO plan currently sold to the public. These are generally denoted as "plus" plans (i.e., SmartSense Plus or Clear Protection Plus). Feller-Freed settlement beneficiaries have a different set of plan options which limit to specific plans (20 total) to which the Feller beneficiary may move. These plan change options are made without medical underwriting.
If you are eligible for both Serencsa and Feller-Freed it is best to exercise your plan change option under Serencsa BEFORE you exercise a change option under Feller-Freed. If you use Feller-Freed first, you lose your Serencsa settlement option. If you use your Serencsa first, you maintain your Feller-Freed option which can be used at any subsequent Feller-Freed Open Enrollment period to make a further plan change if desired, again with no medical underwriting.
I hope that this post helps to clarify a confusing situation for you. Being eligible for both Serencsa and Feller-Freed has implications in terms of which settlement option is best or may void the other settlement option right to change plans. As always, plan changes under either Serencsa or Feller-Freed will change status for those currently on Grandfathered plans to non-Grandfathered status.
Dave
www.an-insurance.com
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