Producer guide - IHC Health Solutions

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Table of ContentsImportant Addresses and Phone Numbers 2Communicating for America, Inc 3Eligibility of ApplicantsIssue Ages for Individual or Family Coverage 3Issue Ages for Child(ren) Only Coverage 3Adopted Children 3Legal Custody 3Resident State 4Foreign Nationals 4Overseas Travelers 4Medicare Eligible Individuals 4Restricted Occupations 4Underwriting GuidelinesMedical Underwriting Sources 5Height and Weight Guidelines 6-7Preferred Rating 7Co-Morbidity Factor 8Expectant Parenthood 8Disabled Applicants 8Unacceptable Health Conditions 8Pre-Screening 9Term Life Insurance Underwriting Guidelines 9Submitting an ApplicationChecklist for New Applicant 9-10Application Withdrawals 10Pre-Existing ConditionsPre-Existing Conditions 10Full Disclosure of Health Conditions 10Pre-Existing Credit 10HIPPA Eligible Individual 10-11Underwriting DecisionsIssued as Applied 11Exclusionary Riders 111Empowered Underwriting Matrix 12-14Rating 14Higher Deductible 14Decline 14Requirements to PlacePending Requirements 15Exclusionary Riders 15Premium Rating 15Producer Kit/Delivery Certificate 15Effective Dates and BillingEffective Dates 15Billing Date 15Billing Mode Options 15Commissions 15After the SaleInforce Certificate Changes 16-17Medical Claim Review 18Rescission or Reformation of Coverage 18Reinstatement of Coverage 18Continuation 18Turning Age 65 – Medicare Eligibility 181
This guide was designed for the Companion Life Insurance Company’s individually sold health plans made availablethrough IHC Health Solutions and administered by Insurers Administrative Corporation (IAC). It contains importantinformation about new business processing and underwriting guidelines to assist the sales representative in determiningthe eligibility of prospects and applicants. By following these procedures and guidelines, you will help facilitate theprompt review, processing and issuance of your health cases. Throughout this guide, producers will be referred to as“you,” IAC will be referred to as “us” and Companion Life will be referred to as “the company.”Nothing in this guide is intended to guarantee that the described underwriting practices apply in all circumstances. Thecompany’s actual underwriting practices in effect at the time an application is reviewed will apply to the processing andunderwriting of new business.Important Addresses and Phone NumbersInsurers Administrative CorporationUnderwriting Administration and Billing Claims (PPO claims use the address on ID card)1173 W. Main St. Ste. E PO Box 37457 P.O. Box 828Whitewater, WI 53190 Phoenix, AZ 85069-7457 Park Ridge, IL 60068-0828Phone: 866-472-6555 Phone: 800-887-1480 Phone: 877-519-4972Fax: 602-674-9015 Fax: 602-906-4745 Fax: 602-395-0496UW E-mail: Administration E-mail: Claims E-mail:UWind_Wisconsin@iacusa.com admin@iacusa.comCAclaims@iacusa.comWeb site: http://thinkihc.iacusa.comFor information on Communicating for America, Inc. contact:Communicating for America, Inc. (CA)112 E Lincoln Ave.Fergus Falls, MN 56537Phone: 800-432-3276Fax: 218-739-3832Web site: www.CommunicatingforAmerica.orgFor supplies and contracting contact:IHC Health Solutions – Fergus Falls110 E Lincoln Ave.Fergus Falls, MN 56537Phone: 800-576-7179Fax: 1-866-566-2711Forms and Supplies E-mail: supplies@cainc.org (or download from http://thinkihc.iacusa.com)Product Support E-mail: Patty.Strickland@thinkIHC.comFor product support, contest/promotional information, agency support and recruiting contact:IHC Health Solutions – Bloomington8009 34 th Ave. S., Suite 360Bloomington, MN 55425Phone: 866-746-6610Fax: 952-746-6611Product Support and Contest E-mail: Annie.Hauskins@thinkIHC.comRecruiting and Agency Support E-mail: John.Carlson@thinkIHC.com2
Page 4 and 5: Communicating for America, Inc.The
Page 6 and 7: In addition to the list of occupati
Page 8 and 9: Juvenile Build Table, Ages 14 and U
Page 10 and 11: Pre-ScreeningIf a client has a cond
Page 12 and 13: Underwriting DecisionsAfter review
Page 14 and 15: Empowered Underwriting Matrix, cont
Page 16 and 17: Underwriting Decisions, continued3.
Page 18 and 19: Type of ChangeIncrease DeductibleAd

Producer guide - IHC Health Solutions

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