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Compete and Complete Plus are changing

Pre-existing condition clause dropped from limited-duration health plans

Meeting our members’ needs is a core part of Arkansas Blue Cross and Blue Shield’s mission. And the COVID-19 public health emergency has highlighted a need for greater flexibility on limited-duration coverage, in particular.

So, effective April 1, 2020, the pre-existing condition clause has been removed from all Complete and Complete Plus limited-duration individual health plans.

Claims with dates of service of April 1, 2020, or later will no longer be excluded due to a pre-existing condition. Here are a couple of key things to remember about this change:

  • It will not impact rates.
  • It does not apply to our short-term individual health plans.

The brochure for our limited-duration plans has been updated and can be found here: http://news.arkansasbluecross.com/docs/librariesprovider4/agent-news-posts/9382-2020-limited-duration-bro-ag.pdf

You can use this listed of anticipated questions and responses when visiting with clients/prospects about this change:

  1. What changes have been made to Complete and Complete Plus plans?

    Pre-existing condition exclusions will be removed from all Complete and Complete Plus plans – both for existing and new members. This means we will not deny claims for services received for a pre-existing condition.

  2. When does the change take place?

    The change is effective April 1, 2020. (Any services on or after this date will not be excluded due to a pre-existing condition.)

  3. Why are the changes to pre-existing conditions happening in April?

    As our Complete and Complete Plus plans have increased in popularity, we wanted to improve the benefits both for our existing and new members.

  4. Will claims previously denied due to pre-existing conditions be reversed?

    No. Services for pre-existing conditions will only be covered beginning April 1, 2020. We will not reverse previously denied claims due to pre-existing conditions if the date of service was before April 1, 2020.

  5. Why won’t previously denied claims related to pre-existing conditions be covered?

All benefit changes must be accomplished through policy amendments that are filed with Arkansas Insurance Department. Any changes, generally speaking, must be made for a future date.

Questions? Please contact your Individual Products representative.