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Update on Certificates of Creditable Coverage

May 15, 2014

Anthem sent out an article the week of May 12th that was somewhat unclear about the Certificates of Creditable Coverage (COCCs) that are called for by the Health Insurance Portability and Accountability Act (HIPAA). They hope this makes it clearer.

As of January 1, 2015, Anthem will no longer send COCCs to members when their coverage ends. Part of the Affordable Care Act (ACA or health care reform law) says that insurance companies cannot use pre-existing conditions as a reason to not give people insurance, so these COCCs are no longer needed. This applies to all grandfathered, non-grandfathered, and grandmothered fully-insured and self-funded (ASO) plans. It does not apply to Retiree plans, Medicare, Medicaid or stand-alone Specialty business. The rule to remove pre-existing waiting periods goes into place for groups and individuals with new and renewing dates in 2014.

In addition, COCCs should not be used as evidence of a qualifying event. Members should ask their employer for a letter on the employer's letterhead providing evidence relating to a qualifying event. Qualifying events can have other means of validation, such as birth certificates, divorce or separation decrees, marriage licenses, and so forth.

For questions about Certificates of Creditable Coverage, please ​contact a member of your beere&purves Sales Team - 888.722.3373.

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