Colorado Child-Only Health Coverage

PW_E169355
Qualified applicants under the age of nineteen are accepted on a guarantee issue basis without any limitations or riders based on health status. A carrier may deny coverage to an applicant for enrollment in a child-only plan if other creditable coverage is available, which can include current enrollment in a high-risk pool plan. Other eligibility requirements may also apply. For Child-Only applicants under age nineteen we are offering the SmartSense Plus Child-Only 2500 Standard Rx (0H69) product. Applicants should apply separately using the Colorado Child-Only Application (COCHOAPP) during either an Open Enrollment period or upon a Qualifying Event. 
 
Open Enrollment 
Open Enrollment periods occur every January 1-31 and July 1-31, followed by a 30-day waiting period with a policy effective date of March 1st or August 31st. Applications must be received during the Open Enrollment period. 
Anthem must receive the application by 3 pm MT (5 pm ET) the last day of the Open Enrollment period. 
 
Qualifying Events 
Applications will be processed for Child-Only plans if Anthem receives the application within 30 days of a qualifying event listed below. Coverage can start on any day of the month after the date we receive the application for a qualifying event. The requested effective date is not a guarantee that the effective date will be the requested date in the event we agree to provide coverage. 
Qualifying events include: 
Lost employer-sponsored health insurance;
Lost eligibility under the Colorado Medical Assistance Act or the Children’s Basic Health Plan;
Involuntarily loss of other existing coverage for any reason other than fraud, misrepresentation or failure to pay premium;
Marriage or dissolution of marriage;
Entry of a valid court or administrative order mandating the child be covered; or
Birth or adoption.
 
The birth month of a child is not a qualifying event. 
 
New Rating Tier: 
Child-Only policies are guarantee issue but are medically underwritten for assignment of correct medical risk tier. We have added a Level 1+200 rate tier in support of the Child-Only policy. 
 
Product Information 
Colorado Child Only Open Enrollment 1/1/2012
SmartSense Plus Child-Only 2500 Standard Rx - Brochure
 
How to Apply 
1. View, print, and complete the CO Individual Child-Only Enrollment Application. If you are working with a Broker, please make sure you enter the Broker information on your application. 
2. Mail or fax your completed application to: 

Anthem Blue Cross and Blue Shield
P.O. Box 9041
Oxnard, CA 93031-9041

3. Or fax to: 1-800-327-9255 
 
Applications should be completed separately for each child within a family.  
Information about additional public programs administered by the Department of Health Care Policy and Financing 
 

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Anthem Blue Cross and Blue Shield is the trade name of: In Colorado Rocky Mountain Hospital and Medical Service, Inc. HMO products underwritten by HMO Colorado, Inc. In Connecticut: Anthem Health Plans, Inc. In Indiana: Anthem Insurance Companies, Inc. In Kentucky: Anthem Health Plans of Kentucky, Inc. In Maine: Anthem Health Plans of Maine, Inc. In Missouri (excluding 30 counties in the Kansas City area): RightCHOICE® Managed Care, Inc. (RIT), Healthy Alliance® Life Insurance Company (HALIC), and HMO Missouri, Inc. RIT and certain affiliates administer non-HMO benefits underwritten by HALIC and HMO benefits underwritten by HMO Missouri, Inc. RIT and certain affiliates only provide administrative services for self-funded plans and do not underwrite benefits. In Nevada: Rocky Mountain Hospital and Medical Service, Inc. HMO products underwritten by HMO Colorado, Inc., dba HMO Nevada. In New Hampshire: Anthem Health Plans of New Hampshire, Inc. In Ohio: Community Insurance Com pany. In Virginia: Anthem Health Plans of Virginia, Inc. trades as Anthem Blue Cross and Blue Shield in Virginia, and its service area is all of Virginia except for the City of Fairfax, the Town of Vienna, and the area east of State Route 123. In Wisconsin: Blue Cross Blue Shield of Wisconsin ("BCBSWi"), which underwrites or administers the PPO and indemnity policies; Compcare Health Services Insurance Corporation ("Compcare"), which underwrites or administers the HMO policies; and Compcare and BCBSWi collectively, which underwrite or administer the POS policies. Independent licensees of the Blue Cross and Blue Shield Association. ® ANTHEM is a registered trademark of Anthem Insurance Companies, Inc. The Blue Cross and Blue Shield names and symbols are registered marks of the Blue Cross and Blue Shield Association. Use of the Anthem Web sites constitutes your agreement with our Terms of Use