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Group Coverage @ Anthem Life
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Employee Changes

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Processing employee changes
Every request for change (including adding or deleting dependents) should include the employee’s social security number. If a new application is necessary, the Employer/Group section of the application form should always be completed. This section is intended to assist the employer in identifying requirements and the billing impact associated with frequently requested employee changes.  
 
This section includes:
When an Employee Changes Coverage
When an Employee Drops Coverage
When an Employee Leaves the Group
When an Employee Dies
When an Employee Reaches the End of the Continuation of Coverage Period
When an Employee’s Insurance Amount Changes Due to Change in Salary or Class
When an Employee Wants to Change Beneficiary
When an Employee Marries
When an Employee Adds Dependent Coverage
When an Employee Loses Spouse/Dependent(s) Because of Death
When an Employee Loses Spouse/Dependent(s) Because of Divorce
 
When an employee changes coverage
Submit a new application showing any changes requested. In most cases, changes will become effective on the first billing due date after we receive the request, subject to any required underwriting approval.  
 
When an employee drops coverage
Check the Adjustment Box on the group billing statement, list the effective date, and use reason code “3” for Dropping Benefits.  
 
When an employee leaves the group
Check the Adjustment Box on the group billing statement, list the last day worked as the effective date and use reason code “1” for Left Employment. Notify the employee of his/her conversion right.  
 
When an employee dies
Check the Adjustment Box on the group billing statement, list the date of death as the effective date, and use reason code “4” for Deceased. If the employee had covered dependents at the time of death, notify the dependents of their life insurance conversion right.  
 
When an employee reaches the end of the continuation of coverage period
When an employee reaches the end of the continuation of coverage period, report the employee as terminated by checking the Adjustment Box on the group billing statement. List the effective date and the appropriate reason code for the termination.  
 
When an employee’s insurance amount changes due to a change in salary or class
When an employee’s life insurance or short term disability insurance amount changes due to a change in salary, class or occupation, the change should be reported by checking the Adjustment Box on the group billing statement. List the effective date, the appropriate reason code, and the information that is changing.  
 
When an employee wants to change a beneficiary
If an employee wishes to change their beneficiary designation, they should complete an Anthem Life Beneficiary Designation Form. Check to make certain that the form is signed and dated. The employer should keep that form or a copy of the form in the employee’s personnel file.  
 
When an employee marries
If the insurance program includes group term life insurance for dependents, an employee who is planning to marry should apply to add the spouse or any new dependent children to their coverage. The employee should complete and sign the application form within 31 days of the marriage date. If the application for dependent life coverage is received more than 31 days after the marriage date, the spouse and/or any dependents must submit evidence of insurability unless the dependent life coverage is non-contributory (employer pays the entire premium).  
 
When an employee adds dependent coverage
If an employee wishes to add dependent coverage, the employee must submit an application form requesting that change, listing all eligible dependents.  
Application for dependent coverage should be made within 31 days after the employee acquires eligible dependents by marriage or a child’s birth or adoption. Otherwise, coverage will be subject to evidence of insurability.  
For Agency Adoptions, the adoption date is the date of adoptive placement as specified in the placement agreement.  
For Independent Adoptions, the adoption date is the later of the date the child is placed in the physical custody of the employee or the date the petition is filed for adoption with the probate court.  
 
When an employee loses spouse/dependent(s) because of death
A death claim should be filed immediately. If the employee does not have any other eligible dependents at the time of the dependent’s death, the employee should cancel dependent coverage by submitting an application form requesting that change. The change will be reflected on the next billing date after we receive the request for cancellation.  
 
When an employee loses spouse/dependent(s) because of divorce
If an employee has covered dependents, please notify Anthem Life immediately in the event of a divorce. Upon divorce, the former spouse is no longer eligible for coverage. If the employee does not have any other eligible dependents to be covered, the employee should cancel dependent coverage by submitting an application form requesting that change. The change will be reflected on the next billing date after we receive the request for cancellation.  
 
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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