How to Tell What Plan the Member has in InsPro

Use the last two digits of the Transamerica InsPro Base Plan code and this chart to determine which product the member has. 

NOTE: Under Hartford, we use the group plan (AGP-XXXX) and the Tricare Plan Type Job Aid. Match the codes on the Coverage Tab.

 The chart has both, Transamerica’s Base Plan number and Hartford’s Plan number.

However, please note that some insureds who appear to be on a TRICARE Supplement are “treat as CHAMPVA” because they signed up for the CHAMPVA Supplement with ASI before ASI had a specific certificate or plan design for CHAMPVA Supplement. Currently, to see if someone truly has CHAMPVA as the primary, you will need to …

 

  • o    Go to Imagenow
  • o    Find any claim
  • o    View the claim information
  • o    If the EOB came from CHAMPVA, it’s really a CHAMPVA policy and not TRICARE Supplement

 

To determine the association name (When Transamerica is the carrier) connected to the policy, view the Reporting Sub-Category field of the Policy Overview screen. Every policy record has an association affiliation, even if the group is a Corporate group.

 To determine which children are actively covered, you cannot rely solely on the Interested Parties tab. You must take a look at several things:

 

  1. Click on the Child Coverage Details button at the bottom of the Interested Parties tab. This screen may tell you the effective date and termination date for each child. See P000998490 as an example.
  2. Look at the covered person code on the Coverage Summary Tab. If all children have been removed, you should be able to tell.
  3. The coverage status in Emerge (1051232) for each child. This is probably the best method.
  4. Read the InsPro memos to see if a child has been removed.


Note: These insureds used to be marked as CHAMPVA on the Coverage Detail Part II screen in InsPro. To see this screen, click on the Coverage Tab > Coverage Detail > click on the link > click on the tab for Coverage Detail Part II. See P000641865 as an example. However, this indication is not currently showing up in InsPro. Additionally, the indicator that formerly showed up in Emerge no longer shows up there. Claims is working with IT to have this corrected.

Was this article helpful?