From time to time you may come across a “Grandfathered” Tricare/CHAMPVA healthcare supplement plan initiated with ASI. Many of those policies will have an effective date prior to 2014, our acquisition of ASI, and/or have a premium not in our “rate plan” table. 

When both of those criteria exist, the caller will question the rates they see online, want the rates they see & request a refund. 

When that happens please follow these steps. 

• Explain the new policy can be created.
• Explain the new business rates based on age and the rate increase policy.

·Explain deductibles. 

• Explain you are going to email the application and please ask the member/insured to write across the top of the application “Switching from current P000XXXXXX”. When we receive the application, we will start the termination/re-key process. Please refer to your “Duties” job aid. 
• Explain a new P number and welcome package will be sent to the member. 
• Explain their policy was acquired from ASI, and those policies are grandfather under the certificate language as well as rates.

Pre-ex is not waived for members who re-enroll to avoid the higher premium cost of their current supplement plan. A new Emerge number must be assigned so that pre-ex will apply to the new record. (Continue on next page)

• Pre-ex is not waived for Corporate members who switch to a Retail plan. A new Emerge number must be assigned so that pre-ex will apply to the new record.

Refunds will not be given. The policy the member/insured enrolled in has the correct rates and we maintained those rates. As the new administrator, we did create New Business Rates for new members/insureds.

Grandfathered policies do not exist any longer. If the policy is switched to our new business the insured can not go back to the old Comprehensive plans.