Use the last two digits of the InsPro Base Plan code and this chart ( product look up tool) to determine which product the member has. You will find the product look up tool in the Tricare Shortcuts located on your desktop.
NOTE: Under Hartford, we use the group plan (AGP-XXX) along with the Tricare plan type located on the coverage tab.
The chart has both, Transamerica’s Base Plan number and Hartford’s Plan number.
InsPro Plan Number |
Product Name |
Supplemental Deductible |
Primary Deductible Covered |
Catastrophic Cap |
Excess Charges Covered |
Notes |
02/5926 (HTF) |
$0 |
$0 |
$1000 |
100% |
If VFW, see VFW section of chart. |
|
04/5925 (HTF) |
Retail Prime A or B (No Prime A under Hartford) |
$0 |
$0 |
$3000 |
0% |
|
06/5925 (HTF) |
Retail Prime A or B (No Prime A under Hartford |
$0 |
$0 |
$3000 |
0% |
If VFW, see VFW section of chart. |
07/5925 (HTF) |
Retail Prime A or B (No Prime A under Hartford |
$0 |
$0 |
$3000 |
0% |
If VFW, see VFW section of chart. |
17/5943 (HTF) |
$0 |
$150 |
$3000 |
100% |
||
18/5943 (HTF) |
$0 |
$150 |
$3000 |
100% |
||
19/5943 (HTF) |
$0 |
$150 |
$3000 |
100% |
||
22, client ID 0001755/5946 (HTF) |
$0 |
$75 |
$3000 |
100% |
Corporate policy sold in error to some Retail insureds by Mike Collins during the fourth quarter of 2015. |
|
23/5946 (HTF) |
$0 |
$75 |
$3000 |
100% |
Corporate policy sold in error to some Retail insureds by Mike Collins during the fourth quarter of 2015. |
|
26/5942 (HTF) |
$100 |
$150 |
$3000 |
100% |
||
28/5944 (HTF) |
$100 |
$75 |
$3000 |
100% |
||
29/5944 (HTF) |
$100 |
$75 |
$3000 |
100% |
||
31/5944 (HTF) |
$100 |
$75 |
$3000 |
100% |
||
33/5928 (HTF) |
$150 |
$0 |
$3000 |
0% |
||
34/5928 (HTF) |
$150 |
$0 |
$3000 |
0% |
||
35/5925 (HTF) |
$150 |
$50* |
$3000 |
80% |
*TC Ded Credit |
|
36/59250 (HTF) |
$150 |
$50* |
$3000 |
80% |
*TC Ded Credit |
|
37/5928 (HTF) |
$250 |
$0 |
$3000 |
0% |
||
38/5928 (HTF) |
$250 |
$0 |
$3000 |
0% |
||
39/5925 (HTF) |
$250 |
$0 |
$3000 |
100% |
||
41/5925 (HTF) |
$250 |
$0 |
$3000 |
100% |
||
42/5925 (HTF) |
$250 |
$0 |
$3000 |
100% |
||
43/5925 (HTF) |
$250 |
$0 |
$3000 |
100% |
||
46/5925 (HTF) |
$250 |
$150* |
$3000 |
100% |
*TC Ded Credit |
|
47/5925 (HTF) |
$300 |
$150* |
$3000 |
0% |
*TC Ded Credit |
|
48/5950 (HTF) |
$300 |
$150* |
$3000 |
0% |
*TC Ded Credit |
|
49/5927 (HTF) |
$75 |
$0 |
$3000 |
100% |
||
50/5927 (HTF) |
$75 |
$0 |
$3000 |
100% |
||
51/5927 (HTF) |
$75 |
$0 |
$3000 |
100% |
||
52/5927 (HTF) |
$75 |
$0 |
$3000 |
100% |
||
53/5925 (HTF) |
$250 |
$0 |
$3000 |
100% |
||
54/5925 (HTF) |
$250 |
$0 |
$3000 |
100% |
||
55/5926 (HTF) |
$0 |
$0 |
$1000 |
100% |
||
VFW 01/5935 (HTF) |
$350 |
$150 |
$3000 |
100% |
VFW Only |
|
VFW 02/5935 (HTF) |
$150 |
$0 |
$3000 |
100% |
VFW Only |
|
VFW 05/5933 (HTF) |
$0 |
$0 |
$1000 |
100% |
VFW Only |
|
VFW 06/5934 (HTF) |
$200 |
$0 |
$3000 |
100% |
VFW Only |
|
VFW 07/5935 (HTF) |
$0 |
$0 |
$3000 |
100% |
VFW Only |
Continued below …
InsPro Plan Number |
Product Name |
Supplemental Deductible |
Primary Deductible Covered |
Catastrophic Cap |
Excess Charges Covered |
Notes |
AGP5951 (HTF) |
(WA EEs alternate to 782) |
$100 |
$150 |
$3000 |
100% |
|
AGP-5952 (HTF) |
(WA EEs alternate to 783) |
$0 |
$150 |
$3000 |
100% |
|
AGP-5951 (HTF) |
(WA EEs alternate to 784) |
$100 |
$150 |
$3000 |
100% |
|
03 |
Unknown |
$0 |
$0 |
$1000 |
0% |
|
08 |
Unknown |
$0 |
$0 |
$3000 |
100% |
|
09 |
Unknown |
$0 |
$0 |
$3000 |
100% |
|
11 |
Unknown |
$0 |
$0 |
$3000 |
100% |
|
13 |
Unknown |
$0 |
$0 |
$3000 |
100% |
|
14 |
Unknown |
$0 |
$0 |
$3000 |
80% |
|
15 |
Unknown |
$0 |
$0 |
$3000 |
80% |
|
16 |
Unknown |
$0 |
$150 |
$3000 |
0% |
|
20 |
Unknown |
$0 |
$50 |
$1000 |
100% |
|
21 |
Unknown |
$0 |
$50 |
$3000 |
100% |
|
25 |
Unknown |
$0 |
$0 |
$3000 |
100% |
|
56 |
Unknown |
$0 |
$50 |
$1000 |
80% |
|
57 |
Unknown |
$1000 |
$0 |
$3000 |
100% |
|
58 |
Unknown |
$200 |
$0 |
$3000 |
100% |
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 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:
- 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 P000649903 & P000902751 as an example. Warning: This button does not always give you the information you need.
- Look at the covered person code on the Coverage Summary Tab. If all children have been removed, you should be able to tell.
- The coverage status in Emerge for each child. This is probably the best method.
- 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.