FAQ for Individual HMO Rate Increase
Below are some answers to frequently asked questions about the recently approved rate increase for the Individual medically underwritten HMO plans. We also have provided information about age brackets and alternative plan options. Click on a topic below to view a list of related questions.
If you have any other questions, please contact us at 1-888-249-2118.
- About the Rate Increase
- About Age Brackets
- About Alternative Medically Underwritten Individual Plan Options
- Billing Questions
- What Happens If You Select a New Plan
About the Rate Increase
About Age Brackets
About Alternative Medically Underwritten Individual Plan Options
- Does IBC offer any other plan options for me?
- What action do I need to take if I want to continue my current plan at the new rate?
- How do I change my current coverage to a lower-cost program?
- If I select a lower-cost plan option, do I need to submit a questionnaire with my health history?
- I’m interested in a plan that offers a higher level of benefits than my current coverage. What steps do I take?
- Are my dependents eligible for coverage under my plan, and, if so, what do I need to do to add them to my policy?
Billing Questions
- Will my next bill reflect my new rate?
- I submitted my Plan Change Request Form, but my bill does not reflect the updated rate. What amount should I pay?
- My latest bill does not reflect my recent plan choice submission. Why?
- I pay my bill quarterly. How is that affected by this change?
- Is there a grace period for payment because of the higher rates?
- What happens if I do not pay my bill?
- How does the change to the new plan affect my ZipCheck payment?
- How does the change to the new plan affect my ACH payment?
What Happens If You Select a New Plan
- When will my coverage and bill change?
- When will I receive my new ID card?
- When will I receive my new contract?
About the Rate Increase
Why are my rates changing?
We carefully consider all options before increasing premiums. However, as the cost of medical care continues to increase, premiums must also be adjusted so that we are able to continue to provide quality health care coverage for our members. About 88.5 cents of every health care premium dollar paid to Independence Blue Cross (IBC) goes to providers to pay for our members’ care. As the costs for these services go up, so must the premium rates that our members pay for their coverage.
How will my rates be affected?
The Pennsylvania Insurance Department approved a nine percent increase for all Individual medically underwritten HMO plans. This increase will affect your monthly premiums. In addition, your rate may be increasing if the oldest member covered under your policy entered a new age bracket.
About Age Brackets
What are age brackets, and how do they affect my premium?
Rates for our individual plans are based on five-year age brackets. In general, we increase premiums as members get older because experience shows that members use more health services as they age. Age brackets will affect your premium if the oldest member covered under your policy either:
- entered a new age bracket since July 2011, when we last adjusted premiums based on age, or;
- will enter a new age bracket when the rate increase goes into effect.
Individual Medically Underwritten Plan Age Brackets
- Age 18
- Age 19-24
- Age 25-29
- Age 30-34
- Age 35-39
- Age 40-44
- Age 45-49
- Age 50-54
- Age 55-59
- Age 60-64
About Alternative Medically Underwritten Individual Plan Options
Does IBC offer any other plan options for me?
Our medically underwritten individual product line offers three series of products — copay, deductible, and health savings account (HSA) programs. If you do not already have the lowest cost individual health care plan (i.e., PPO 8000 Deductible), you may want to consider changing your current coverage to a plan that has a lower monthly premium, but higher out-of-pocket costs.
View our 
Coverage Options flyer to help you compare your individual plan options.
What action do I need to take if I want to continue my current plan at the new rate?
You do not need to take any action if you wish to continue your coverage under your current individual plan. Your new rate will automatically be reflected in your next bill.
How do I change my current coverage to a lower-cost program?
If you decide to enroll in a lower cost plan, please complete the Plan Change Request Form. Select the new plan desired, and sign and date the form where indicated. If you return the form to us in the postage-paid envelope by the due date, your next bill should reflect your new coverage and your new monthly premium. If IBC receives your Plan Change Request Form after the due date, the change will be reflected on your next bill. We make every effort to process your form as soon as we receive it and update your account immediately. If you receive a second bill that does not reflect your correct plan, we may have received your form too late to process before the second bill was generated. Please contact your broker or call Customer Service at the number on your ID card to verify that we have received your Plan Change Request Form.
Mail or fax the completed Plan Change Request Form to:
Independence Blue Cross
P.O. Box 41452
Philadelphia PA 19101
Fax: 215-238-7067
If I select a lower-cost plan option, do I need to submit a questionnaire with my health history?
No. If you are changing your current coverage to a lower-cost plan, you are not required to re-submit details about your current health status and medical history to IBC. However, if you are adding a dependent up to age 26 who is not currently on your plan, you must complete a paper application as part of the medical underwriting process. IBC reviews this information to determine your final premium rate.
I’m interested in a plan that offers a higher level of benefits than my current coverage. What steps do I take?
If you would like a plan that offers higher benefits than your current coverage, you must complete an enrollment application. Upgrading your coverage will require medical underwriting. You may print out the paper application, complete it in full (including medical details for all applicants), and return by mail for review. Please note that online applications will not be accepted. Please send the completed application to:
Independence Blue Cross
Individual Medical Underwriting
P.O. Box 41474
Philadelphia, PA 19101-1474
Once our medical review is complete, we will advise you of the outcome.
To ensure that you maintain continuous coverage, you should not cancel your current plan until you receive a final determination on your application for the change.
Are my dependents eligible for coverage under my plan, and, if so, what do I need to do to add them to my policy?
At this time, you may add dependents up to age 26 that are not currently on your plan. However, before you can add dependents to your plan, you need to complete a paper application for review and medical underwriting. Please send the completed application to:
Independence Blue Cross
Individual Medical Underwriting
P.O. Box 41474
Philadelphia, PA 19101-1474
You will receive a letter in the mail advising you whether your application was approved. The letter will provide a contact name and phone number for questions concerning your particular application.
Billing Questions
Will my next bill reflect my new rate?
If IBC receives your Plan Change Request Form by the due date, your next bill should reflect your new coverage and your new monthly premium. If IBC receives your Plan Change Request Form after the due date, the change will not be reflected until your next bill. We make every effort to process your form as soon as we receive it and update your account immediately. If you receive a second bill that does not reflect your correct plan, we may have received your form too late to process before the second bill was generated. Please contact your broker or call Customer Service at the number on your ID card to verify that we have received your Plan Change Request Form.
I submitted my Plan Change Request Form, but my bill does not reflect the updated rate. What amount should I pay?
Members should pay the premium amount indicated on their bill. Any difference between this rate and your new rate will be adjusted on your next bill.
My latest bill does not reflect my recent plan choice submission. Why?
If you recently changed your plan by completing and submitting a Plan Change Request Form, we may not have received your form and processed your change before the latest bill was generated. We will update your plan and correct your next month’s bill.
I pay my bill quarterly. How is that affected by this change?
Depending on your billing cycle, you may see retroactive adjustments to your premium. If you made a plan change but we did not receive a Plan Change Request Form by the due date, your election may not be reflected in your current bill. If this happens, your next bill may show a retroactive adjustment that reflects the difference between what you paid for the last billing cycle and what you actually owed.
If you pay by check, simply send payment in full by the due date on your bill. Members who pay electronically by Automated Clearing House (ACH) will have the correct payment amount deducted from their checking account. If you pay by ZipCheck®, please call Customer Service at the number on your ID card to find out if you have a balance due. If so, you will need to send a check for payment to:
Independence Blue Cross
Treasury Services
43rd floor
1901 Market Street
Philadelphia, PA 19103
Please include your account and/or member ID number on the check. If you prefer, you may bring your payment to our Walk-In Customer Service department, which is located inside our headquarters, at 1901 Market Street in Philadelphia.
Is there a grace period for payment because of the higher rates?
In order for your coverage to remain in effect, pay your premium in full by the due date on your bill. If you receive a bill that does not reflect your correct plan choice, it is possible that we did not receive your Plan Change Request Form before the bill was generated. Please pay the bill you received by the due date. Your next bill should show your correct plan and any premium adjustments. You may also call Customer Service at the number on your ID card to verify that we have received your Plan Change Request Form.
What happens if I do not pay my bill?
If you do not pay your bill, your coverage will be terminated for nonpayment and your medical claims paid only up to the termination date. You will need to contact Customer Service at the number on your ID card and discuss full payment of the balance due to have your coverage reinstated. Reinstatement is subject to approval, and, if approved, you will be notified of the full premium balance due.
How does the change to the new plan affect my ZipCheck® payment?
ZipCheck is set up to deduct your current monthly premium, and it will automatically adjust to your new monthly premium amount. However, if there is a retroactive change to your plan that results in additional premium charges, ZipCheck will not deduct the retroactive amount. Please contact Customer Service at the number on your ID card to determine the balance due. You will need to send a check for that amount to:
Independence Blue Cross
Treasury Services
43rd floor
1901 Market Street
Philadelphia, PA 19103
Please include your account and/or member ID number on the check. If you prefer, you may bring your payment to our Walk-In Customer Service department, which is located inside our headquarters, at 1901 Market Street in Philadelphia.
If you make a plan change that lowers your monthly premium, your account will have a credit, and IBC will send you a refund check.
How does the change to the new plan affect my ACH payment?
Customers who pay using the ACH method do not need to do anything. The new premium amount, including any retroactive payment required, will be deducted automatically from your bank account. If you make a plan change that lowers your monthly premium, you will receive a credit that will reduce the amount of your next bill.
What Happens If You Select a New Plan
When will my coverage and bill change?
If you sent the Plan Change Request Form to us by the due date, your next bill should reflect your new coverage and your new monthly premium. If you sent the Plan Change Request Form after the due date, your bill may not reflect your selection, and we will update your plan and correct your premium amount in the next possible bill.
When will I receive my new ID card?
You will receive your new ID card after we receive your first premium payment for your new plan. Your old ID number will continue to work, but your benefits will be changed to reflect the benefits of the new plan you select. You can always visit www.ibxpress.com to print a temporary ID card to use until you receive your new card.
When will I receive my new contract?
We will print and mail contracts to our HMO plan members after we receive your first premium payment for your new plan. PPO plan members may visit www.ibxpress.com or contact their broker or Customer Service for a copy of their new contract. If you have any other questions about the new plans, please contact your broker or call Customer Service at 1-888-249-2118
.