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Third-Party Premium Payments Policy

Purpose:

 

 

 

Policy:

The purpose of this policy is to document that the premium payments for individual plans are a personal expense to be paid for directly by the individual and family plan subscribers. The U.S. Department of Health and Human Services (HHS) advises health insurers to reject payments from non-personal accounts, known as “third-party payers,” except in specific circumstances.  

This policy applies to fully-insured commercial lines of business, including individual/family plans and group plans. It does not apply to government program plans, including Medicare Supplemental plans or FEP.

Blue Cross Blue Shield of Wyoming will only accept premium payments from the policyholder (group or individual), a family member of the insured, or entities from whom we are required by law to accept premium payments.

Blue Cross Blue Shield of Wyoming will accept third-party payment for premium directly, as required by federal law, from the following entities:

  • The Ryan White HIV/AIDS program under title XXVI of the Public Service Act;
  • Indian Tribes, tribal organizations or urban Indian organizations; and
  • State and Federal Government programs.

BCBSWY may choose, in its sole discretion, to allow payment from not-for-profit foundations, provided those foundations meet non-discrimination requirements and pay premiums for the full policy year for each of the Covered Individuals at issue.

BCBSWY may choose, in its sole discretion, to accept premium payments from third-parties but only when each of the following criteria has been demonstrated:

  • The third-party payer is not a Health Care Provider, Supplier, Facility or Clinic; and
  • The third-party payer is not an employer seeking to pay or paying premiums on behalf of members enrolled or seeking to enroll in an individual/family plan (excluding a self-employed individual paying for his/her own coverage); and
  • The third-party payer does not have any direct or indirect financial interest in the payment of the premium. 

BCBSWY has the discretion to reject payments from third-party payers in accordance with law.

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