03/31/2009
What agents can and can't do on behalf of a member
Agents can submit some applications on a member's behalf, but there are a few things that only the member can submit themselves.
A member must call or write if they want to change their effective date; change their EFT information; cancel or add a newborn; or request a plan change. If your member forwards such information to you in an email, you can forward the email to wa-individual-sales@regence.com. We will accept the email only if the information is clearly viewable.
To avoid confusion, we have created a chart that identifies what an agent is allowed to do on behalf of Individual and Medicare clients.
| Activity |
Agent |
| Correct Spelling of Names |
Yes |
| Correct Date of Birth |
Yes |
| Correct Gender |
Yes |
| Correct Social Security Number |
Yes |
| Correct or Update Billing Address or Phone Number |
Yes |
| Change Mailing Address or Phone Number |
Yes |
| Cancel EFT |
Yes |
| Change EFT Information |
No |
| Request Reinstatement |
Yes |
| Request an Appeal |
Yes - if the member signs a Disclosure Authorization allowing the agent to act on the member's behalf |
| Request a Hold be Placed on Account |
Yes |
| Change Effective Date |
No |
| Change Billing Cycle |
Yes |
| Request Corrections or Allocation of Payments |
Yes |
| Change or Correct Member PCP |
Yes - as directed only for a minor child |
| Request ID Cards |
Yes |
| Obtain Information on Health Factor |
Yes |
| Cancel an Application that has not been Activated |
Yes |
| Request a Copy of Health Questionnaire |
Yes |
| Request a Copy of the Member's Application |
Yes |
| Request to Add a Newborn |
No |
| Receive Claim Information |
Yes - if in the capacity of our Business Associate |
| Request HIPAA Cert to Other Covered Entity |
N/A - must be sent to other covered entity |
| Add or Change a Broker |
Follow state rules for agent updates |
| Cancel Anyone other than Themselves |
No - cannot cancel policy or dependents |
| Request a Benefit Change |
No |
If you have any questions, please talk to your Regence Sales contact.
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