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Agent Policies and Procedures

General:

  • Conduct business practices that promote the image of Blue Cross Blue Shield of Michigan, Blue Care Network of Michigan and other agents.
  • Report to BCBSM/BCN any actual or suspected illegal activities or breach of policies or agent agreement.
  • Submit accurate and timely paperwork associated with enrollment and/or group-wide changes.
  • Keep updated on BCBSM and BCN policies, procedures and products.
  • Comply with all business practices, policies and procedures as communicated by BCBSM or BCN (agent alerts, newsletters, seminars, etc.)
  • Comply with the Health Insurance Portability and Accountability Act of 1996 Privacy laws related to protected health information.

Servicing Role:

  • Develop proposals for prospective clients.
  • Resolve operational issues such as billing, claims and other administration problems on behalf of a subscriber, member or group administrator.
  • Deliver annual rate renewals.
  • Assist experience rated and Administrative Services Contract self-funded groups with quarterly and annual settlements.
  • Conduct employee education meetings as requested.
  • Keep group administrators updated on policies and procedures.
  • Update clients on benefit changes that affect their health care plan.
  • Participate and support union negotiations relative to health care benefits.