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Broker Guidelines for Movement from MD Indemnity Dental to

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					                     Broker Guidelines for Movement from MD Indemnity
                                  Dental to Regional Dental
Groups currently enrolled in the Traditional or Preferred Maryland Dental plans will be migrated
to the new Regional Dental plans upon renewal beginning April 1, 2004. Brokers are asked to
work with their clients and employees to ensure that all necessary paperwork is completed in a
timely manner. Your CareFirst Broker Representative will assist you in answering any questions
that you are asked and will provide detailed training on the new Regional products and the
migration process. Below is a summary of the required paperwork based on the medical and
dental products currently offered to the group through CareFirst.

Medical with PPN and/or MPOS and Traditional/Preferred MD Dental:
Based on the employer’s benefit decision, employees may enroll with different coverage levels
between dental and medical and may choose to enroll in one or both products; this is referred to
as “non-parallel” group enrollment. If a group offers “parallel” group enrollment and both
medical and dental are offered, all eligible employees must choose both medical and dental
coverage with each employee enrolling at the same coverage level for both medical and dental, or
no coverage at all.

“Non-Parallel”Enrollment Examples:
        (1) The Group offers both medical and dental coverage. The employee chooses only
dental coverage OR The employee chooses only medical coverage.
        (2) The group offers both medical and dental coverage. The employee chooses family
medical coverage and individual dental coverage.

“Parallel”Enrollment Examples:
       (1) The Group offers both medical and dental coverage. The employee chooses both
           family medical and family dental coverage.
       (2) The Group offers both medical and dental coverage. The employee chooses both
           individual medical and individual dental coverage.
       (3) The group offers both medical and dental coverage. The employee chooses not to
           enroll in both the medical and dental coverage.

Retirees enrolled in dental coverage will be enrolled under the Regional Dental product.

Paperwork Required:
♦ No member applications are required unless the employee is newly enrolling in dental or if
   they are changing personal information or coverage level.

♦ Groups will need to complete the Small Group Regional Dental Information Form (attached)
  prior to the Regional Dental benefits being activated for employees. Information on this form
  is essential to group set-up on FACETS.

♦ A first month’s premium check must be provided if the group is being billed directly by
  CareFirst. Not required if a CAREFIRST DBE is billing the group.

♦ Renewal rate proposal for the chosen Regional Dental plan

♦ Wholesalers/DBE’s will need to complete a New Group Benefit Change Worksheet
CareFirst BlueCross BlueShield is the shared business name of CareFirst of Maryland, Inc. and Group Hospitalization and Medical Services, Inc.
                    CareFirst BlueCross BlueShield and CareFirst BlueChoice, Inc. are independent licensees of the Blue Cross and Blue Shield Association.
                        ® Registered trademark of the Blue Cross and Blue Shield Association. ®’ Registered trademark of CareFirst of Maryland, Inc.
Medical with BluePreferred and/or BlueChoice and Traditional/Preferred MD Dental:
Based on the employer’s benefit decision, employees may enroll with different coverage levels
between dental and medical and may choose to enroll in one or both products; this is referred to
as “non-parallel” group enrollment. If a group offers “parallel” group enrollment and both
medical and dental are offered, all eligible employees must choose both medical and dental
coverage with each employee enrolling at the same coverage level for both medical and dental, or
no coverage at all.

“Non-Parallel”Enrollment Examples:
        (1) The Group offers both medical and dental coverage. The employee chooses only
dental coverage OR The employee chooses only medical coverage.
        (2) The group offers both medical and dental coverage. The employee chooses family
medical coverage and individual dental coverage.

“Parallel”Enrollment Examples:
       (1) The Group offers both medical and dental coverage. The employee chooses both
           family medical and family dental coverage.
       (2) The Group offers both medical and dental coverage. The employee chooses both
           individual medical and individual dental coverage.
       (3) The group offers both medical and dental coverage. The employee chooses not to
           enroll in both the medical and dental coverage.

Required Paperwork:
♦ No member applications are required unless the employee is newly enrolling in dental or if
   they are changing personal information or coverage level. If the group chooses to offer a
   DHMO, all enrolling employees will need to complete the BlueChoice member application.
   The DHMO is not available to employees choosing BluePreferred medical benefits and those
   choosing the DHMO must enroll at the same coverage level as they do for BlueChoice.

♦ When “non-parallel” group enrollment is chosen, and BlueChoice medical benefits are
  selected by the employee, both the BlueChoice member application (for medical) and the
  GHMSI member application (for dental) will be required. Selection of “parallel” group
  enrollment with any POE combination will require completion of only one member
  application (for both medical and dental).

♦ When the employer is offering both BluePreferred and BlueChoice, Group Applications for
  both products are required. If the employer has chosen “parallel” group enrollment and offers
  either BlueChoice products only or BluePreferred products only, one Group Application is
  required.

♦ If the employer has chosen “non-parallel” group enrollment, and BlueChoice products are
  included in the medical offering, two Group Applications will be required.

♦ A first month’s premium check must be provided if the group is being billed directly by
  CareFirst. Not required if a CAREFIRST DBE is billing the group.

♦ Renewal rate proposal for the chosen Regional dental plan

♦ Wholesalers/DBE’s will need to complete a New Group Benefit Change Worksheet
         CareFirst BlueCross BlueShield is the shared business name of CareFirst of Maryland, Inc. and Group Hospitalization and Medical Services, Inc.
            CareFirst BlueCross BlueShield and CareFirst BlueChoice, Inc. are independent licensees of the Blue Cross and Blue Shield Association.
                 ® Registered trademark of the Blue Cross and Blue Shield Association. ®’ Registered trademark of CareFirst of Maryland, Inc.
Traditional/Preferred MD Dental and no CareFirst, INC Medical:
Retirees enrolled in dental coverage will be enrolled under the FreeStanding Regional Dental
products written under a CFMI contract.

Paperwork Required:
♦ No member applications are required unless the employee is newly enrolling in dental or if
   they are changing personal information or coverage level.

♦ Groups will need to complete the Small Group Regional Dental Information Form (attached)
  prior to the Regional Dental benefits being activated for employees.

♦ A first month’s premium check must be provided if the group is being billed directly by
  CareFirst. Not required if a CAREFIRST DBE is billing the group.

♦ Renewal rate proposal for the chosen Regional Dental plan.

♦ Wholesalers/DBE’s will need to complete a New Group Benefit Change Work.

♦ If the physical address of the group is in P.G./Montgomery counties, the GHMSI Group
  Application is required.




         CareFirst BlueCross BlueShield is the shared business name of CareFirst of Maryland, Inc. and Group Hospitalization and Medical Services, Inc.
            CareFirst BlueCross BlueShield and CareFirst BlueChoice, Inc. are independent licensees of the Blue Cross and Blue Shield Association.
                 ® Registered trademark of the Blue Cross and Blue Shield Association. ®’ Registered trademark of CareFirst of Maryland, Inc.

				
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