Third-Party Policy

As an anti-fraud measure, Blue Cross and Blue Shield of Louisiana (BCBSLA) and HMO Louisiana Inc., have a policy across the group and individual health insurance market of not accepting premium payments from any third parties who are not related (by blood or marriage - see below for examples) to the subscriber, unless otherwise required by law.

We are required by law to accept premium payments from the following:

• Ryan White HIV/AIDS Program
• Indian tribes, tribal organizations or urban Indian organizations
• State and federal government programs

How does this affect you?
With this process, we will accept premium payments only from subscribers or their immediate family members or blood relatives. This includes any legal entity that subscribers own or that immediate family members or blood relatives own, such as a family-owned business.

For example: If your parents pay your premium, nothing will change. If a medical clinic pays your premium, we will no longer accept their payments on your behalf.  If your employer pays for all or part of your policy by deducting money from your paycheck and submitting that to BCBSLA, this does comply with our policy and will still be allowed.

Who is an immediate family member or blood relative?
Your parents, spouse, aunt, uncle, grandparents, brother, sister or legal guardian.

Who is a third-party?
A medical clinic, hospital, law firm in which you are not an employee, nonprofit organization or similar entity, or individual who is not related to you.

What should you do?
If a third-party pays for your policy now, you must make arrangements to ensure your premium payments comply with the policy stated above.  To discuss this change and how you can pay your premiums in a way we can accept, call our Customer Service department at 1-800-392-4087.

What if I believe I qualify under the law to have my premiums accepted from a third-party payer?
Any person or entity who believes s/he qualifies under law to have third-party premium payments accepted by Blue Cross and Blue Shield of Louisiana and/or HMO Louisiana, Inc. should prepare a written request for such determination. This written request should clearly outline under which law(s) the payment qualifies and provide evidence of compliance with this/these laws by the requesting party. Please provide contact information in the event Louisiana Blue should have follow-up requests. You may mail these requests to:

Blue Cross and Blue Shield of Louisiana (or HMO Louisiana, Inc.)
ATTN - Third Party Payer Determination
P. 0. Box 84656
Baton Rouge, LA 70884-4656
BCBSLA and HMO Louisiana Inc. will accept Ryan White HIV/AIDS Program payments without the need for such a determination.

I have an individual policy and my employer collects all of my premium through my paycheck and sends that to your office. Is this ok?
Yes, even though your employer is sending the payment to us, you are still paying the premium from your funds and that complies with our policy.

My doctor/medical provider has offered to pay my premium if I keep getting services/supplies from his/her company. Is this ok?
No, our policy specifically prohibits this type of third-party payment due to possible abuses and even fraud that might occur in these situations.

I was in an accident and did not have health insurance.  The law firm representing me has offered to pay for my policy.  Is this ok?
No, our policy specifically prohibits this type of third-party payment due to possible abuses and even fraud that might occur in these situations.

If third-party payment issues are noted, the matter must immediately be brought to the attention of the Financial Investigations Department, fraud@bcbsla.com. If inappropriate third-party Premium payments are confirmed the eligibility of the member’s contract will be reviewed and possibly terminated. Appropriate provisions will also be followed regarding required notifications to the Department of Insurance.