What to do when a Elevance Health (Anthem) account holder dies

The Anthem member contract states that upon termination Anthem returns promptly the unearned portion of any premium paid. Because coverage terminates the day after death, any premium already paid for the rest of that period is unearned and is estate property. Ask Anthem for the refund when you report the death, and be ready to provide the death certificate and, if the refund must be issued to the estate rather than to a surviving subscriber, Letters Testamentary or Letters of Administration and the estate's EIN.

Both directions are estate matters. On payments out, the member contract says that upon the death of a member, claims will be payable in Anthem's discretion to either the member's estate or a beneficiary designated to Anthem, and directly to the provider when the provider is in network — so a personal representative may need to give Anthem the estate's name, EIN, and Letters. On money owed, unpaid deductibles, coinsurance, and provider balances are creditor claims against the estate and are handled through the state's probate claim process, not paid personally by the executor. Separately, if the decedent was in a Medicaid managed-care plan (Wellpoint or an Anthem Medicaid plan), estate recovery is pursued by the STATE Medicaid agency under Social Security Act sec. 1917 (42 U.S.C. 1396p(b)), not by the health plan.

Start with the deceased employee's employer or benefits department: the employer holds the group policy, verifies coverage, and completes the employer portion of the claim. The beneficiary then completes a beneficiary statement and submits it with a certified death certificate (an AD&D claim also generally needs a death certificate stating cause of death and a police or accident report). File online through the claim submission tool at https://app.standard.com/benefits/employee/soc/, or call the Life Claims Service Center at 800-552-2137 (Mon-Fri 8:00 AM - 8:00 PM ET) for the claim package, or mail it to Anthem Life, Attn: Life Claims Service Center, P.O. Box 2717, Portland, OR 97208-9830 (fax 800-850-0017, email AL-Claims@standard.com). State-specific forms are at https://www.anthem.com/mcr/anthemlife/forms.

It can receive it, not own it. A trust can be named as the beneficiary of group term life, supplemental life, or AD&D coverage — use the trust's full legal name and the date it was established on the designation form the employer keeps on file, and the death benefit is paid to the trust and administered under its terms, outside probate. The coverage cannot be assigned into an irrevocable life insurance trust the way an individually owned policy can, because the employer owns the group policy and the employee holds only a certificate. Also note that the coverage generally ends when employment ends; the Group Conversion / Portability team (800-801-6142) handles continuing it as an individual policy, and only a converted individual policy could later be owned by a trust.