3.0 Blue Cross Policies
This Guide has been structured to assist Providers ("you") in submitting Claims for Members. Before you submit Claims for our Members, we want to inform you about the different types of Policies. It is important to understand these differences, when applicable.
3.1 Policies
Pacific Blue Cross administers many different types of Policies that can be classified into three broad categories:
Employer/Association-Arranged Policies
These are group plans arranged by employers, unions, associations, or trusts, that provide benefit coverage for their Members.
Individual Health Policies
These are plans purchased by individuals in British Columbia and the Yukon. Individuals may be self-employed, without employer benefits, choose to supplement their employer's benefits, or retired.
Government-Funded Policies
These are plans for individuals in British Columbia and the Yukon that are funded by a government program.
First Nations Health Authority
First Nations Health Authority (FNHA) provides coverage for its clients, Pacific Blue Cross administers medical supply and equipment, vision, hearing, dental and some pharmacy claims as well has approved Mental Health Providers on their behalf