Medical evaluations are used to determine the financial risk assumed by Mountain State Blue Cross & Blue Shield in providing health care coverage to members. Due to the vast array of product options available and wide range of employer size, our medical screening process varies depending upon the number of employees to be covered.

For groups having 2 - 50 enrolled employees, Mountain State conducts medical history screenings through the employee enrollment application. If necessary, to clarify a subscriber's health condition, an Attending Physician Statement (APS) may be required. An APS is the medical opinion of the physician who treated the condition.

Mountain State does not pay any costs incurred as a result of obtaining an APS.

Groups having over 50 employees may be asked to complete medical history screening through the employee enrollment application if sufficient prior claims experience is not available. Due to the larger number of employees participating, this enables the risk to be spread among a greater number of individuals, and this reduces the financial burden associated with coverage.

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