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Welcome

December 2008

Dear Business Partner:

As we approach the end of 2008, we would like to extend our thanks for the dedication and insight you contribute to support our company and the Sales Division.

In this issue of eNews, we are pleased to offer you a sneak preview of this month's Important Administrative Information and offer you an update regarding our sound financial standing. We also announce the launch of our unique partnership with Google Health™, an online destination that will transform the way that many of our members manage their health care information.

Below, you'll find the latest on minimum creditable coverage (MCC) including a recent amendment passed in mid-October, MCC updates to Dental Blue® summaries, and a breakdown of the changes to the 2008 1099-HC forms. We also give you the details on our product and benefit updates for January 1, 2009, and make you aware of a provider initiative intended to encourage physicians to use electronic prescription software. We congratulate Indigo brokers on a successful first year, and lay out some of Indigo's plans for 2009, including broker incentives. You'll read about Healthy Times, our annual member mailing, which will be downloadable for the first time from our dedicated member website, Member Central. Finally, we give you the latest on the evolution of our account-based prevention and wellness programs.

This month's BlueLinksSM is filled with information that can help you as we transition into 2009. If you have any questions or comments, please don't hesitate to share them with your account executive.

Sincerely,

Carlos Cubia
Vice President
Sales Division

In this issue of BlueLinks eNews:

A Sneak Peek at the December IAI
Getting the news before it's printed is an advantage afforded to a lucky few. That's why we're rewarding loyal BlueLinks eNews readers with the opportunity to read the December 2008 Important Administrative Information (IAI) before it goes to print.

Each quarter we mail a printed version of the IAI to accounts and brokers across Massachusetts. It delivers the news and information that helps benefits administrators and brokers like you stay current. And this month, you can get ahead of the game by downloading the IAI to your desktop right now.

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Financial Stability Continues, Despite Market Uncertainty
Blue Cross Blue Shield of Massachusetts reserves remain strong, (well capitalized) with a Risk Based Capital (RBC) at or above 500%. This level of reserve is consistent with levels maintained by all non-profit health plans in Massachusetts and meets the requirements of the Division of Insurance.

Blue Cross Blue Shield of Massachusetts has more than $2 billion of conservatively invested assets under a well-diversified asset allocation plan, which includes bonds, stocks and real estate. The average quality of these assets is 'AA'. Blue Cross Blue Shield of Massachusetts was not and is not invested in the asset classes that have been highlighted in the news, such as auction rate securities.

The Boston Globe published an article November 28, which provides further context about local health plans' financial stability.

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Introducing Google Health
Google Health is finally here. We are proud to be the first health insurer to enable members to securely collect, store, and manage their personal health information through Google's unique online health destination.

Google Health puts users in charge of their health information so that it is accessible anytime, from anywhere in the world. Now Blue Cross Blue Shield of Massachusetts members can:

  • Import their Blue Cross Blue Shield of Massachusetts claims information
  • Share medical information with physicians, if they choose
  • Access their medical records from anywhere in the world
  • Keep track of prescriptions and potential drug interactions

To learn more about our unique partnership with Google Health, read the December press release. If you're a Blue Cross Blue Shield of Massachusetts member, activate your own Google Health account today.

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Minimum Creditable Coverage Changes
Minimum Creditable Coverage (MCC), the minimum level of benefits for health plans that an individual must have in order to meet the requirement for Massachusetts residents to have health insurance and avoid a tax penalty, will take effect on January 1, 2009.

On October 17, 2008 the Connector Board passed an amendment to these regulations that will have a minimal impact in 2009, but a more significant effect in 2010. The purpose of this article is to summarize these changes. To review the actual revised MCC regulations, please visit the Connector website.

2009:
For 2009, MCC remains largely unchanged and all Blue Cross Blue Shield standard plans that have been deemed MCC-compliant for 2009 remain so. The elements that have been added to MCC for 2009 are intended to increase flexibility for accounts to demonstrate that their plans are compliant.

To this end, the Connector has created a review process whereby the Connector may determine that a plan meets MCC by demonstrating that the actuarial value of the plan's health benefits are comparable to the actuarial value of Bronze level plans sold through the Connector, even though some specific details with the plan deviate from MCC requirements. The Connector is formalizing the process by which carriers and employers may apply for MCC approval status based on actuarial value. Plans that do not meet MCC because they exclude coverage for required medical services, such as pharmacy or mental health, are not eligible for this additional consideration.

2010:
Beginning January 1, 2010, two important changes to MCC will take effect.

  1. All health benefit plans must contain a newly expanded broad range of medical benefits.

  2. Federally qualified high deductible health plans (HDHP) must also meet MCC standards. A health benefit plan with deductibles exceeding $2,000 individual/$4,000 family and/or out-of-pocket maximums for in-network covered services exceeding $5,000/$10,000 will meet MCC as long as:

    • The underlying health benefits include "a broad range of medical benefits" and pre-deductible preventive care requirements
    • Plan sponsors or carriers provide individuals enrolled in an HDHP with access to a health savings account (HSA). Individuals may decide whether or not to open or fund the HSA account.

Blue Cross Blue Shield of Massachusetts is reviewing the plans we offer in light of the amended regulations for 2009 and for 2010 and will follow up with accounts and their brokers or consultants, as needed, should their current plan be affected by the new MCC requirements. If you have questions, please contact your account executive.

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MCC Updates to Dental Blue Summaries
You may have noticed that we recently added the minimum credible coverage non-compliant symbol to our Dental Blue summaries. This symbol is being used to satisfy the Division of Insurance requirement to inform our members when a plan they are purchasing does not meet the minimum requirements for health insurance. Our Dental plans were developed to care for our member's oral health, which is an important part of their overall health. However, they were not designed to meet health insurance requirements. This is an important distinction that we hope you will share with your clients.

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2008 1099-HC Forms
The Massachusetts Health Care Reform law requires residents over the age of 18 to have health care coverage or pay a fine. Individuals will be required to transcribe data contained in the 2008 1099-HC form to their annual state income tax filing statement provided by the Massachusetts Department of Revenue (DOR).

By January 31, 2009, Blue Cross Blue Shield of Massachusetts will issue 2008 1099-HC forms to qualifying subscribers residing in Massachusetts and who are enrolled in a Blue Cross Blue Shield of Massachusetts product at any time during the calendar year.

The following subscribers will not be receiving a 1099-HC form:

  • Subscribers younger than 18 years old
  • Subscribers having a dental- and/or vision-only plan through Blue Cross Blue Shield of Massachusetts
  • Subscribers enrolled in Medex®' or one of our Medicare Advantage plans

What's Different on the 2008 1099-HC Form?

The Department of Revenue (DOR) has required all health care insurance companies, including Blue Cross Blue Shield of Massachusetts, to provide their qualifying in-state subscribers with information indicating which months out of the year they had health insurance through Blue Cross Blue Shield of Massachusetts.

If a subscriber was insured through Blue Cross Blue Shield of Massachusetts for all 12 months of the tax year, the "Full Year Coverage" box will be checked off. If a subscriber was insured through Blue Cross Blue Shield of Massachusetts for less than 12 months, only those months that the subscriber or a dependent on the policy had 15 or more days of health insurance in a given month will have a check in the appropriate month's box.

If a subscriber had health insurance through another carrier, they should be receiving a separate 1099-HC form from that carrier.

To help support our members and answer questions they might have about getting a 1099-HC form, please visit www.bluecrossma.com/1099HC.

Please direct all tax-related questions (including preparation of tax filings and financial penalties for not having insurance), to the Massachusetts Department of Revenue via www.mass.gov/dor or call 1-800-392-6089.

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Product and Benefit Updates for January 1, 2009
At Blue Cross Blue Shield of Massachusetts, our product portfolio provides employers and individuals with options to meet a range of health coverage and budget needs. As a result of your and your clients' feedback, effective January 1, 2009, we are introducing new plans and benefit changes across many of our existing plan designs.

Fully Insured Tiered Network PPO Plan Available February 1, 2009

Preferred Blue PPO Options V.2, a new, PPO-based, fully-insured version of our Blue Options tiered network plans, will be available to all size groups and individuals, for effective dates starting February 1, 2009. PPO Blue Options is also available on a self-funded basis.

Part of the ongoing evolution of our Blue Options product line, this fully insured PPO plan combines the flexibility of a PPO with the premium savings and member incentives of a tiered-network plan.

Preferred Blue PPO Options has three cost-sharing benefit tiers for Massachusetts network primary care physicians (PCPs) and acute care hospitals. As a PPO, coverage is also available for members who prefer to use an out-of-network provider. Cost-sharing for Blue Card PPO™ providers outside of Massachusetts is at the most favorable tier level.

For more information
If you are interested in the Preferred Blue PPO Options plans for your clients, please contact your account executive. Benefit Summaries are available on Bluelinks for Brokers.

View a detailed list of enhancements to our product portfolio

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e-Prescribing
In our ongoing effort to improve the quality, affordability, and efficiency of care for our members, effective January 1, 2011, we will be requiring primary care physicians (PCPs) and specialists who prescribe medications to transmit prescriptions electronically in order to qualify for any of Blue Cross Blue Shield of Massachusetts' physician incentive programs.

In 2006, physicians who used an e-prescribing device chose cost-efficient drugs more often and saved five percent on their drug costs relative to those prescribers who did not use this technology. Of that savings, Blue Cross Blue Shield of Massachusetts members saved approximately $800,000 in copayments associated with their prescriptions.

Read the press release to learn more about the upcoming e-prescribing requirement. If you have any questions, please contact your account executive.

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Indigo Celebrates a Successful First Year
Indigo Insurance Services, LLC (Indigo), a wholly owned subsidiary of Blue Cross Blue Shield of Massachusetts, began offering a range of Group and Voluntary Life and Disability coverage options in early 2008. We would like to take this opportunity to thank our brokers for helping to make our first year a success.

With 2009 fast approaching, we are eager to improve our offerings and streamline our business. Our underwriter, USAble Life, will be reducing its base rates on products with quote dates of January 1, 2009 or later. USAble also plans to introduce a standalone broker bonus package for producers who meet certain thresholds of new business production and existing business persistency. Indigo will launch a more efficient billing process featuring a single electronic bill that combines medical, dental, and ancillary products in the first quarter of 2009. Finally, look for new worksite products to be offered during the second half of 2009.

After a great 2008, there's a lot to look forward to from Indigo in 2009. If you have any questions, please contact your account executive.

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Healthy Times
This year, Blue Cross Blue Shield of Massachusetts will distribute its member newsletter, Healthy Times, in an electronic format. Members will receive a postcard in the mail beginning December 15 directing them to view and download a copy of Healthy Times at www.bluecrossma.com/healthytimes. For members for whom we have an email address and who have opted in to receive emails from us, we will also be sending them an invitation to view Healthy Times by email. If desired, members can request a printed copy of Healthy Times by calling 1-800-262-BLUE (2583).

Healthy Times will be featured on Member Central, our dedicated website for members, launching on December 15. Member Central will make it easier for members to find what is important to them, including finding a doctor and pharmacy formulary changes as well as tools to manage their health care expenses. Member Central is the gateway to everything members need in one central location, including registering and logging in to Member Self Service. Member Central can be found at www.bluecrossma.com/membercentral beginning Monday, December 15, 2008. For more information, please contact your account executive.

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Enhanced Prevention and Wellness Programs
Blue Cross Blue Shield of Massachusetts is committed to providing prevention and wellness programs for employers that will deliver consistent, customized, targeted solutions for a company's total employee population, whether enrolled in a Blue Cross Blue Shield of Massachusetts health plan or not. We recognize that controlling health care costs begins with helping our customers support their employees in making wise health care choices by educating them about the connection between lifestyle habits and their long-term health and financial well-being.

With that in mind, Blue Cross Blue Shield of Massachusetts will introduce a dramatically improved version of MyBlueHealth, our online personal health assessment (PHA) and health information site. The comprehensive prevention and wellness solution will support businesses in deploying strategies to increase employee engagement and utilization of wellness tools, which will help drive long-term behavior change. Changes to MyBlueHealth will launch in the second quarter of 2009 and will include an expanded suite of online programs including a new PHA template, online coaching, tracking tools, customized action plans, social networking communities, and reporting capabilities.

Our goal is to continue to provide easy-to-use prevention and wellness programs to your employees to help them manage their health and quality of life, regardless of where they fall on the health continuum. We look forward to providing you with more updates and details, as we get closer to launching our improved MyBlueHealth. If you have any questions, please contact your account executive.

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