In this issue of BlueLinks eNews: |
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Welcome March 2009 Dear Business Partner: As you may know, Blue Cross Blue Shield of Massachusetts Executive Vice President Steve Booma recently announced that he has decided to take his career in a new direction, and will be leaving the company this July. During Steve's nine-year tenure, the organization has grown by more than one million members, and continues to deliver world-class customer service. Steve has played an important role in leader development, and helped spearhead key initiatives that have maintained Blue Cross Blue Shield of Massachusetts' position at the forefront of Massachusetts health care. Steve said, "This is a tremendous company. Our leaders, associates, and brokers have consistently demonstrated the insight and drive needed to be the best health insurer in the state. Today is a bittersweet moment, but it's the right time for me to move on to the next phase of my career." Steve will work with Chairman, President, and CEO, Cleve Killingsworth, Executive Vice President Andrew Dreyfus, and Chief Financial Officer Allen Maltz on his transition over the weeks to come. Andrew Dreyfus and Allen Maltz will continue to be responsible for managing business operations at Blue Cross Blue Shield of Massachusetts. I am sure you all join me in wishing Steve great success in his future endeavors. As we prepare for a busy spring season, we also want to be sure that you are up-to-date on all of the latest developments at Blue Cross Blue Shield of Massachusetts. This issue of eNews offers you a sneak peek at 2009's first edition of Important Administrative Information, and includes a save the date for the spring 2009 broker training series. This issue of BlueLinks is filled with important information that can help you this spring and throughout 2009. If you have any questions or comments, please don't hesitate to share them with your account executive. Sincerely, Tim O'Brien |
The March 2009 Important Administrative Information (IAI) is almost ready to go to print, but we're giving loyal BlueLinks eNews readers the opportunity to find out what's new at Blue Cross Blue Shield of Massachusetts right now.
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. As a valued member of our core business, you can read the March IAI and get ahead of the game today.
Save the Date: Spring 2009 Broker Training
Please join us at a training/information session for the latest news about our industry and products. Please extend this invitation to others in your office who may benefit from this training.
Please select one of the five session locations and RSVP by Friday, April 18th to brokertraining@bcbsma.com.
Sessions scheduled as follows:
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Quincy Blue Cross Blue Shield of Massachusetts One Enterprise Drive |
Boston Blue Cross Blue Shield of Massachusetts Landmark Center |
Westborough Doubletree Hotel |
Springfield - Holyoke Holiday Inn |
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Tuesday, |
Tuesday, |
Wednesday, Wednesday, |
Thursday, |
Formal invitation to follow.
April 1, 2009 Product and Benefit Updates
At Blue Cross Blue Shield of Massachusetts, our comprehensive product portfolio provides many options to meet the varied health coverage and budget needs of individuals and employer groups in Massachusetts. We also continue to enhance our portfolio to meet changing customer needs. Therefore, as of April 1, 2009, we are introducing two new products and making some changes to our product portfolio.
HMO Blue® Premier Value with Co-insurance
This plan offers the same benefits as HMO Blue Premier Value while incorporating co-insurance and deductible features. HMO Blue Premier Value with Co-insurance offers groups and individuals a lower premium than HMO Blue Premier Value, in addition to coverage for primary care and specialist office visits at low copayments. This plan is being made available to the individual and small-group markets, effective April 1, 2009.
Benefits Overview
| Network | HMO Blue |
| Deductible | $1,00 individual plan year deductible $2,500 family plan year deductible Applies to inpatient admissions only |
| Out-of-Pocket Maximum | $2,000 individual plan year OOP max $4,000 family Includes medical deductibles, co-insurance, and copays > $100 |
| Emergency Room | $150 per visit, no deductible |
| Inpatient Care | $1,000 individual plan year deductible per admission $2,500 family plan year deductible per admission |
| Outpatient Day Surgery | 35% co-insurance per visit, no deductible |
| Primary Care Physician Office Visit | $25 per visit, no deductible |
| Specialist Office Visit (including chiropractic services) |
$40 per visit, no deductible |
| Preventive Care Office Visit | $15 per visit, no deductible |
| Diagnostic Labs and X-Rays | 35% co-insurance, no deductible |
| CT, MRI, and PET Scans | 35% co-insurance, no deductible |
| Pharmacy | Retail—$15/$30/$50 Mail Service—$30/$60/$150 |
HMO Blue New EnglandSM Premier Value with Co-insurance
This plan offers the same benefits as our HMO Blue New England Premier Value plan while incorporating co-insurance and deductible features. HMO Blue New England Premier Value with Co-insurance offers groups and individuals a lower premium than HMO Blue New England Premier Value, in addition to coverage for primary care and specialist office visits at low copayments. The plan gives members the flexibility to access providers throughout New England. This plan is being made available to the individual and small-group markets as of April 1, 2009.
Benefits Overview
| Network | HMO Blue New England |
| Deductible | $1,00 individual plan year deductible $2,500 family plan year deductible Applies to inpatient admissions only |
| Out-of-Pocket Maximum | $2,000 individual plan year OOP max $4,000 family Includes medical deductibles, co-insurance, and copays > $100 |
| Emergency Room | $150 per visit, no deductible |
| Inpatient Care | $1,000 individual plan year deductible per admission $2,500 family plan year deductible per admission |
| Outpatient Day Surgery | 35% co-insurance per visit, no deductible |
| Primary Care Physician Office Visit | $25 per visit, no deductible |
| Specialist Office Visit (including chiropractic services) |
$40 per visit, no deductible |
| Preventive Care Office Visit | $15 per visit, no deductible |
| Diagnostic Labs and X-Rays | 35% co-insurance, no deductible |
| CT, MRI, and PET Scans | 35% co-insurance, no deductible |
| Pharmacy | Retail—$15/$30/$50 Mail Service—$30/$60/$150 |
Plans Closing
The following products are being closed for new sales to employer groups with fewer than 50 employees and for individuals for effective dates on or after April 1, 2009:
- HMO Blue $10
- HMO Blue New England $10
- HMO Blue PreferencesSM $600 Plan
- Blue Care Elect PreferredSM (100/80)
Employer groups currently enrolled in these products may continue to renew their coverage. If you have any questions about the new or closing products, please contact your account executive.
Changes to Coverage for Biologically Based Mental Conditions
Under all of our products, mental conditions are classified as either biologically based conditions or non-biologically based conditions. Effective July 1, 2009, four categories of non-biological conditions are being reclassified as biologically based conditions. These categories are substance abuse, eating disorders, post-traumatic stress disorder (PTSD), and autism.
How This Affects Accounts
Effective July 1, 2009, the benefits that are provided for these four conditions will be the same as benefits provided for biologically based conditions.
For example, under an insured plan, a benefit limit such as the 24 outpatient visit limit would no longer apply for substance abuse, eating disorders, PTSD, or autism.
For administrative service contract (ASC) plans, the benefits that an account provides for biologically based conditions will now apply to these four conditions. For example, if there is no benefit limit on clinical depression, there will be no benefit limit on substance abuse, eating disorders, PTSD, or autism. Or, if an ASC account has an overall benefit limit for all mental conditions, regardless of biological classification, the benefit limit would still apply. Thus, the benefit level is not being changed; only certain classifications are changing.
Upcoming Federal Mental Health Parity Changes
These changes in classification come in advance of an important change regarding mental health coverage that will be effective in October 2009 because of the new federal Mental Health Parity Act. More detailed information regarding the effect of the federal Mental Health Parity Act will be forthcoming in the June issue of IAI.
The recently passed American Recovery and Reinvestment Act includes important changes to COBRA benefits, including a 65 percent federal subsidy of premiums for employees who were laid off from September 1, 2008 through December 31, 2009. To learn more, review the COBRA American Recovery Fact Sheet that will be mailing with the March IAI.
Important information for employees whose employer-sponsored coverage is ending.
Blue Cross Blue Shield of Massachusetts has plan options to fit most budgets and lifestyles. People interested in learning more or to enrolling in one of our direct-pay (non-group) plans should call us at one of the toll-free numbers below, weekdays 8:00 a.m. to 5:00 p.m. ET, or visit www.getbluema.com.
Members under age 65: 1-800-422-3545 (TTY: 1-800-522-1254)
Members over age 65: 1-800-678-2265 (TTY: 1-800-522-1254)
Health Insurance Responsibility Disclosure Amendments
As you may be aware, the Massachusetts Health and Human Services Division of Health Care Finance and Policy has proposed several changes to the Health Insurance Responsibility Disclosure (HIRD) form to become effective April 1, 2009. The proposal would update the HIRD form to eliminate information that the Division of Health Care Finance and Policy deems unnecessary, and add new questions regarding employer disclosures. Below is a brief summary of the proposed changes to the HIRD requirements:
- Employer HIRD forms would now be due at the same time as the Fair Share Contribution filings. For some employers this means that they would be limited to submitting one employer HIRD report per year.
- In designating whether an employer has 11 or more full-time employees, the determination would be based on quarterly payroll hours rather than annual payroll hours.
- Employers would be required to report new information, including details about the employer's full-time criteria, and whether the employer collects employee HIRD forms from employees that decline to participate in the group health plan or Section 125 plan.
- Employers would be required to collect signed employee HIRD forms if they have either 5,500 payroll hours in any quarter or 22,000 payroll hours in a year.
If you have any questions about HIRD or these new changes, please contact your account executive.
News & Updates Enhancements on BlueLinks For Brokers
In an effort to make it easier for you to locate important announcements and regular communications, such as the IAI and BlueLinks eNews, we recently launched enhancements to the news and updates sections on the BlueLinks for Employers and BlueLinks for Brokers websites.
BlueLinks Enhancements:
- News and updates are grouped together on the homepage, so you can quickly find out what's new
- Organized homepage news and update links
- A link on the employer homepage allows your clients to sign up for email communications from Blue Cross Blue Shield of Massachusetts
Visit www.bluecrossma.com/broker to view the latest news and updates from Blue Cross Blue Shield of Massachusetts.
Member Enrollment/Change Form Now Editable
To make it easier for members to enroll, we have developed an editable version of the Member Enrollment/Change form. Previously, members were required to write their information by hand, making the forms difficult to read. The editable form allows members to type in their information online, print two copies, and send one copy to their employer for approval as they normally would. The form can be found in the Forms and Brochures section of BlueLinks for Employers, and in the Resource Library of BlueLinks for Brokers.
As part of our ongoing efforts to provide our members with timely, effective communications, we started a program to send emails to members inviting them to sign up for ongoing Blue Cross Blue Shield of Massachusetts email messages via a link on Member Central.
Contact information was suppressed for members in accounts that previously indicated that their members should not be contacted via email. Members who sign up to receive emails from us will be among the first to receive important plan updates and health news and information. In accordance with Blue Cross Blue Shield of Massachusetts privacy policy, members' email addresses are not shared with outside parties, except as permitted by law. Members may opt out of email messages at any time.
Contact your account executive if you have any questions about member email communications.
Save Time and Money with Convenient One-Stop Shopping
We have great news for Massachusetts-based companies with 2 to 99 employees. When they offer Dental Blue® along with coverage for two or more group ancillary products* from Indigo Insurance Services, they will:
- Save four percent on their Dental Blue coverage
- Simplify their bill paying with a single electronic bill for dental, health, and ancillary plans
- Enjoy convenient one-stop shopping for all their insurance needs
For more information on these great benefits and savings, contact your account executive.
* Group ancillary coverage options include Group Term Life, Group Short Term Disability, and Group Long Term Disability.
If the above links are not functioning in your email, copy and paste the URLs listed below into a browser window:
March 2009 Important Administrative Information
http://mailcenter.distribion.com/bluecrossma/dsc/collateral/march_2009_iai.pdf
GetBlueMA.com
http://www.getbluema.com/
BlueLinks for Brokers website
http://www.bluecrossma.com/broker
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2009 Blue Cross and Blue Shield of Massachusetts is an Independent Licensee of the Blue Cross Blue Shield Association. |