Important Administrative Information (IAI) is a quarterly mailing that delivers the latest news about Blue Cross Blue Shield of Massachusetts products and services to employers and consultants. Sign up today to get the IAI sent directly to your email mailbox.
We're Updating Our Plans for 2016
Beginning January 1, 2016, we will be making changes to our health plans. These changes will ensure that our plans continue to meet the ongoing requirements of health care reform under the Affordable Care Act (ACA) while continuing to provide employers and their employees access to high-quality, affordable health plan options. We will also be expanding our product portfolio with new affordable plan designs.
Summary of Benefits and Coverage (SBC) Changes for 2016
As of January 1, 2016, we'll include online access on the SBC to the coverage policy documents for members who are part of small group or individual plans. Members of large group (51 eligible employees or more) plans will have access to sample coverage policies. Members can find the web address located in the disclaimer box on page one of their SBC. Learn more.
Pharmacy Program Changes Coming in 2016
Important pharmacy program changes are coming in 2016 for commercial plans with pharmacy benefits, and Medex® plans with the three-tier pharmacy benefit. These changes affect non-covered medications, Quality Care dosing limits, and more. Learn more.
New Enhancements for Dental Plans in 2016
We're making a few important changes to our dental plans starting in January. They include adding coverage for composite resin fillings on posterior teeth, and changing the end date for Essential Health Benefits. Learn more.
Introducing Telehealth—An Entirely New Way to See a Doctor
Telehealth is a real-time, video visit with a health care provider using a smartphone, tablet, or computer. Members with the Telehealth benefit can access credentialed doctors and therapists for non-urgent care in a fast and convenient manner. Learn more.
Medicare Creditable Coverage Notice Requirements
Group health plan sponsors that provide prescription drug coverage to Medicare-eligible members must notify these members whether or not their coverage is creditable. Creditable coverage means that the plan is expected to pay on average as much as the standard Medicare prescription drug coverage. Learn more and access our fact sheet.
Introducing the Blue Cross MA Message Wire
Beginning in October, we will be introducing a new communication channel, the Blue Cross MA Message Wire. This new channel uses a simple text message to engage members and connect them to relevant content through a secure web-based channel. This new resource helps members better understand their plans, improve their health, and maximize the value of their benefits. Learn more.
Get Ready for Our Newly Improved Find a Doctor and Estimate Costs Tool
Later this year, we will unveil our newly redesigned Find a Doctor and Estimate Costs tool, giving members a simple and actionable way to take control of their health care. Learn more.
Limiting the Spread of the Flu Virus
We make it easy for members and their families to get vaccinated. This flu season, we're offering a range of provider, workplace, and pharmacy-based vaccine opportunities. Coverage depends on the plan type and the nature of the care received. Learn more.
We Surpassed Medical Loss Ratio Requirements for 2014.
Annually, insurers are required to meet federal and state medical loss ratio requirements. Insurers who do not meet both requirements must issue rebates to all clients and members.
For the reporting year of 2014, Blue Cross Blue Shield of Massachusetts will not issue rebates, as our loss ratio exceeded state and federal requirements for all market segments. Learn more.
Transforming the PPO Payment Model
Health care delivery is rapidly changing, and a stronger focus on delivering value—a combination of quality and cost—is critical to employers and their employees. With our broad local presence, unprecedented national scale, and the largest provider network in the industry, we're strongly positioned and firmly committed to addressing these needs. Learn more.