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Employer Newsletter - IAI

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.

Current Edition:

Clarification for PPO Products for Enrolled Members with Medicare as the Primary Payer
The following clarification affects members who have Medicare as their primary payer and are enrolled in a fully insured or self- funded PPO product with BCBSMA.
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We Surpassed Medical Loss Ratio Requirements for 2013
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 2013, 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 about medical loss ratio at or

Bulletin Prohibits Health Plan Discrimination Toward Gender Identity or Gender Dysphoria.
We are updating our benefits in response to a bulletin that prohibits health insurers from discriminating against individuals with Gender Dysphoria.
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Supporting Healthcare Consumerism with Cost Estimation Resources
Through our Find a Doctor tool, members have access to online cost estimation information on hundreds of common services and treatments. Members can access the tool by logging in to their Member Central account and clicking on the Find a Doctor link. Additionally, if necessary, members can request a written cost estimate by filling out and submitting a request form.
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Lower Dental Out-of-Pocket Maximums
To comply with Affordable Care Act (ACA) mandates, we are decreasing the out-of-pocket maximums for ACA compliant dental plans sold to small groups, beginning January 1, 2015.
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Pharmacy Program Changes Coming in 2015
Starting in 2015, commercial plans with pharmacy benefits and Medex®' plans with the three-tier pharmacy benefit will see important changes to their pharmacy program. In addition, we'll be making coverage changes to some specialty medications.
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We're Updating Our Plans for 2015
We will be updating our health plans to meet new state and federal requirements. We will also be expanding our product portfolio with new affordable plan designs.
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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 workplace, pharmacy, and other retail-based vaccine opportunities. Coverage depends on the plan type and the nature of the care received.
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Members to supply information to comply with Affordable Care Act minimum essential coverage in coming year
Pursuant to the Affordable Care Act (ACA) Individual Responsibility provision, federal law mandates that health plans provide evidence of minimum essential health care coverage to individual members in fully insured accounts by 2016.
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Blue Options v.4 and Hospital Choice Cost Sharing Tier Update
Effective January 1, 2014, Blue Options v.4 and HCCS members will have lower out-of-pocket costs at Harrington Memorial Hospital.
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Employees Can Achieve Their Wellness Goals from Their Phone
Your employees can take ahealthyme with them everywhere they go with our new HealthyNow app. With it, they can track their activities, log their meals, and update their weight anytime, anywhere from their smartphone or tablet. To download and activate HealthyNow, visit ahealthyme.

Changes to how carriers' calculations of Small Group business premiums
The Affordable Care Act (ACA) indicates new rules for how insurance carriers calculate premiums for Small Group business (1-50 eligible employees). Although the new methodology is premium neutral, there are a few differences from our current methodology.


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