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.
Introducing MyBlue—a new digital member experience
This October, we're launching MyBlue, an improved digital experience that helps members manage their plan and their health. MyBlue will replace our current member portal, Member Central. Now with a simplified design, MyBlue will give members a more personalized and streamlined digital health care experience. Learn more
2017 Plan Updates
Beginning January 1, 2017, we’ll make some changes to our health plans. These changes will ensure that our plans continue to meet the ongoing requirements of the Affordable Care Act (ACA), while continuing to provide high-quality, affordable health coverage options. We’re also excited to soon offer new plan options. Learn more.
Changes to Out–of–Network Provider Claims Reimbursement
To reduce exposure to high, out-of-network provider charges, Blue Cross Blue Shield of Massachusetts is enhancing the standard out-of-network provider reimbursement approach for fully insured PPO plans. Learn more.
Mass Connector Certifies New High Deductible Health Plans
We’re pleased to announce that several of our high deductible health plan designs have received Minimum Creditable Coverage (MCC) certification from the Connector for 2016 and 2017. Learn more.
2017 Pharmacy Program Changes
Starting in 2017, commercial plans with pharmacy benefits and Medex plans with the three-tier pharmacy benefit will experience changes to their pharmacy programs. 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 locations. Coverage depends on the plan type and the nature of the care received. Learn more.
We Surpassed Medical Loss Ratio Requirements for 2015
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 2015, 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.
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. Learn more.
ACA Update on Nondiscrimination
On May 18, 2016, the U.S. Department of Health and Human Services (HHS) Office for Civil Rights (OCR) issued a final rule on Section 1557 of the Affordable Care Act that prohibits discrimination on the basis of race, color, national origin, sex, age, or disability in certain health programs and activities. Learn more.
ACA Member Months Report–Reminder
As a reminder, all of our Administrative Services Contract (ASC) accounts are being offered a tax reporting service, which follows the Affordable Care Act (ACA) guidelines. This service is available at no cost to ASC accounts for the 2016 tax year on their Member Months Coverage Report. Please notify your account executive prior to November 1, 2016, if you want Blue Cross to run this report. Learn more.
Skilled Nursing Facilities Change
On November 1, 2016, we will implement a new Medicare Advantage network of skilled nursing facilities. As of that date, members in our Medicare Advantage plans who need skilled nursing facility services should use this new network for in-network care. By collaborating more closely with a smaller network of these facilities, we hope to improve quality of care and reduce overall costs for Medicare Advantage members. Learn more.
Provider Tier Update for Blue Options v.5 and Hospital Choice Cost Sharing
Effective January 1, 2017, the provider tiers for our Blue Options v.5 benefit designs and Hospital Choice Cost Sharing benefit designs will be updated. Learn more.
NCQA Rates Our Plans Among Highest in Nation for 2016
We are pleased to announce our 2016 quality ratings from the National Committee for Quality Assurance (NCQA). The NCQA ratings are the primary measure of health plan quality in the U.S. Once again, Blue Cross Blue Shield of Massachusetts is one of the highest-rated health plans in the nation. Learn more.
New MA Law Addresses Opioid Crisis
The misuse of the prescription painkillers known as opioids is a major nationwide health care crisis. On March 14, 2016, Governor Baker signed landmark legislation that addresses this crisis into Massachusetts law. This law, which affects insured and ASC 32B accounts, will increase the availability of substance use treatment, focus on public education, and encourage the use of best-practices in prescribing. Blue Cross Blue Shield of Massachusetts has long been actively working to address the opioid crisis. Learn more.