Blue Links for Employers

We're Updating Our Plans for 2016

As of January 1, 2016, we will update the hospital and primary care provider tiers within our Blue Options and Hospital Choice Cost Sharing (HCCS) tiered plans.

Why We Are Updating our Tiers?
Periodic updating of our tiers with the most current available data is an important step in maintaining our tiered network plans as an affordable choice for our members. It also encourages providers in our network to continue to improve their cost and quality performance by reflecting these changes over time in the provider's tier.

What is the Impact on Members?
The tier update will change the cost of care for some primary care providers and hospitals. Member cost will increase or decrease, depending on the new tier their primary care provider or hospital is assigned.
These changes will go into effect for all Blue Options plans the next time they renew, beginning January 1, 2016. For plans that include HCCS, all changes will go into effect on January 1, 2016. The updating of tiers will be identified on member ID cards and in our provider directory as Blue Options v.5.

Summary of Massachusetts Hospital Changes for Blue Options

Hospital Name 2015 (current) Blue Options Tier 2016 (new) Blue Options Tier
Addison Gilbert Hospital Standard Benefits Tier Enhanced Benefits Tier
Beth Israel Deaconess—Plymouth Standard Benefits Tier Enhanced Benefits Tier
Beth Israel Deaconess Med. Center Enhanced Benefits Tier Standard Benefits Tier
Beverly Hospital Standard Benefits Tier Enhanced Benefits Tier
Charlton Memorial Hospital Standard Benefits Tier Enhanced Benefits Tier
Clinton Hospital Standard Benefits Tier Enhanced Benefits Tier
Cooley Dickinson Hospital Standard Benefits Tier Enhanced Benefits Tier
Clinton Hospital Standard Benefits Tier Enhanced Benefits Tier
Good Samaritan Medical Center Standard Benefits Tier Enhanced Benefits Tier
Holy Family Hospital Enhanced Benefits Tier Standard Benefits Tier
Marlborough Hospital Enhanced Benefits Tier Standard Benefits Tier
Nashoba Valley Medical Center Enhanced Benefits Tier Standard Benefits Tier
North Shore Med. Ctr (Salem & Union) Basic Benefits Tier Enhanced Benefits Tier
South Shore Hospital Basic Benefits Tier Enhanced Benefits Tier
St. Anne's Hospital Standard Benefits Tier Enhanced Benefits Tier
St. Elizabeth's Medical Center Enhanced Benefits Tier Standard Benefits Tier
St. Luke's Hospital Standard Benefits Tier Enhanced Benefits Tier
Tobey Hospital Standard Benefits Tier Enhanced Benefits Tier

 

Summary of Massachusetts Hospital Changes for Hospital Choice Cost Sharing (HCCS)

Hospital Name Previous HCCS Cost Share HCCS Cost Share 1.1.16
North Shore Med. Center (Salem & Union) Higher Cost Share Lower Cost Share
South Shore Hospital Higher Cost Share Lower Cost Share

 

HMO Blue New England Options Tiered Network Plans

HMO Blue New England Options HMO Blue New England Options Deductible II
HMO Blue New England Options Deductible HMO Blue New England Options Deductible III

Members in these plans already have access to 6 provider networks within New England. They will continue to have access to the same network of providers they do today. However, New Hampshire primary care providers and hospitals will now be placed into one of two benefit tiers. Member costs for some doctors and hospitals in New Hampshire will change, depending on the new tier a doctor or hospital is assigned.

A network primary care provider or network general hospital located in NH
will now be considered either:

A Tier 1 (Enhanced Benefits Tier) provider A Tier 2 (Standard Benefits Tier) provider

There will be no NH providers equivalent to the Basic Benefits Tier. Network primary care providers or general hospitals in the New England network located outside of Massachusetts or New Hampshire will continue to be in the Enhanced Benefits Tier. For our New England plans with the Hospital Choice Cost Sharing feature, there is no change to the member's cost share. All New Hampshire hospitals are considered "Lower Cost Share."

For help in finding the benefits tier of a provider, visit the online provider search tool at
www.bluecrossma.com/findadoctor and search for HMO Blue New England Options v.5.

Blue Cross Blue Shield of Massachusetts

Blue Cross Blue Shield of Massachusetts is an Independent Licensee of the Blue Cross and Blue Shield Association.
® Registered Marks of the Blue Cross and Blue Shield Association.
© Blue Cross and Blue Shield of Massachusetts, Inc.
101 Huntington Avenue, Suite 1300, Boston, MA 02199-7611 | 1-800-262-BLUE (2583)