Blue Links for Employers

Special Announcements

Update on the Shellshock Bash Software Vulnerability
We are aware of the recent vulnerability from the Shellshock Bash software bug. Our analysis shows that no data has been compromised due to this vulnerability. We will continue to monitor all of our systems and take this threat seriously. The security and privacy of your data is of the utmost importance to us.

IRS releases new guidance adjusting the PCORI fee dollar amount
The ACA created the nonprofit Patient-Centered Outcomes Research Institute to help health care providers and others evaluate and compare health outcomes, clinical effectiveness, and the risks and benefits of treatments. To fund this research, the ACA is charging a fee to certain health insurers (those who offer fully insured plans) and plan sponsors of self-insured health plans.

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.

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.

Introducing Zaffre Investments-A New Shade of Blue
Zaffre Investments is a new, wholly owned subsidiary of Blue Cross Blue Shield of Massachusetts. They make strategic investments that add new value and offerings for our customers, while strengthening and diversifying our core business.

Our Medical Loss Ratio Surpasses Requirements for 2013
Blue Cross Blue Shield of Massachusetts will not be issuing rebates, as our loss ratio of approximately 90 percent exceeded both state and federal medical loss ratio standards. Our ability to surpass the state and national standards reflects our commitment to offering the best possible value to our customers and to keeping our administrative costs as low as possible.

CEO Andrew Dreyfus featured in The Boston Globe Magazine
At Blue Cross, we're proud of the efforts undertaken in Massachusetts to make quality health care affordable. Together, we've been able to moderate health care costs for the individuals, families and employers that call Massachusetts their home.

Important Surveys: Medical Loss Ratio and Employer Group Size
In July, you will receive up to two surveys from us in the mail to determine medical loss ratios and how many workers you employ. Your response is important as the surveys help us comply with the Patient Protection and Affordable Care Act and Medicare Secondary Payer laws.

Upcoming Changes to Preventive Services
As mandated by the Affordable Care Act, we're making changes to our preventive services coverage based on new recommendations from the United States Preventive Services Task Force. Effective September 24, 2014, and January 1, 2015, fully insured and self-insured non-grandfathered health plans must cover select services without copayments, co-insurance, or deductibles.

PPO Members Can Avoid High Costs by Using In-Network Providers
Out-of-network doctors and hospitals can charge significantly more than what Blue Cross pays in-network providers. When a member uses an out-of-network doctor, hospital, or other health care provider, the member is responsible for the difference between what the provider charges and the amount Blue Cross pays those providers. This significantly increases the member's out-of-pocket medical costs.

PPO Members Can Avoid High Costs by Using In-Network Providers
Out-of-network doctors and hospitals can charge significantly more than what Blue Cross pays in-network providers. When a member uses an out-of-network doctor, hospital, or other health care provider, the member is responsible for the difference between what the provider charges and the amount Blue Cross pays those providers. This significantly increases the member's out-of-pocket medical costs.

Introducing the Wellness Corner
This new section of the IAI will feature updates from our Prevention and Wellness Division, such as ahealthyme® secure site upgrades, employer success stories, technology improvements, and wellness tips.

Introducing Blue 20/20
Blue 20/20 is a stand-alone vision product that we recently launched. It's powered by EyeMed Vision Care®' and is available to groups with two or more employees.

Members Can Now Find Doctors and Compare Costs
We've enhanced the health care provider search and cost estimation capabilities within our Find a Doctor tool.

North Adams Regional Hospital Community Visits
In response to the closure of the North Adams Regional Hospital and several affiliated medical practices, we are visiting the area on Friday, April 4th to help answer our members' questions and support the community.

North Adams Regional Hospital Closure Update
In light of the recent, unexpected closing of North Adams Regional Hospital, we have recently contracted with Southwestern Vermont Medical Center to provide our members with HMO Blue® (Massachusetts-only network) health plans with adequate health care access.

North Adams Regional Hospital Closing
North Adams Regional Hospital, along with several affiliated medical practices, has announced its plans to close today, March 28, 2014.

Safely Discard Unwanted Drugs on April 26
The U.S. Drug Enforcement Administration's next National Prescription Drug Take Back Day will take place on Saturday, April 26, 2014, from 10:00 a.m. to 2:00 p.m.

New: PPO member primary care provider changes
We want our members to get the best care possible. That's why we're asking all members, including PPO members, to have a primary care provider on file. This change does not affect PPO coverage. PPO members still don't need a referral to see other doctors or specialists.

New Behavioral Health Program Available to Select Members
We're offering a new program for select members with behavioral health conditions—at no additional cost to members. The goal is to provide these members with community support services that will assist them in achieving healthier, more stable lives while reducing their health care costs.

Great News: New Orthodontic Coverage Options for Small Groups
We're expanding our selection of Dental Blue® Pediatric Essential + Adult plans by allowing them to be purchased with traditional orthodontic coverage options.

Have you "liked" us yet?
From Facebook and Twitter to LinkedIn and YouTube, Blue Cross continues to have a presence in the social scene. Social media sites help us connect and inform our customers about important health information, Member Service support, job openings, and more.

Treasury Department Delays ACA Employer Mandate for Certain Employers
Treasury Department Delays Affordable Care Act (ACA) Employer Mandate Until 2016 for Employers with 50-99 Employees that do not yet Provide Affordable Insurance to Full Time Workers.

Notifying Members of Their Mental Health Benefits
The Massachusetts Division of Insurance requires us to inform members of their rights according to federal and state mental health parity laws.

Members Will Have an Easier Time Finding Doctors and Comparing Costs
Coming soon! We're enhancing the provider search and cost estimation capabilities within Find a Doctor. Soon, members will have an easier time making more informed health care decisions.

Watch and Share: Tutorials Explain Consumer-Directed and Blue Options Plans
If you offer a consumer-directed health plan or a Blue Options plan, you know it can be challenging for your employees to understand the ins and outs of their coverage.

How Members Can Avoid Costly Trips to the Emergency Room
We've created a page on Member Central for members to learn about cost-saving alternatives to the emergency room.

Important Change to PPO Plans That Could Reduce Your Costs
To help lower costs for employers and members, Blue Cross may negotiate lower, out-of-network claims. This change takes effect in 2014 and applies to self-funded employers with commercial PPO plans.

Specialty Pharmacy Name Change
On January 1, 2014, CuraScript®'', a subsidiary of Express Scripts®'', will join Accredo Health Group, Inc.®'' You can use the Accredo website and telephone number listed below for questions related to a specialty medication. This change will not interrupt or delay future refills, as only the name of the pharmacy is changing.

Pharmacy Changes, Effective January 1, 2014
Coming January 1, 2014 there are updates to the Pharmacy Formulary Program. They range from medication tier status to prior authorization, expansion of our list of specialty medications not covered when administered in certain settings to a new step therapy policy.

Blue Options v.4 Tiering Updates
Effective January 1, 2014, Blue Options v.4 members will have lower out-of-pocket costs at Holyoke Medical Center and Athol Memorial Hospital.

New Treatment Estimates Help Members Plan for Upcoming Costs
Beginning October 1st, members can request an estimate for an upcoming treatment or medical procedure.

2014 Product Portfolio and Benefit Design Updates
Beginning January 1, 2014 we will be making several benefit changes to our medical and dental plan designs resulting from national health care reform and state requirements.

Important Survey: Employer Group Size and Medical Loss Ratio
In July 2013, employers that have a fully insured (premium) financial arrangement with Blue Cross Blue Shield of Massachusetts received surveys in the mail to help us categorize employers as "Small" or "Large" to determine the medical loss ratio as defined by the Patient Protection and Affordable Care Act (PPACA).

Pharmacy Formulary Program Updates
Changes to our pharmacy formulary program are coming in 2014. They range from medication tier status to prior authorization to expansion of our list of specialty medications not covered when administered in certain settings.

Healthy Actions Now Available to Accounts with 51-99 Employees
Great news! Our innovative Healthy Actions wellness program is now available to qualifying employers with 51-99 employees for new sales and plan renewals with an effective date beginning January 1, 2014.

The Affordable Care Act and the Multi-State Option
The Affordable Care Act includes a Multi-State plan provision that requires the federal government, specifically the Office of Personnel Management (OPM) to select national health insurance companies to offer health benefit plans on each state's insurance exchange.

Updates to Our Notice of Privacy Practices and Business Associate Agreements
Earlier this year, the U.S. Department of Health and Human Services further strengthened existing Health Insurance Portability and Accountability Act (HIPAA) provisions with the Omnibus Rule. This rule established new requirements that impact our Notice of Privacy Practices and Business Associate Agreements.

Do You Qualify for a Wellness Tax Credit?
You may be eligible for a state tax credit for up to 25% of the costs of your program. Find out how.

Special Open Enrollment Opportunity in Response to DOMA Decision
During this special Open Enrollment period, same-sex spouses and their dependents, who are not already enrolled in their spouse's current policy, can be added to it.

ReportBlue Replaces Standard Cost and Utilization Trend Reports
It's official. The Standard Cost and Utilization Trend Reports have been discontinued. Data is now available through ReportBlue.

Governor Repeals Fair Share Contribution Plan
On July 12, 2013, Governor Deval Patrick signed a budget bill that includes a repeal of the Massachusetts Fair Share Contribution plan.

Key Affordable Care Act Provisions Postponed
Last night the U.S. Department of Treasury made two key announcements related to the Affordable Care Act implementation.

Healthy Actions Wellness Program Updates
Healthy Actions now rewards both subscribers and employers with 1 to 50 employees for taking steps toward better health.

New! Members Can Get Vaccines at Pharmacies
Effective immediately, members 18 years of age and older with pharmacy benefits can get 11 different immunizations at a participating Express Scripts®′ retail pharmacy. There's no cost share and a prescription is not required.

New MA Law mandates coverage for oral anticancer drugs
Blue Cross Blue Shield of Massachusetts will provide full coverage for prescribed, orally administered anticancer drugs. For HSA-compliant high-deductible health plans, the overall deductible will still be applicable.

$9 Generic Medications
Your employees can pay just $9 for each 90-day supply of certain prescription medications at the Express Scripts Mail Service Pharmacy®′.

New Sleep Management Program Improves Convenience, Compliance, and Affordability
Beginning July 1, 2013, we will introduce a sleep management program for our HMO and POS members (excluding Medicare Advantage) to improve convenience and enhance health care affordability.

Brand-New Find a Doctor Tool Now Available
Our completely redesigned Find a Doctor tool makes it easier for your employees to search for providers and make informed health care decisions.

New for 2013: Summary of Health Plan Payments
We renamed and redesigned our Explanation of Benefits, also known as Claim Summary. Now called the Summary of Health Plan Payments, this simpler and easier-to-understand statement shows our members how we process their claims.

Update: Three New State Mandated Changes
Blue Cross Blue Shield of Massachusetts has updated our plans to reflect the changes Governor Deval Patrick signed into law in August.

New! Blue Funding Solution: A New Self-Funding Option
Learn how employers with 51-99 employees can maximize their savings potential while limiting risk and managing cash flow

New! Dental Blue® Community Rated Voluntary Dental Plans for Small Groups
Our new community rated voluntary dental plans offer competitive rates, local and national coverage, and the dependability of a world-class health care leader. Dental Blue members see the provider of their choice. Because it's a voluntary plan, employers can offer this popular benefit without incurring additional costs.

Pathway to Savings: A multi-year roadmap to lower cost and better health
Available for fully insured accounts with 100+ employees, Pathway to Savings, is a customized and integrated, multi-year strategy designed to help ease rising health care costs and improve employees' health.

A Guide to HMO Blue® Coverage Outside the Area
Learn what's covered when your employees are living or traveling outside their service area.

New: Coaching For Inner Strength Program
Dealing with a serious, ongoing illness can be exhausting and stressful, not only for the member who is ill, but also for his or her family and coworkers as well. Now there's a new program from Blue Cross Blue Shield of Massachusetts that gives members personalized support as they cope with challenging medical issues.

New! Mobile Services Website
Members can easily connect with mobile services—apps, websites, social media sites, and text programs—from our new site.

Do Your Employees Know the Importance of Referrals?
When employees understand that referrals actually help them receive better care, they are more likely to request them. However, you may need to explain their importance.

Members Invited to Join Study Promoting Medication Adherence
Beginning in January, we will contact select members and invite them to participate in a research study investigating ways to get patients to take their medications as prescribed.

A Guide to Coverage Outside the United States
Learn what's covered when employees carry Blue Cross Blue Shield of Massachusetts cards while traveling outside the country.

Introducing a New Plan for Large Groups (51+)
Beginning January 1, 2013, we will be offering a new affordable option: HMO Blue New England $3,000 DeductibleSM.

Coming January 1, 2013: Updates to Pharmacy Formulary Program
With these changes, members and doctors will continue accessing a variety of safe, clinically effective medications at affordable prices.

New Approach to Health Management
To better help members with common chronic conditions, we are launching a state-of-the-art in-house care management service.

Update: Expanded Prevention Coverage for Colorectal Services
Starting January 1, 2013, we will remove the age and frequency restrictions for preventive colorectal services in our preferred provider organization (PPO) and Indemnity plans.

New: Coaching For Inner Strength Program
A new program from Blue Cross Blue Shield of Massachusetts that gives members personalized support as they cope with challenging medical issues.

BlueValue RxSM Formulary Will Be Discontinued
Starting January 1, 2013, we will begin phasing out our generic medication-based formulary, BlueValue Rx.

Walgreens Returning to Retail Pharmacy Network
Walgreens and Express Scripts®' reached a multi-year agreement for Walgreens and its subsidiary pharmacies.

Metro Drugs Joins Specialty Pharmacy Network for Fertility Medications
With the addition of Metro Drugs, our members have another high-quality option for purchasing their prescription medications that treat infertility.

Introducing Next Generation Blue365®: Because health is a big dealSM
To encourage members to live a healthier lifestyle and promote their well-being, the Blue365 program offers weekly deals on healthy discounts from top national and local retailers.

Update: BlueLinksSM Help Desk Hours Changed
If you need help, call the BlueLinks for Employers Enrollment Management Help Desk during our new hours: 8:30 a.m. to 5:00 p.m. ET.

Additional Dental Products for Small Groups
Beginning October 1, 2012, we will increase our standard dental plan selections for small group employers.

Coming Fall 2012: Summary of Benefits and Coverage (SBC)
Under the federal Affordable Care Act, health insurers and group health plans are required to provide an SBC to those who have private insurance.

The 2012-2013 Flu Season
Blue Cross Blue Shield of Massachusetts remains committed to helping limit the spread of the flu virus.

Changes to Women's Preventive Health Services Coverage
The U.S. Department of Health and Human Services has issued guidelines to ensure that all women have access to preventive health services necessary for women's health and wellbeing.

Blue Options Tiers Being Updated
We are updating the hospital and primary care provider groups tiering levels within our Blue Options plans. The changes will go into effect for employer groups currently offering a Blue Options plan on the group's first renewal date on or after January 1, 2013 and for all new accounts on or after January 1, 2013.

Change in Tiered Network Benefits For Some Serious Conditions
Our tiered network plans now include a new benefit for certain members with a serious health condition, such as cancer or cystic fibrosis.

Expanded Prevention Coverage for Women's Health and Wellbeing
The U.S. Department of Health and Human Services has issued new guidelines that require health plans to cover the recommended women's preventive health services without charging a copayment, co-insurance, or deductible.

New: Affordable Mail Service Pricing at Retail Pharmacies
With our Exclusive Home Delivery benefit, members can use Express Scripts®' mail pharmacy for certain maintenance medications.

AcariaHealth™ Joins Specialty Pharmacy Network
Members who take specialty medications are required to use one of the specialty pharmacies in our network. We're pleased to announce that AcariaHealth is now part of that network.

Healthy Actions Program
Healthy Actions is a unique wellness program is available to small group employers with 10-50 employees enrolled in a qualifying plan. This program rewards employees for taking an active role in their health. And based on employee success and participation rates, employers get rewarded with up to 5 percent of their premium.

Enhancement: Large Group Voluntary Dental Program
Beginning in June of 2012, we're excited to increase our presence in the voluntary market by offering our full portfolio of standard dental products on a voluntary basis to employers with 100 or more employees.

Ahealthyme.com-An Enhanced Approach to Family, Fitness, and Fun
We've made some improvements to ahealthyme.com that make it even easier for your employees to manage their health and their health plan. These include expanded wellness content and easy access to Member Central for Blue Cross Blue Shield of Massachusetts members.

CVS MinuteClinics®': Quick, Convenient Care
We've partnered with CVS to give Blue Cross Blue Shield of Massachusetts members access to a range of simple medical treatments at CVS MinuteClinics. Members can get care at these limited services clinics, usually for the same copayment as their primary care provider and without the need for a referral.

New Prior Authorization Requirement for Infant Formula Effective August 1, 2012
For members up to 12 months of age, Blue Cross Blue Shield of Massachusetts will require prior authorization before coverage will be provided for infant formula purchased from a pharmacy with a prescription.

New Quality and Safety Measures in Opioid Management, Effective July 1, 2012
Blue Cross Blue Shield of Massachusetts has consulted with an external advisory group of pain management experts, addiction experts, and primary care providers and pharmacists to develop a comprehensive program to promote evidence-based, safe, high quality, opioid prescribing.

Updated Quality Results Help Members Select a Primary Care Provider
We've incorporated updated quality results into the Find A Doctor tool on Member Central to make it even easier for our members to make informed choices.

Enhanced Cost Comparison Tool Helps PPO Members Better Manage Costs
We've improved our Medical Cost Comparison guide to make it even easier for our members of our Preferred Provider Organization (PPO) plans and their doctors to make effective health care choices.

Account Reminder: Status Change
As a reminder, it is critically important that you provide Blue Cross Blue Shield of Massachusetts with the most up-to-date enrollment status data, so that benefits can be coordinated as efficiently as possible.

Walgreens Leaving the Express Scripts Inc.® Pharmacy Network
Express Scripts, Inc. is the company that administers pharmacy benefits on behalf of Blue Cross Blue Shield of Massachusetts. Walgreens has notified Express Scripts that it will no longer participate in the Express Scripts retail pharmacy network as of January 1, 2012.

Important Reimbursement Changes in Blue Choice & Blue Choice Plan 2
In an effort to deliver more affordable products to our accounts and members, we are changing the way we reimburse members in certain plans for services received from non-participating1 providers and facilities in Massachusetts, effective January 16, 2012.

Safely Discard Unwanted Drugs on October 29
The U.S. Drug Enforcement Administration's next National Prescription Drug Take Back Day will take place on Saturday, October 29, 2011, from 10:00 a.m. to 2:00 p.m.

Reimbursement for Out-of-Network PPO Providers
Effective January 1, 2012, claim payments will change under our commercial PPO plans for covered services provided by most non-participating covered providers.

Quick, Convenient Care with Minute Clinics
We've partnered with CVS to give Blue Cross Blue Shield of Massachusetts members access to a range of simple medical treatments at CVS Minute Clinics.

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