Notification of Appeals Process Changes for Self-Insured Accounts
As a result of national health care reform, new internal and external appeals process obligations have been established for self-insured plans1 and their members have been granted new rights.
These new rights and obligations will become effective on anniversary for plans renewing after September 23, 2010. While some of the changes will take effect immediately upon plan renewal, others will be effective by July 1, 2011.
In the coming weeks, we will be sending a letter to our self-insured accounts to make them aware of these new changes and their potential impact. The letter urges our accounts to review their new obligations and outlines changes to the appeals process.
For more information on this topic, please see the Internal and External Member Appeals provision. If you have additional questions, contact your account executive.
1. If a plan has elected to maintain "grandfathered" status, its obligations may be different.
This information is provided for informational purposes only and does not constitute legal advice. Please consult your legal counsel regarding your specific situation.
Please note that this content is only intended to describe national health care reform requirements under the Patient Protection and Affordable Care Act (PPACA). It does not address Massachusetts law requirements or the potential impact of Massachusetts law on federal PPACA requirements.
For purposes of PPACA implementation, Blue Cross Blue Shield of Massachusetts assumes the plan year is the policy year, unless an account notifies us otherwise.