Summary of Benefits and Coverage (SBC) Changes for 2016
As of January 1, 2016, we'll include online access on the SBC to the coverage policy documents for members who are part of small group or individual plans. Members of large group (51 eligible employees or more) plans will have access to sample coverage policies. Members can find the web address located in the disclaimer box on page one of their SBC.
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.
Affordable Care Act Preventive Services Update
The United States Preventive Services Task Force has announced changes that will go into effect in 2015. Both fully insured and self-insured accounts will be affected by these changes, including grandfathered accounts that adopted Affordable Care Act preventive services benefits. Blue Cross Blue Shield of Massachusetts has developed an aggressive implementation schedule for these changes in order to gain administrative efficiencies. Read more here.
Certificates of Creditable Coverage No Longer Required by the Affordable Care Act
Beginning January 1, 2015, insurers are no longer required to issue certificates of creditable coverage to members.
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.
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 Blue Cross Blue Shield of Massachusetts.
Members to supply information to comply with ACA coverage
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. We will send out letters to subscribers (including member dependents) requesting their tax ID numbers in late 2014 and over the course of 2015. Members who don't prove they have minimum coverage will be penalized when they file federal income tax returns in 2016.
Changes to how carriers calculate 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.
New mothers can order a breast pump at no cost
We are pleased to announce that members living in Massachusetts can now order select breast pumps, at no cost to them, through our newly contracted suppliers, Ameda Direct and Medela, two of the nation's leading breast pump manufacturers.
Final Regulations for Mental Health Parity and Addiction Equity Act
Final regulations regarding the Mental Health Parity and Addiction Equity Act (MHPAEA) are effective July 1, 2014 upon renewal and apply to all commercial plans, administrative service contracts, and fully insured plans—including grandfathered and non-grandfathered plans.
MA Health Care Reform
In May 2006, Massachusetts enacted a health care reform law that made the Commonwealth the first state in the nation to provide nearly universal health care coverage.
National Health Care Reform
View news and information on National Health Care Reform.
Required Reporting of Social Security Numbers.
Early Intervention Mandate
An overview of the Early Intervention Mandate.
Racial, Ethnic & Language Health Care Disparities
Collecting member data to help improve quality of care.
An overview of COBRA and mini-COBRA subsidies and what they mean for your business and your employees.
HIPAA Standard: Version 5010
Blue Cross Blue Shield of Massachusetts prepares to implement the next HIPAA Standard: Version 5010.
Important Direct Pay Eligibility Changes
Find out about your Direct Pay eligibility and enrollment options for 2010.