The annual enrollment period is closed for 2014.   But, you can still get a quote and apply if you have a Qualifying Life Event so you can enroll during our Special Enrollment Period.  Otherwise, you will not have the opportunity to apply until our Open Enrollment which starts 11/15/2014 for a 1/1/2015 effective date.  When completing the Blue Cross Blue Shield of North Carolina application, you will have the option to select which Qualifying Life Event may be applicable to you.  If you have extraordinary circumstances, you should talk with the Marketplace to determine if you can enroll without one of the Qualifying Life Events outlined below.  Please call our office 888-765-5400 to talk with one of our qualified representatives who can help guide you through the process of applying and assist you in determining if you could be subsidy eligible.

Special circumstances for enrolling outside of the open enrollment period include:

•Loss of minimum coverage (employer coverage, government plans, etc.)

•Adding a dependent through birth, adoption or marriage

•Gaining citizenship

•Enrollment/non-enrollment errors by the federal Marketplace or the US Department of Health and Human Services

•Qualified health plan violates the material provision of its contract with the individual

•Newly eligible for a subsidy or a change in the amount of subsidy you are eligible for

•Moving to a new state

•American Indian/Alaska Native status (may change once a month)

In August, 2014 Jerry Ballard was inducted by Blue Cross Blue Shield of North Carolina into their Hall of Fame, the highest honor bestowed upon any employee, agent or broker.   Jerry was recognized for outstanding performance and production in the field of health insurance.   Jerry has led the company in individual sales for the last 10 consecutive years and has also been awarded by Blue Cross Blue Shield of North Carolina (BCBSNC) membership in its President’s Club as a top agent every year since its inception.  Jerry is a Charter Member of that exclusive group and has been serving both groups and individuals in the insurance business throughout North Carolina for over 40 years.

Jerry  leads his company with an impressive team of Agents that provide exemplary service to all of their customers throughout North Carolina.  Jerry expanded his business model to the internet in 2000 providing customers the opportunity to shop for their health insurance online 24/7.  Jerry resides in Morehead City, North Carolina with his wife and business partner, Cathy.

Webster’s Dictionary defines the word essential as “extremely important and necessary,” and Blue Cross Blue Shield of North Carolina couldn’t agree more.  Regardless of the coverage you choose, health care reform requires that qualified health plans include 10 essential health benefits that fall into the following categories that will help keep you and your family healthy and secure.

• Ambulatory Services
• Emergency Services
• Hospitilization
• Maternity and Newborn Care
• Mental health and substance abuse services (including behavioral health)
• Prescription drugs
• Rehabilitative and habilitative services and devices
• Laboratory services
• Preventive/wellness services and chronic disease management
• Pediatric services, including dental and vision

BCBSNC understands that your health care matters and that these essential services are extremely important and necessary to your overall wellness and peace of mind.  With a variety of health care policies to meet your essential needs, Blue Cross Blue Shield of North Carolina is committed to offering quality health care that more than covers the basics.  To find a BCBSNC health plan you can trust with your essential care, click here.

For more information on health insurance coverage in North Carolina, please visit our website at www.nchealthplans.com or call our toll free number 888-765-5400 and speak with one of our professional agents. Our agency provides coverage for health insurance in North Carolina through Blue Cross Blue Shield of North Carolina (BCBSNC). It would be our pleasure to help you navigate through the Health Care Reform changes in accordance with the new regulations of Obamacare. Call us for details.

 

To help make health care more affordable, the federal government offers advance premium tax credits, or subsidies, to low-to middle-income individuals and families. Your subsidy is an advance premium tax credit and is applied directly to your premium. Government subsidies reduce the amount you pay for your insurance plan.

To be eligible for a subsidy, you must meet certain requirements.

• Be between 100% and 400% of the federal poverty level (FPL).
• Not eligible for public coverage, such as Medicaid, the Children’s Health Insurance Program,  Medicare or military coverage, such as Tricare.
• Not have access to minimal essential coverage through an employer. (An exception may be made if your employer’s plan does not cover at least an average of 60% of covered benefits or if the employee’s share of the premium is more than 9.5% of his or her income.  Employers can tell you if their plans meet these criteria.)

Subsidies can be used on any plan you choose except for grandfathered plans and catastrophic plans for those under 30. How much of a subsidy you qualify for is based on income and household size.

Our free BCBSNC Rate Quote offers a calculator to determine if a subsidy may be available to you.

2016 POVERTY GUIDELINES FOR THE 48 CONTIGUOUS STATES AND THE DISTRICT OF COLUMBIA
Persons in family/household	100% Poverty guideline	250% Poverty guideline	400% Poverty guideline
1	$11,770	$29,425	$47,080
2	$15,930	$39,825	$63,720
3	$20,090	$50,255	$80,360
4	$24,250	$60,625	$97,000
5	$28,410	$71,025	$113,640
6	$32,570	$81,425	$130,280
7	$36,730	$91,825	$146,920
8	$40,890	$102,225	$163,560
For each additional person, add:	$4,020	$10,050	$16,080

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

For more information on Blue Cross Blue Shield of North Carolina insurance coverage, the Marketplace and healthcare gov to apply for your subsidy, please visit our website at www.nchealthplans.com or call our toll free number 888*765-5400 and speak with one of our experienced and professional agents.  Let us help you navigate through the Health Care Reform changes in accordance with the new regulations of The Affordable Care Act, also known as Obama care.

 

 

 

 

 

 

Negotiating new terminology is one of the toughest parts to understanding all the recent changes in health care policies and procedures.  Terms like “open enrollment,” “government subsidies,” and “qualifying life event (QLE)” can be confusing even to the most thorough students of health insurance and the Affordable Care Act.  When applying for health coverage, however, understanding these terms and how they can affect your health care options is an absolute imperative.

Under the Affordable Care Act, there are two different periods in which an individual may apply for health insurance.  The first is referred to as Open Enrollment and during this time any person may apply for health coverage.  During Special Enrollment, however, there are more restrictions and a person is required to have what is referred to as a Qualifying Life Event (QLE) in order to acquire health insurance.  If you do not have one of these Qualifying Life Events, you may not purchase health insurance during Special Enrollment and must wait until the Open Enrollment Period.  This is not a Blue Cross Blue Shield of North Carolina policy, but rather a policy of the federal government under the Affordable Care Act with which BCBSNC must comply.

Basically, a Qualifying Life Event is a specific circumstance that has altered your life—and there are strict guidelines to determine exactly what qualifies.  For example, a recent  marriage, divorce or birth of a child are all events that would make you eligible to enroll in health coverage during a Special Enrollment period, so long as you enroll within 60 days of that life altering event.  Losing previously held health insurance involuntarily is another example of a Qualifying Life Event, as is changing your permanent place of residence. If your income increases so that you are no longer eligible for Medicaid, you are also able to enroll in new coverage during a Special Enrollment Period.  Because the list of Qualifying Life Events is so varied, however, it is worth investigating whether you qualify to enroll during a Special Enrollment period.

Although the terminology can be confusing, it is important for you to understand what constitutes a Qualifying Life Event because it can have a huge impact on your ability to purchase health insurance.  In addition, the effective date of your coverage will depend on your QLE and the date of your application.

For more information on health insurance coverage in North Carolina, please visit our website at www.nchealthplans.com or call our toll free number 888-765-5400 and speak with one of our professional agents. Our agency provides coverage for health insurance in North Carolina through Blue Cross Blue Shield of North Carolina (BCBSNC). It would be our pleasure to help you navigate through the Health Care Reform changes in accordance with the new regulations of Obamacare. Call us for details.

 

Qualifying Life Event

Which type of Qualifying Life Event have you or a dependent experienced within 60 days?

• Lost eligibility or access to minimum essential coverage – not through an employer
• Lost eligibility or access to minimum essential coverage – through an employer
• Gained a dependent or became a dependent through birth, adoption, placement for adoption or placement as a foster child
• Gained a dependent or became a dependent through marriage or the establishment of a domestic partnership
• You or a dependent gained US citizen status
• You or your dependents gained access to coverage as a result of a permanent move to (NC) or as a result of a move to a new county within NC
• Your or your dependents’ enrollment or non-enrollment in another benefit health plan was made as a result of an error by the Health Insurance Marketplace
• You or your dependents demonstrated that the health benefit plan you were previously enrolled in substantially violated material provisions of the contract
• You or your dependent are determined newly eligible or ineligible for advance payments of the premium tax credit (APTC)/subsidy or have a change in eligibility for cost-sharing reductions
• You or your dependent has been released from incarceration

Blue Cross Blue Shield of NC offers several network options when selecting your health insurance plan to allow you the flexibility to choose the coverage that bests suits your needs.  It is important to understand these networks before making your final plan selection.

To gain access to the best and largest network of doctors and hospitals, go with a Blue Advantage plan.  Blue Advantage offers you a broad choice of doctors, specialists and hospitals with the largest network available that includes 91% of doctors and 99% hospitals.

Does having the option to save money by selecting a doctor from two tiers of in-network providers appeal to you? Blue Select plans offer you this opportunity. With Blue Select, BCBSNC has tiered benefits and providers to help you make the most of your health care spending. BCBSNC has evaluated doctors and specialist physician practices on their quality outcomes, cost efficiency, and accessibility and created two categories:

Tier 1 are providers who received top ratings, and you’ll receive a richer benefit when you choose these providers.

Tier 2 are providers who still meet the usual standards for being part of the network, and you’ll receive a less rich benefit when you choose these providers. By tiering the benefits and providers, you’ll save up to 6% on your monthly premium and have a clear way to save more money by choosing Tier 1 providers. You can see which tier your providers are in by visiting the Find a Doctor tool.

Is having a plan with a lower premium more important to you than having the largest network of doctors and hospitals available? If so, a Blue Value plan might work for you. Blue Value features a limited network of providers and some of the lowest costs of all the plans.  Blue Value can offer up to 9% savings, but has a limited network of doctors, hospitals, and pharmacies to lower costs. (Blue Value may not be available in all areas.)

 

For more information on health insurance coverage in North Carolina, please visit our website at www.nchealthplans.com or call our toll free number 888-765-5400 and speak with one of our professional agents. Our agency provides coverage for health insurance in North Carolina through Blue Cross Blue Shield of North Carolina (BCBSNC). It would be our pleasure to help you navigate through the Health Care Reform changes in accordance with the new regulations of Obama care. Call us for details.

“An ounce of prevention is worth a pound of cure.” – Benjamin Franklin

Preventive Care is  the single most effective way to maintain health and wellness and that is why Blue Cross Blue Shield of North Carolina is committed to providing customers with preventive health care options that are covered at 100% on every health plan available, including Blue Advantage, Blue Value and Blue Select, and Blue Local.

A leader in the industry for preventive care, Blue Cross Blue Shield of North Carolina was the first health insurer in the nation to cover physician office visits and diagnostic tests and to treat obesity as a primary condition.  They led the way in offering co-payment waivers for generic drugs, providing free nutritionist visits and rewarding North Carolina residents for routine physical activity.  Preventive Care includes all medical services related to the prevention of disease, provided by or upon the direction of a doctor or other provider and includes routine physical checkups, mammograms, colonoscopies and many other wellness exams, as expressed in the preventive care guidelines.  For a complete list of preventive care services click here.  Blue Cross Blue Shield of North Carolina understands the power of prevention and they are pleased to provide customers with the coverage you need to stay well.

For more information on Blue Cross Blue Shield of North Carolina insurance coverage, please visit our website at www.nchealthplans.com or call our toll free number 888-765-5400 and speak with one of our experienced and professional agents.

 

Transitional Plans Available for 2015 – Applies to Both Individual and Small Group Plans

Blue Cross Blue Shield of North Carolina will extend individual and small group transitional plans* for the 2015 year.

Background Information: On March 5, 2014, the White House provided additional guidance on the transition policy for individual and small group health plans that was originally announced on November 14, 2013. This guidance announced that carriers could once again extend this benefit for additional plan years. Extension of these “transitional plans” was not a requirement.  Carriers could elect to offer or discontinue the plans.BCBSNC has elected to allow individual and small group transitional members to continue to keep their plan for the 2015 plan year.

Key Points:

Annual rate changes that occur at the group renewal date, or on January 1 for individual policies, will apply to these transitional plans.

Individual policies: Members will lose transitional plan status if they move to another plan, or if they drop maternity coverage. Once transitional plan status is lost, members cannot switch back to their transitional plan.

Exceptions:  Some changes can be made without losing transitional plan status: Members on an individual policy may add maternity coverage without losing transitional status. Members may add dependents without losing transitional plan status. Members may remove dependents without losing transitional plan status.  Group policies: Groups will lose transitional plan status if they move to another plan. Once transitional plan status is lost, groups cannot switch back to their transitional plan.

Info provided by Blue Cross Blue Shield of North Carolina on 06/11/2014

For more information on health insurance coverage in North Carolina, please visit our website at www.nchealthplans.com or call our toll free number 888-765-5400 and speak with one of our professional agents. Our agency provides coverage for health insurance in North Carolina through Blue Cross Blue Shield of North Carolina (BCBSNC). It would be our pleasure to help you navigate through the Health Care Reform changes in accordance with the new regulations of Obama care. Call us for details.

 

Wake Forest University has received a $3 million gift from Blue Cross Blue Shield to help the school promote well-being at the university, Wake Forest officials said.

The money will go to develop projects designed to promote what is being called a holistic approach to health that spans eight dimensions of well-being: physical, emotional, spiritual, social, intellectual, financial, occupational and environmental.

 “Our approach to well-being is intentional and a natural extension of our mission to educate the whole person,” said Wake Forest University President Nathan O. Hatch, in a statement. “Well-being is not the absence of illness and stress, but the presence of healthy habits, purpose and joyful relationships. We are grateful to Blue Cross and Blue Shield of North Carolina for its transformative gift to enhance well-being on our campus and across the state.”

(more…)

$50… from Blue Cross Blue Shield to you!  Current members that are enrolled in individual BCBSNC health insurance plans can take a 15-minute personalized, confidential health assessment right now, and BCBSNC will send you a $50 gift card.  It’s that simple!  Even if you earned $50 last year, you can earn it again.  Then complete a wellness program designed around your needs and earn points to qualify for another $50 gift card.  This is a limited-time offer! Act now by visiting My Members Services- Healthy Outcomes.

Members must be 18 years of age or older to participate.  Health Assessment must be completed within the first 150 days of your plan’s 2014 effective date.  After completing the Health Assessment, you will receive your $50 gift card reward within 5-9 weeks.  You must complete the wellness program components between Jan 1 2014 and Sept 30 2014 and earn at least 120 points in the program to qualify.

Remember if you have an individual health insurance plan with Blue Cross Blue Shield, ACT TODAY!

For more information on health insurance coverage in North Carolina, please visit our website at www.nchealthplans.com or call our toll free number 888-765-5400 and speak with one of our professional agents. Our agency provides coverage for health insurance in North Carolina through Blue Cross Blue Shield of North Carolina (BCBSNC). It would be our pleasure to help you navigate through the Health Care Reform changes in accordance with the new regulations of Obama care. Call us for details.

Apply for your Blue Cross Blue Shield of North Carolina coverage today if you have a Qualified Life Event that enables you to enroll during the Special Enrollment Period.  Below we have outlined some examples of these qualified life events.  To generate your quote and get started click here.  BCBSNC offers an array of health insurance plans that will fit any budget and are all ACA compliant.

Marriage, having a baby, adopting a child or placing a child for adoption or foster care, moving outside your insurer’s coverage area, gaining citizenship, leaving incarceration.
Gaining status as member of an Indian tribe. Members of federally recognized Indian tribes can sign up for or change plans once per month throughout the year.
For people already enrolled in Marketplace coverage: Having a change in income or household status that affects eligibility for premium tax credits or cost-sharing reductions
 Losing other health coverage due to losing job-based coverage, divorce, the end of an individual policy plan year in 2014, COBRA expiration, aging off a parent’s plan, losing eligibility for Medicaid or CHIP, and similar circumstances. Important: Voluntarily ending coverage doesn’t qualify you for a special enrollment period. Neither does losing coverage that doesn’t qualify as minimum essential coverage.

For more information on health insurance coverage in North Carolina, please visit our website at www.nchealthplans.com or call our toll free number 888-765-5400 and speak with one of our professional agents. Our agency provides coverage for health insurance in North Carolina through Blue Cross Blue Shield of North Carolina (BCBSNC). It would be our pleasure to help you navigate through the Health Care Reform changes in accordance with the new regulations of Obama care. Call us for details.