If you applied in the past for Blue Cross Blue Shield Individual insurance or through another carrier and were declined due to medical ineligibility, we wanted to make you aware of new 2014 underwriting regulations through the Affordable Health Care Act, also known as Obamacare.  Under these new regulations, applicants who apply for coverage with a January 1^st or later effective date will no longer be underwritten with regards to their health or pre-existing conditions and therefore will be guaranteed issued with no rate increase for health conditions. The law also requires insurance companies to cover all applicants within new minimum standards and offer the same rates regardless of pre-existing conditions or gender.  Beginning October 1^st, we will be enrolling new customers into Blue Cross Blue Shield plans for 2014 effective dates.  Please give us a call or go online to generate your free rate quote on or after October 1^st and secure your Blue Cross coverage for 2014. If you would like to get your free rate quote and/or apply on line for Blue Cross Blue Shield coverage, please CLICK HERE and complete the information to generate your quote.

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). Call us for details.

The Affordable Care Act (ACA) requires individual and group health plans to report publicly their medical loss ratios (MLR), which represent the percentage of each premium dollar that is spent on health care services and quality improvement. ACA also requires such plans beginning on January 1, 2011, to provide an annual rebate to enrollees if the MLR is below the minimum requirement for the applicable market. The minimum requirement is 80% for individual and small group markets and 85% for the large group market.

Though the ACA directs a national standard for all insurance carriers’ MLR, some states may require more stringent ratios. The ACA’s MLR requirements will serve as a floor, below which insurance carriers may not fall without being penalized as noted above. However, US Department of Health and Human Services (HHS) has the discretion to grant a state-specific waiver of the MLR requirement, and several states have requested and received waivers. North Carolina received an MLR waiver from HHS, effectively reducing the minimum MLR for individuals in 2011 to 75%. In 2012, that requirement will be raised to the statutory minimum of 80%. Otherwise, MLR requirements are 80% for small groups, and 85% for large groups.
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Executive Brief
Prepared by BCBSNC Health Policy Office
Overview
The Affordable Care Act (ACA) changes the very foundation of the way health insurance is purchased with the introduction of public health insurance Exchanges, a standardization of health insurance plans, and the creation of new financial assistance programs call subsidies. Each American may have a different experience with many of the reforms depending on factors such as their income, health status, and how they currently obtain their insurance. One group that received special attention under the ACA are American Indians and Alaska Natives (AN/AIs). Of particular note to health insurance issuers is the fact that these groups will have unique rules regarding subsidies and enrollment.
Subsidies
Two types of subsidies exist under the ACA: premium tax credits and cost-sharing reductions. Only available through the public Exchanges, the premium tax credits reduce the cost of the premium to individuals and families while the cost-sharing reductions reduce the out-of-pocket costs once a member has enrolled. For AI/ANs, the premium tax credits are applied just like anyone else who qualifies on the Exchange. However, the cost-sharing reductions have been modified for AI/ANs. For most individuals without access to other affordable coverage, the (more…)

Blue Cross Blue Shield wants to help you save. Consider one of our new low cost plan options. To help lessen the financial impacts of health care reform, BCBSNC has created several new plan options for 2014.

BCBSNC Catastrophic Plans in 2014:

+Substantial savings with preventive care covered at no charge3

+ Exemption from some of the rules of the Affordable Care Act (ACA)

Subsidies cannot be applied to this plan.

IFor 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.

Information from a BCBSNC publication on 8/12/13.

You will need a new BCBSNC plan for 2014.
+ BCBSNC automatically map you to a new 2014 plan and send you that rate in September. To maximize savings, it is important for you to explore your options.
+ Starting October 1 in accordance with Obama Care, you will be able to go to Member Services  to link to the Health Insurance Marketplace where you can confirm subsidy eligibility. Compare your rate from our September rate letter to the rate of a new 2014 plan with subsidies or a low cost plan. This side by side comparison will help you decide what is best for you.
+ Remember, changes to the plan you were mapped to must be made by December 15, 2013 for the plan to be effective January 1, 2014.
+ If you make no changes, your mapped plan will start January 1, 2014.

Here’s what you should know about your plan:
+ The rate you pay for health insurance has always changed due to rising medical costs, but your rate may increase even more because of changes under health care reform. Some of the changes include increased benefits and new taxes and fees.
+ You may qualify for new federal subsidies that can help offset your monthly premium.
+ On October 1, log into Member Services and we will link you to the Health Insurance Marketplace so you can confirm subsidy
eligibility and ensure maximized savings.
+ Another way to save on premium costs is to consider one of the many new, low cost plan options such as Blue Value or Blue Select.

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.

Information from a BCBSNC publication on 8/12/13.

BlueCross BlueShield wants to help you save. Consider one of our new low cost plan options. To help lessen the financial impacts of health care reform, BCBSNC has created several new plan options for 2014.

Blue Value is one of these options.  The coverage you need, the savings you want. Blue Value features the lowest costs of all our plans. This plan offers:

+ Quality, cost-effective coverage
+ A limited network of providers and pharmacies
+ Prescription drug requirement

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). You may qualify for a 15% healthy lifestyle discount if you are in excellent health. Call us for details.

Information from a BCBSNC publication on 8/12/13.

If you like your Grandfathered Plan, keep it. Automatic renewal will continue coverage. If you switch to a new 2014 BCBSNC plan, subsidies may save you money. Not switching may mean you are “leaving money on the table”.

BCBSNC will be sending you your new 2014 rate in September. Starting October 1, you can go to Member Services to link to the Health Insurance Marketplace to confirm subsidies. You can compare your rate from our September rate letter to the rate of a new 2014 plan with subsidies. This side by side comparison will help you decide what is best for you.  Remember, changes to your plan must be made by December 15, 2013 for the plan to be effective January 1, 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). You may qualify for a 15% healthy lifestyle discount if you are in excellent health. Call us for details.

Information from a BCBSNC publication on 8/12/13.

Cost-Sharing Reductions are only available to those who qualify. Again, they do not apply to Grandfathered Plans. If you qualify, you will want to take advantage of both Cost-Sharing Reductions and Advanced Premium Tax Credits. You can use them both to maximize your savings.Cost-Sharing Reductions are only available to individuals who are ineligible for public coverage and are unable to get qualified health insurance through an employer.

COST-SHARING REDUCTIONS:

2014 plans will be grouped into four metallic levels: Bronze, Silver, Gold and Platinum. In order to take advantage of Cost-Sharing Reductions, you must choose a Silver plan. They help lower out-of-pocket expenses, such as deductibles, co-pays and coinsurance.

Cost-Sharing Reductions are only available for households with incomes thatare between 100% and 250% of the Federal Poverty Level (FPL).

For example, let’s say you go to the doctor and are charged $100. Normally with a Silver plan you might have a co-pay of $25, but because
you qualify for Cost-Sharing Reductions and you chose a Silver plan, you may have a co-pay as low as $5.

Cost-Sharing Reductions can also lower deductibles. For example, a $3,500 deductible may be lowered to $500.

With Cost-Sharing Reductions, you essentially pay for a Silver plan but receive the richer coverage of higher metallic level plans, thereby reducing your out-of-pocket expenses. If you qualify for Cost-Sharing Reductions, you should take advantage of this cost savings benefit.

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). You may qualify for a 15% healthy lifestyle discount if you are in excellent health. Call us for details.

Information from a BCBSNC publication on 8/12/13.

There are two types of federal subsidies to help reduce health care costs in 2014.They are Advanced Premium Tax Credits and Cost-Sharing Reductions.

+ Advanced Premium Tax Credits lower your monthly premium.

+ Cost-Sharing Reductions help lower out-of-pocket expenses including deductibles, co-pays and coinsurance at the place of service, like doctor and hospital visits. Subsidies are only available on new 2014 plans for those who qualify. Subsidies cannot be applied to Grandfathered Plans, but it may be worth it to switch.

+ Advanced Premium Tax Credits are only available to individuals who are ineligible for public coverage and are unable to get qualified health insurance through an employer.

+ Advanced Premium Tax Credits are determined by income and family size in relation to established Federal Poverty Levels (FPL). Many Americans will qualify for Advanced Premium Tax Credits, including the middle class. Those that qualify must have a household income between 100% and 400% of FPL for their family size.

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You are going to hear a lot about health care reform over the next few months, including information on federal subsidies.

+ Those individuals without a Grandfathered Plan will have to move to a new 2014 plan. Subsidies will make health care more accessible to more
people and ease the impact of higher premium costs.

+ Subsidies are determined by income and family size in relation to established Federal Poverty Levels.

+ You may qualify for subsidies, however, they do not apply to your Grandfathered Plan. You do have the option of switching to a new 2014 plan (leveraging potential subsidies), but these benefits may come at an increase to your monthly premium.

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Federal and NC Definitions Now Aligned

Date: 08/23/2013

Recently, the North Carolina (NC) legislature passed House Bill 649, which made changes to NC’s Small Employer Group Health Coverage Reform Act in order to align federal and NC definitions related to small employer group health plans – specifically, those definitions included as part of the Affordable Care Act.

Important changes affecting BCBSNC employer groups beginning January 1, 2014 include:

Sole Proprietorship Change

Self-employed individuals (or sole proprietors) with no common-law employees are no longer eligible for non-grandfathered small employer health plan coverage; conversely, a sole proprietor is eligible for group coverage if there is at least one common law employee (e.g., non-family member, etc.) employed.

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There are three ways to go about purchasing insurance for yourself and for your small business: by going through the health care exchange,
contacting an insurer or speaking with a broker.

Health Insurance Exchanges:

You’ve probably heard about exchanges.  The exchange is an online marketplace where various private insurance companies such as Blue Cross Blue Shield will offer their plans.  To simplify the options that will be available on the exchange, and to give a basis for comparison, all plans will be classified according to four levels: bronze, silver, gold or platinum. Bronze plans will provide the least generous coverage, and platinum plans will provide the most generous coverage.

The exchange will enable people to:

• Review plans, compare prices and enroll all at once
• Find out if they are eligible for subsidies It’s important to know that the exchange is the only place to apply for subsidies. It will provide step-by-step instructions to guide you through the process.

Open enrollment on the exchange – the time period in which you will be able to enroll for your 2014 health insurance plan – begins Oct. 1, 2013.  As mentioned earlier, you can also purchase insurance by contacting health insurance companies directly. Or, by speaking with an insurance broker.  No doubt, there is a lot to take in, but we’re dedicated to helping you find an insurance plan that meets your needs and to keeping premiums as affordable as possible.

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). You may qualify for a 15% healthy lifestyle discount if you are in excellent health. Call us for details.