Producer Newsletter
September 2021, Volume 3

What’s Inside:
Date change coming for the October 6 pharmacy webinar | New member ID cards in 2022 for all commercial membership | Medical Loss Ratio (MLR) rebates issued | Health plan solutions tailored to employer groups’ needs | 2022 group product portfolio and open enrollment support | Affordable aligners are now part of many Capital Blue Cross Dental plans | HRA Administration Application | Members are eligible for healthy deals and discounts

UPDATE: Date change coming for pharmacy webinar

Please note that we have postponed our webinar about pharmacy program enhancements that was originally scheduled for October 6. It is now scheduled for Thursday, October 21, from 10:00 to 11:00 AM ET.

If you already registered, you should have received an email to confirm the date change along with a calendar update. Haven’t registered yet? Sign up today!

Thank you for your flexibility and understanding.

New member ID cards in 2022 for all commercial membership

A provision of the Consolidated Appropriations Act (CAA) requires health plans to include out-of-pocket maximums and out-of-network maximums, among other new information, on member identification (ID) cards starting in 2022. As a result, all employer group and individual plan members will be receiving a new ID card upon renewal next year. We will share more details with you as they become available.

Medical Loss Ratio (MLR) rebates issued

The Affordable Care Act requires health insurance companies to issue a rebate if they do not spend at least 80 percent of the premiums received for healthcare services and activities to improve healthcare quality. No more than 20 percent of premiums may be spent on administrative costs. This requirement is referred to as the “Medical Loss Ratio” (MLR) standard or the “80/20 rule.”

Members who had individual PPO coverage underwritten by Capital Advantage Assurance Company (e.g., individual ACA, PersonalBlue) at any time in 2020 qualified for a rebate based on MLR calculations. Those members recently received their rebate checks. The specific rebate amount depends on factors such as the plan in which a member was enrolled, how long the coverage was in place, and the federal formula for calculating MLR. If the member received a government subsidy to help pay for coverage, we still issue the refund to the member.

Rebates may have a tax impact to the member. We will not issue any tax forms to MLR Rebate recipients. They are advised to consult their tax advisor for information on how a rebate will impact them, or contact the Internal Revenue Service.

For questions, members may contact our Member Services team at 800.730.7219, or by sending a secure email through their secure account. They may also visit one of our Capital Blue Cross Connect health and wellness centers.

Health plan solutions tailored to employer groups’ needs

Capital Blue Cross has strategically designed benefit plans with network solutions that consider localized care.

Employers can start with our traditional PPO as their foundation then supplement it with options that can drive savings and empower employees with choice and access to providers who are committed to delivering high quality. Check out our quality-driven health plan solutions and share details of these plans during your client consultations this peak season.

You can also refer to our presentation about these products that we delivered earlier this year.

2022 group product portfolio and open enrollment support

Thank you to all who were able to attend the 2022 Group Product webinar held last week. A recording is available if you weren’t able to join us or would like to watch the webinar again. You also can download a copy of the presentation to review at your convenience. We also have several resources available to help you consult with your clients during the peak open enrollment season.

• 2022 Capital BlueCross Group Product Portfolio Overview
• 2022 Small Group PPACA Benefit Grid
• 2022 Mid-Market, Small Business ASO, and PremierChoice Benefit Grid
• 2022 Capital Blue Cross Dental Products Benefit Grid
• 2022 Capital Blue Cross Vision Products Benefit Grid

As mentioned during the webinar, we also have a new online package of resources and documents to support your clients’ open enrollment plans. Think of them as digital open enrollment in a box . They include resources and documents to get your clients’ employees on board with many of their plan benefits and services, including Capital Blue Cross Virtual Care, health and wellness programs, healthy deals and discounts from Blue365, and so much more.

Affordable aligners are now part of many Capital Blue Cross Dental plans

Individual and group members will have access to SmileDirectClub’s clear aligner program for teeth straightening. SmileDirectClub uses a telehealth platform and is designed for members age 12 years and older with mild to moderate orthodontic needs.

For individual standalone dental members:

• Capital Blue Cross Dental PPO members will have access to Smile Direct Club’s offerings through discounted pricing.
• Capital Blue Cross Dental Select members will receive in-network coverage from Smile Direct Club’s convenient, remote orthodontia care, at reduced member copayment.

For commercial group dental members:

• Capital Blue Cross Dental PPO members with orthodontia coverage will receive in-network coverage of SmileDirectClub’s convenient, remote orthodontia care.
• Capital Blue Cross Dental PPO members without orthodontia coverage will have access to SmileDirectClub’s offerings through discounted pricing.
• Capital Blue Cross Dental Select members will receive in-network coverage from SmileDirectClub’s convenient, remote orthodontia care, at a reduced member copayment.

We’ll share details of the program with members in an upcoming edition of their newsletter. In the meantime, share an overview with your Capital Blue Cross Dental program groups during open enrollment meetings.

HRA Administration Application

A new interactive version of the HRA Administration Application for Mid-Market, Small Business ASO, and Premier Choice is now available in the Salesforce Partner Community content library. This form can be used for 2021 and 2022 new and renewing groups.

A new HRA application is required upon renewal for all groups. Please submit completed forms at least 30 days prior to the group effective date to avoid delays to HRA claims processing.

Members are eligible for healthy deals and discounts

Your clients’ Capital Blue Cross health plan includes Blue365, an awesome program from BCBSA that offers our members free access to health and wellness discounts from dozens of national brands.

Want to learn more about the program? Join BCBSA for one of two upcoming program demonstrations.

• October 26, 2021, 2:00 to 3:00 PM ET
• December 8, 2:00 to 3:00 PM ET

Register for a demo

Please share with your clients. Anyone who registers for one of the demonstrations will be entered for a chance to win a $50 Amazon gift card.