January 2016

January 2016

A Word From Melissa Cummings

Senior Vice President and Chief Customer Officer

Are you ready for 2016? As we wait for the first real snow of the winter—or so I think anyway—we continue to push toward our 2018 strategic goals, including the opportunity to make healthcare simple and affordable for all Rhode Islanders.

We have a number of efforts underway that will achieve this objective in 2016. We’re addressing the cost of healthcare at the same time that we’re adding services that make choices simpler for employers and members. These changes also make it easier for you to help your clients.

First, we already told you about our enhanced 2016 broker compensation plan and our new Preferred Broker program. If you didn’t see that email, let us know and we’ll make sure you get the information. We are excited to offer you additional opportunities for recognition given the work you do on behalf of your clients.

Here is another exciting change to tell you about, one that can lower costs: We now can offer a bundling discount on medical and dental plans, thanks to recent approval from the Office of the Health Insurance Commissioner. That gives you an additional way to offer more affordable insurance and simple administration.

We have plenty of other improvements planned throughout 2016, changes that move us closer to our strategic goals. We’ll keep you informed as our work and the year progresses.

We look forward to working closely with you in 2016 and I send my best for a year filled with continued success, happiness, and health.

News You Can Use

Great News about Selling Dental to Your Clients

We’ve got exciting news that will make it easier to sell Blue Cross Dental to your clients. The OHIC recently approved a 3% Blue Cross Dental bundling discount effective January 1, 2016 for small and large group fully insured business, new and renewal. The discount will be applied to Dental premiums and will be available to existing groups that:

  • Have BCBSRI medical coverage and want to add new Blue Cross Dental coverage
  • Have Blue Cross Dental and want to add new BCBSRI medical coverage
  • Have BCBSRI medical coverage and Blue Cross Dental coverage and sign a new multi-year agreement

The discount will also be available to new groups that want to purchase both BCBSRI medical coverage and Blue Cross Dental coverage. We will continue to offer a discount of $1.00 off the medical administrative expense per member per month for self-insured customers.

For more information about how to receive this credit, please contact your BCBSRI sales representative.

Update: State Issues Rates for Immunization Programs (Mandated Assessments for RI Healthcare Programs)

The State of Rhode Island (the State) recently announced the 2016 assessment rates for the Rhode Island Vaccine Assessment Program (RIVAP), an immunization program for children and adults that provides vaccination medication at lower costs than would otherwise be available.

This is a follow up to an article from the August issue of The Broker Brief.

What will be the charge for each assessment?

The charges for the RIVAP assessments will be as follows:

  • Child immunization rate: $20.59 per child per month
  • Adult immunization rate: $3.70 per adult per month

BCBSRI will remit payment of these assessments to the State on behalf of our fully insured and self-insured accounts. Self-funded accounts will be invoiced for these assessments on a quarterly basis.

When will these assessments begin to appear on self-funded accounts’ invoices?

These assessments will be displayed as separate line items on self-funded accounts’ claims invoices beginning in late January 2016.

How often will these assessments be invoiced?

The assessments will be invoiced quarterly in the months of January, April, July, and October. As directed by the State, the assessment is based on retrospective membership data from the previous quarter. For example, fourth quarter 2015 enrollment data will be used to calculate the assessment for the invoices sent to self-insured accounts in late January 2016; first quarter 2016 enrollment data will be used for the April invoices, and so on.

They will appear on self-funded claims invoices as follows:

  • Infant child immunization: “State of RI Mandate Assessment – Infant Child Immunization”
  • Adult immunization: “State of RI Mandate Assessment – Adult Immunization”

Self-funded accounts should contact their dedicated Finance representative (listed on the bottom of their invoice) with any questions about how their immunization assessments were calculated.

IRS Extends Deadlines for Insurance Reporting

As we wrote in the August issue, the Affordable Care Act (ACA) requires new insurance tax reporting for self-insured and fully insured accounts. The IRS recently issued Notice 2016-4, which extends the 2015 reporting deadlines as follows:

Form to be Filed

Original Due Date

New Due Date

IRS Form 1095-B and Form 1095-C to individuals

February 1, 2016

March 31, 2016

IRS Form 1094-B, Form 1095-B, Form 1094-C, and Form 1095-C to IRS for paper filing

February 29, 2016

May 31, 2016

IRS Form 1094-B, Form 1095-B, Form 1094-C, and Form 1095-C to IRS for electronic filing

March 31, 2016

June 30, 2016

BCBSRI will not make use of the extensions granted and will mail Form 1095-B, Health Coverage to all fully insured subscribers this month. Fully insured subscribers should use Form 1095-B to complete their 2015 tax returns. If they have any questions, they can call Customer Service at (401) 459-5000 or 1-800-639-2227 (TDD: 711).

Self-funded employers are required to provide their insured employees with Form 1095-C, Employer-Provided Health Insurance Offer and Coverage. Self-funded subscribers should use Form 1095-C to complete their 2015 tax returns. The Annual Enrollment Report we described in the November issue will be available on bcbsri.com to assist self-funded employers in completing Form 1095-C. We will contact plan administrators once the reports are available.

We have sent letters to fully insured subscribers for whom we do not have Social Security numbers (SSNs) requesting they provide this information to us. Encourage your clients to have their employees call us directly with their SSN if they have received one of these letters. Providing us with this information will help ensure the member’s coverage is properly accounted for by the IRS, and that the member is not otherwise penalized for failing to provide his/her SSN.

Summary of Benefits and Coverage (SBC) for Fully Insured Groups

BCBSRI provides an SBC to our large and small group fully insured employers and members upon enrolling in or renewing their health plan each plan year. The SBC is a helpful tool that helps members better understand their health insurance benefits, and includes:

  • Plan-level benefit information
  • Coverage examples
  • Information on exceptions or services that are excluded from their benefit design

Shortly after employers have chosen a health plan for their employees (for each coverage period), BCBSRI mails the SBC to those members with a letter explaining the SBC and how it should be used. Members can also access their SBC on bcbsri.com after logging in to their member account.

All insurance companies are required to use the same format for the SBCs and include the same type of information creating a standard that can be followed across the healthcare industry.

As the broker of record for your employer clients, you can access their SBCs in the Document Center of the bcbsri.com Broker portal.

Product Updates

Expanded Offerings for 2016

New for 2016, we’ve increased our offerings of value-added products and services that your clients and their employees can add to their medical and dental insurance. We’ve also added services to make it easier for members to get healthcare when they need it, and to find answers to their questions anytime. Below are highlights of our new offerings for members.

Additional products and services

We’ve complemented our core medical, dental, and vision offerings with additional products including:

  • Short-term/long-term disability
  • Term life insurance/AD&D
  • Group voluntary benefits (e.g., cancer care and pet insurance)
  • GeoBlue℠ travel health insurance
  • Hearing aid discount from BeltoneNE™

Healthcare (and help) when it’s needed most

We’ve made it easier for our members to access healthcare when they need it, and to get answers to their questions anytime and anywhere:

  • Telemedicine: Doctors online (available after logging in to bcbsri.com)
  • Retail health clinics
  • Your Blue Store™ locations in Bristol, Lincoln, and Warwick
  • Customer service available 7 days a week
  • Your Blue Touch RI mobile app (coming soon)

Online tools

Members can manage their health plan after logging in to bcbsri.com, and take advantage of:

  • Online customer service
  • My Cost Calculator cost comparison tool
  • Find a Doctor tool
  • Provider Review tool
  • Benefits and Claims Centers
  • HSA (health savings account) access
  • Pharmacy information
  • Plus much more!


2016 Large Group Product Brochures Available

For your convenience, we’ve recently added product brochures for all of our 2016 large group plans to the bcbsri.com Broker portal. Each brochure contains detailed product information you can use at client meetings and open enrollment sessions to help guide clients to choose the plan that is best for them and their employees.

Our large group plans are:

  • BlueCHiP
  • BlueSolutions
  • HealthMate Coast-to-Coast
  • VantageBlue
  • VantageBlue SelectRI

Review the brochures to learn about each plan’s unique benefits.

Talk To Us

If you have any questions about the content of this issue, please contact your BCBSRI sales representative. We want this newsletter to benefit you, so if there are any topics you would like to see covered, please let us know at TheBrokerBrief@bcbsri.org. This newsletter is just one of the ways we’re partnering with you to address your needs—and the needs of your clients.

Thanks for all you do for Blue Cross and our customers.