2017 small group product enhancements

We have updated our 2017 Small Group Medical Product Portfolio to deliver more choice, value, and simplicity to our customers. The goal was to continue to make it more efficient to find the perfect solutions for your clients’ needs, with pre-built, best-in-class plan options and a wide range of costs.

Our 2017 Small Group Portfolio includes these products:

  • BasicBlue
  • BlueCHiP Advance
  • BlueSolutions for HSA
  • VantageBlue
  • VantageBlue SelectRI
  • Portfolio drops

VantageBlue Select $0 deductible/$6,350 in-network (INN) out-of-pocket maximum was removed from the portfolio due to OHIC’s removal of this product requirement.

BlueSolutions Bronze 100%/60% $4,750/$9,500 deductible copay plan was removed from the portfolio because it no longer met the minimum plan value using the 2017 Actuarial Value Calculator.

EXISTING PRODUCT UPDATES

These changes were made to stay within the parameters of
the 2017 Actuarial Value Calculator:

  • VantageBlue Silver 100%/80% $2,000/$4,000 deductible
    • Changed INN individual deductible from $2,000 to $2,250
    • Changed INN family deductible from $4,000 to $4,500
    • Changed INN individual OOP from $6,500 to $6,600
    • Changed INN family OOP from $13,000 to $13,200
       
  • VantageBlue Silver 80%/60% $2,000/$4,000 deductible
    • Changed INN individual deductible from $2,000 to $2,250
    • Changed INN family deductible from $4,000 to $4,500
       
  • BlueSolutions Bronze 100%/60% $5,200/$10,400
    • Changed coinsurance from 100%/60% to 80%/60%
    • Changed INN individual deductible from $5,200 to $5,900
    • Changed INN family deductible from $10,400 to $11,800
       
  • Basic Blue Bronze 100%/NC $6,850/$13,700
    • Changed INN individual deductible from $6,850 to $7,150
    • Changed INN family deductible from $13,700 to $14,300
    • Changed INN individual OOP from $6,850 to $7,150
    • Changed INN family OOP from $13,700 to $14,300
    • Changed non-PCMH copay from $70 to $90
       
  • All Basic Blue plans
    • Now have an annual PCP visit limit of four visits. Any subsequent visits apply to the member’s deductible

BENEFIT ENHANCEMENTS

To help simplify product families in the small and large group segments, we have aligned some of the benefits. These enhancements to small group benefits will be effective upon groups’ 2017 renewals:

  • Added autism benefits to all plans
    • To ensure ongoing compliance with federal and state regulatory requirements, this benefit will not include an age limit on applied behavioral analysis (ABA) services.
    • There will not be a visit limit on physical, occupational, or speech therapy, or preauthorization requirements for speech therapy, when these services are provided to treat autism spectrum disorder (ASD).
       
  • Air/water ambulance
    • Removed the $3,000 per occurrence maximum
       
  • Allergy injections
    • Removed member cost-share (for all non-HSA small group plans)
       
  • Chiropractic visit
    • Increased visit maximum from 12 to 20
       
  • Electric breast pumps
    • Non-hospital grade electric breast pumps were added to members’ preventive benefits and will be covered in-full. This change is effective January 1, 2017.

PHARMACY CHANGES

  • Mail order
    • Generic and preferred brand drugs are available through mail order with a 90-day supply for 2.5 copayments
    • Non-preferred brand drugs are still eligible for mail order with a 90-day supply for three copayments.
    • These changes continue to offer members the convenience of mail order but incent them to use generics and preferred brands.
       
  • Specialty pharmacy
    • Out-of-network benefits will be removed
    • Specialty drugs will continue to be covered in-network through our specialty pharmacy vendors, Walgreens and Village Pharmacy, or with an increased cost-share at our in-network retail pharmacies (for example, CVS).
    • This change ensures members continue to have sufficient geographic access and encourages them to use our specialty pharmacy vendors for a much lower member cost-share and a better overall experience.

The 2017 Small Group Portfolio, benefit summaries, and updated marketing collateral are now available after logging in to the Broker section of bcbsri.com