2018 Updates to Small and Large Group Plan Portfolios

We have updated our 2018 Small and Large Group Plan Portfolios to continue to deliver 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.  For Small Group, we have taken a new approach for 2018 to focus our Plan Portfolio on product families instead of metallic tiers.

2018 Small Group Product

Our 2018 Small Group Portfolio products:
  • VantageBlue
  • BlueSolutions
  • BlueCHiP Advance
  • BasicBlue
  • Network Blue New England new effective 10/1/17
  • Blue Choice New England new effective 1/1/18 

New Product Launch

Two Network Blue New England plans will be launched in October 2017 as part of an off-cycle offering. For 2018, there will be some changes:

  • Network Blue New England 100/NC $1,000/$2,000 Deductible plan
    • This plan will replace the Network Blue New England 100/NC $1,500/$3,000 Deductible plan because it fell out of the parameters of the 2018 Actuarial Value (AV) calculator.
  • Network Blue New England 100/NC $2,000/$4000 Deductible plan
    • This new plan will be added to expand the assortment
  • Network Blue New England 100/NC $3,000/$6,000 Deductible will require some member cost share changes in 2018:
    • Autism Services – will be updated to follow plan design
    • Chiro - will be updated to match the specialist copay
    • Retail Clinic - will be updated to match the PCP copay
    • Outpatient Office Surgery - will be updated to have $0 member cost share

Blue Choice New England will be added to expand the New England Health Plan assortment to include a product family with out-of-network benefits. The three plans include:

  1. Blue Choice New England 100/80 $1,000/$2,000 Deductible
  2. Blue Choice New England 100/80 $2,000/$4,000 Deductible
  3. Blue Choice New England 100/80 $3,000/$6,000 Deductible

Product Changes:

Three BlueSolutions for Health Savings Account (HSA) will be added to expand the assortment:

  1. BlueSolutions 100/60 $2,650/$5,300 Deductible
  2. BlueSolutions 100/60 $5,000/$10,000 Deductible
  3. BlueSolutions 100/60 $6,000/$12,000 Deductible
  • This plan will replace the BlueSolutions 80/60 $5,900/$11,800 Deductible plan 

In an effort to improve the member experience and make the plan easier to explain, the 4 visit limit for PCP office visits will be removed from all three BasicBlue plans.

The RX string will be changed for all three BlueCHiP Advance plans to $10/$30/$50/$75/$125

Discontinued Products/Plans:

There are two product families that will be dropped from the 2018 Plan Portfolio:

  1. VantageBlue Select RI
  2. VantageBlue with Dental

Two VantageBlue plans will be dropped because they fell out of the parameters of the 2018 AV Calculator:

  1. VantageBlue 100/80 $250/$500 Deductible
  2. VantageBlue 80/60 $4,000/$8,000 Deductible 

One Blue Solutions plan will be dropped:

  1. BlueSolutions 90/50 $3,000/$6,000 Deductible + copay plan 

 

2018 Small Group Collateral

The new 2018 Portfolio, Employer Brochure and Benefit Summaries for all 2018 plans will be posted to the broker portal by mid-September.

2018 Large Group Product

Our 2018 Large Group Portfolio products:
  • HealthMate Coast-to-Coast
  • BlueSolutions
  • VantageBlue
  • BlueCHiP with Flex
  • BasicBlue
  • Network Blue New England
  • Blue Choice New England

New Product Launch:

Twenty new Network Blue New England plans will be launched in October 2017 as part of an off-cycle offering. For 2018, there will be some member cost share changes that will impact Network Blue New England Plan 3 -100/NC $1,500/$3,000 Deductible with $20/30/75/150 and Network Blue New England Plan 8 -100/NC $3,000/$6,000 Deductible with $25/40/100/200 only:

  • Autism Services – will be updated to follow plan design
  • Chiro – will be to match the specialist copay
  • Retail Clinic – will be updated to match the PCP copay
  • Outpatient Office Surgery – will be updated to have $0 member cost share
  • The remaining 18 Network Blue New England plans will have no changes for 2018.
  • Twenty Blue Choice New England plans will also be launched in October 2017 as part of an off-cycle offering. The 20 Blue Choice New England plans will have no changes for 2018.

Product Changes:

Five new plans will be added to expand the BlueSolutions for HSA plan offering:

  1. BlueSolutions 100/60 $4,000/$8,000 Deductible with $0/0/0/0 post deductible office visit copays
  2. BlueSolutions 100/60 $4,000/$8,000 Deductible with $25/40/50/150 post deductible office visit copays
  3. BlueSolutions 100/60 $6,000/$12,000 Deductible with $0/0/0/0 post deductible office visit copays
  4. BlueSolutions 100/60 $6,000/$12,000 Deductible with $25/40/50/150 post deductible office visit copays
  5. BlueSolutions 100/60 $6,650/$13,300 Deductible with $0 post deductible office visits and RX

Eight plans will be modified to adjust the out-of-network out-of-pocket values so that the out-of-network coinsurance applies. The standard rule for these plans was changed to be 3 times the in-network out-of-pocket value:

  1. BlueSolutions Plan 71 - 100/60 $1,500/$3,000 Deductible with $0 post deductible member cost share
  2. BlueSolutions Plan 72 - 100/60 $2,000/$4,000 Deductible with $0 post deductible member cost share
  3. BlueSolutions Plan 73 - 100/60 $3,000/$6,000 Deductible with $0 post deductible member cost share
  4. BlueSolutions Plan 74 - 100/60 $5,000/$10,000 Deductible with $0 post deductible member cost share
  5. BlueSolutions Plan 75 - 100/60 $6,350/$12,700 Deductible with $0 post deductible member cost share
  6. BlueCHiP Flex Plan 26 - 100/80 $6,850/$13,700 Deductible with $0/$30/$50/$50/$200 office visit copays
  7. HealthMate-Coast-to-Coast 355 – 100/80 $6,850/$13,700 Deductible with $25/40/50/150 office visit copays
  8. HealthMate-Coast-to-Coast 356 – 100/80 $6,850/$13,700 Deductible with $30/50/50/200 office visit copays

Discontinued Products/Plans:

There is one product family that will be dropped from the 2018 Plan Portfolio:

  1. VantageBlue Select RI

Eleven plans will be dropped from the 2018 Plan Portfolio:

  1. BlueCHiP Flex 11 - 100/80 $1,000/$2,000 Deductible with $30/50/50/200 office visits
  2. BlueCHiP Flex 17 - 100/80 $5,000/$10,000 Deductible with $25/40/50/150 office visits
  3. BlueCHiP Flex 20 - 80/60 $2,000/$4,000 Deductible with $25/40/50/150 office visits
  4. BlueCHiP Flex 22 - 80/60 $3,000/$6,000 Deductible with $25/40/50/150 office visits
  5. VantageBlue 114 - 100/80 $250/$500 Deductible with $30/50/50/200 office visits
  6. VantageBlue 9 - 100/80 $500/$1,000 Deductible with $15/25/50/100 office visits
  7. VantageBlue 103 - 100/80 $500/$1,000 Deductible with $30/50/50/200 office visits
  8. VantageBlue 23   - 100/80 $2,000/$4,000 Deductible with $25/40/50/100 office visits
  9. HMHC2C Coin 348 – 80/60 $1,500/$3,000 Deductible with $25/40/50/150 office visits
  10. HMHC2C Coin 55 – 80/60 $2,000/$4,000 Deductible with $25/40/50/200 office visits
  11. HMHC2C 31– 100/80 No Deductible with $10/10/10/100 office visits

 

2018 Large Group Collateral

The new 2018 Portfolio, Employer Brochure and Benefit Summaries for all 2018 standard plans will be posted to the broker portal by the end of August.

2018 Small Group and Large Group Pharmacy Update

We will be enhancing the pharmacy benefits by adding an Extended Supply Network (ESN) which will allow members to obtain 90-day prescription fills at designated retail pharmacies. The member copay for a 90-day supply will be the standard three copays. This change is intended to offer convenience to our members.

For Large Group only, two 4-Tier RX plans will be dropped:

  • $7/25/40/65
  • $7/30/50/75
2018 Small Group and Large Group Medical Policy Updates

Speech Therapy:

  • The pre-authorization requirement is being removed, effective 1/1/2018.

Physical Therapy/Occupational Therapy/Speech Therapy with an Autism Diagnosis:

  • Member cost share for Physical Therapy, Therapy and Occupational Therapy with an Autism diagnosis will change to follow the Out Patient Mental Health cost share
  • This change will be effective upon a group’s 2018 renewal.