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Dec 1, 2019

Small group updates

Our regional BlueCHiP family is expanding in the small group market with Effective January 1, 2020, BCBSRI will become the insurer for all Lifespan employees. Below is a quick overview about how this plan effects providers:

  • All providers participating in the Blue network are included in Lifespan’s coverage.
  • Providers are tiered and can find their tier status by using the BCBSRI Provider Finder.

the addition of Network Blue New England Options. It offers the next step in the evolution of BCBSRI’s PCP- and referral-required New England Health Plan product line, with the first tiered regional product offered by a Rhode Island-based health plan. The Network Blue New England Options product family includes two plans in the small group standard portfolio. With these plans, the provider network is split into two categories: enhanced and standard. PCPs, facilities, and radiology providers will be tiered based on cost and quality. All other services and providers will not be tiered. Our 2020 small group portfolio includes the following product families:

  • VantageBlue
  • BlueSolutions
  • Network Blue New England
  • Blue Choice New England
  • Network Blue New England Options – new effective January 1, 2020

Deductible changes

  • BlueSolutions 100/60 $3,000/$6,000
    • Deductible changed to $3,400/$6,800
  • BlueSolutions 100/60 $6,550/$6,750
    • Deductible changed to $6,750/$13,500

Out-of-pocket limit changes

  • BlueSolutions 100/60 $1,500/$3,000
    • Out-of-pocket limits changed from $4,500/$9,000 to $6,750/$13,500
  • VantageBlue 100/80 $4,000/$8,000
    • Out-of-pocket limits changed from $6,350/$12,700 to $5,000/$10,000

Copay changes

  • Effective upon a customer’s 2020 renewal, the routine and non-routine vision office visits will have the same copay. Previously, the routine vision copay was higher than the non-routine vision copay. The new copay follows the specialist copay. This change will impact all VantageBlue plans, as well as one BlueSolutions plan.

The following plans will be added to the small group portfolio

  • Network Blue New England 80/NC $1,000/$2,000
  • Network Blue New England 100/NC $4,000/$8,000
  • Blue Choice New England 100/80 $4,000/$8,000
  • VantageBlue 100/80 $8,150/$16,300

VantageBlue

Free sick visit

  • Currently, our VantageBlue plans offer members a first free sick visit.
  • This benefit was introduced a few years ago as a way to shift member utilization away from urgent care and emergency room services and toward seeing their PCP to help reduce their costs.
  • The utilization has remained the same and members are not utilizing this benefit, so it will be removed in 2020 upon renewal.

Acupuncture

  • Acupuncture coverage was added to the VantageBlue 100/80 $1,000/$2,000 plan.
  • All platinum VantageBlue plans will now include acupuncture.
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