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Archive for the ‘Affordable Care Act (ACA)’ Category

Where Does My Health Insurance Premium Really Go?

Wednesday, April 23rd, 2014

Posted April 14, 2014 – Blue Cross Blue Shield- Health Care Reform Blogbigstockphoto_colored_calculator_1756282

By: James LaCorte

Where does my health insurance premium really go? Health insurance customers often ask a simple question about the premium they pay every month:

Where does my premium dollar go? They’re usually not asking for a quick tutorial on how insurance works: Most people understand that everyone pays into a pool, and only those who need medical care take money out in the form of health care claims. What many of these folks really are asking is how much of that money actually pays for health care and how much goes toward running an insurance company — or toward profits.  Fair question.  Blue Cross and Blue Shield of North Carolina (BCBSNC) paid $5 billion in claims in 2013. Recently we announced that we spent almost 86 cents of every premium dollar paying for our customers’ health care – doctor visits, surgery, tests, medicine, eyeglasses, etc.

Our non-medical spending largely goes toward customer service and technology. We are also a full-taxed company. In 2013, we paid out more than $100 million in local, state and federal taxes.

(more…)

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Do you Qualify for a Special Enrollment Period?

Monday, April 21st, 2014

Open enrollment for health insurance has ended; however you may still Questions and Answers signpostqualify for a special enrollment period due to a qualifying event.  Some examples of these qualifying events include:

  1. Marriage, having a baby, adopting a child or placing a child for adoption or foster care, moving outside your insurer’s coverage area, gaining citizenship, leaving incarceration.
  2. Gaining status as member of an Indian tribe. Members of federally recognized Indian tribes can sign up for or change plans once per month throughout the year.
  3. For people already enrolled in Marketplace coverage: Having a change in income or household status that affects eligibility for premium tax credits or cost-sharing reductions
  4.  Losing other health coverage—due to losing job-based coverage, divorce, the end of an individual policy plan year in 2014, COBRA expiration, aging off a parent’s plan, losing eligibility for Medicaid or CHIP, and similar circumstances. Important: Voluntarily ending coverage doesn’t qualify you for a special enrollment period. Neither does losing coverage that doesn’t qualify as minimum essential coverage.

For more information on health insurance coverage in North Carolina, please visit our website at www.nchealthplans.com or call our toll free number 888-765-5400 and speak with one of our professional agents. Our agency provides coverage for health insurance in North Carolina through Blue Cross Blue Shield of North Carolina (BCBSNC). It would be our pleasure to help you navigate through the Health Care Reform changes in accordance with the new regulations of Obama care. Call us for details.

 

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Blue Cross Blue Shield of NC FREE RATE QUOTE

Saturday, March 8th, 2014

bigstock--Free-Quote-blue-button-32217869Affordable Care Act Open Enrollment ends March 31. 2014.  You need to purchase your new health insurance policy before the Open Enrollment period ends, if you plan to purchase through the exchange, or face a penalty. GET YOUR FREE RATE QUOTE AND APPLY TODAY for Blue Cross Blue Shield of North Carolina.

You will not have the opportunity to enroll again until  the next Open Enrollment starting November 2014 for coverage that starts January 1st, 2015. That means you cannot wait for a medical need to enroll.

Blue Advantage plans are available in all metallic levels: bronze, silver, gold and platinum. The levels differ by how much of your medical costs a plan will pay on average. They are based on approximate values for standard medical expenses.  If you qualify for a subsidy through the Marketplace, it could significantly decrease the amount of your monthly premium for your Blue Cross coverage.

For more information on health insurance coverage in North Carolina, please visit our website at www.nchealthplans.com or call our toll free number 888-765-5400 and speak with one of our professional agents. Our agency provides coverage for health insurance in North Carolina through Blue Cross Blue Shield of North Carolina (BCBSNC). It would be our pleasure to help you navigate through the Health Care Reform changes in accordance with the new regulations of Obama care. Call us for details.

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Preventive Care Outline

Sunday, February 23rd, 2014

bigstock-The-word-Health-surrounded-by--43388209The Affordable Care Act does a lot to boost access to preventive services and encourage consumers to use them. Health care reform also requires that many preventive services be provided at no cost to the consumer, such as colonoscopies and contraceptive and many more services.  Click on the link to view all services that is outlined by BCBSNC.

Regular preventive care can help you stay in better overall health.  Make sure you understand how your preventive care benefits work, and be sure to take advantage of them.

Preventive care services are generally covered at 100 percent of the allowed amount when they meet the following conditions:  The service is delivered by an in-network provider;  The service is performed in an in-network, office-based setting or   stand-alone clinic and filed as an office visit;  The service is received only once per benefit period, and the service does not include any additional procedures.  Get your Free Rate Quote today.

For more information on health insurance coverage in North Carolina, please visit our website at www.nchealthplans.com or call our toll free number 888-765-5400 and speak with one of our professional agents. Our agency provides coverage for health insurance in North Carolina through Blue Cross Blue Shield of North Carolina (BCBSNC). It would be our pleasure to help you navigate through the Health Care Reform changes in accordance with the new regulations of Obama care. Call us for details.

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Tax Credits – Lower your Insurance Premium

Tuesday, February 18th, 2014

bigstock-Health-Coverage-Tax-Credit-30011972To help make health care more affordable, the federal government offers advance premium tax credits, or subsidies, to low-to middle-income individuals and families. Your subsidy is an advance premium tax credit and is applied directly to your premium. Subsidies reduce the monthly cost of an insurance plan. You do not have to pay the cost upfront and receive your tax credit later.

To be eligible for a subsidy, you must meet certain requirements.  Be between 100% and 400% of the federal poverty level (FPL). Not eligible for public coverage, such as Medicaid, the Children’s Health Insurance Program, Medicare or military coverage.  Not have access to insurance through an employer. An exception can be made if the employer’s plan doesn’t cover at least an average of 60% of covered benefits or if the employee’s share of the premium is more than 9.5% of his or her income. Employers can tell you if their plans meet these criteria.  Subsidies can be used on any plan you choose except for grandfathered plans and catastrophic plans for those under 30. How much of a subsidy you qualify for is based on income and household size.

Our FREE RATE QUOTE through Blue Cross Blue Shield of North Carolina offers a calculator to estimate your subsidy.  Just click on the blue calculator at the top of your rate quote and enter the income information.

For more information on health insurance coverage in North Carolina, please visit our website at www.nchealthplans.com or call our toll free number 888-765-5400 and speak with one of our professional agents. Our agency provides coverage for health insurance in North Carolina through Blue Cross Blue Shield of North Carolina (BCBSNC). It would be our pleasure to help you navigate through the Health Care Reform changes in accordance with the new regulations of Obama care. Call us for details.

 

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Tax Credits and Cost-Sharing Reductions

Friday, February 14th, 2014

bigstockphoto_man_and_girl_writing_discount__5849701Getting your subsidy starts with a free rate quote.  When you generate your rate quote, you can estimate your subsidy and how it affects your premium.  To apply you simply press Get Started, in your quote, to begin your application.  Once you register, there will be a link you click on that will take you to the Marketplace to complete your subsidy and get the actual amount you qualify for.  You can enroll in your plan through the Marketplace and Blue Cross Blue Shield of North Carolina will send you a bill once healthcare.gov uploads your file to BCBSNC.

In addition to advance premium tax credits, the government also provides cost-sharing reductions (CSR) for those who qualify. Cost Sharing Reductions allows you to pay for a standard silver plan, but get richer benefits.  To be eligible for Cost Sharing Reductions your income must be between 100% and 250% of the federal poverty level (FPL).  CSR is only available on silver plans. These special CSR plans provide enhanced benefits that can mean your “silver” plan has the benefits of a plan with a higher metallic value.

Once at the Marketplace, you will need your Social Security number, employer and income information to register and complete your subsidy application.  You can apply online or you can call and complete your application by phone.   Then you will be automatically transferred back to BCBSNC to see your final subsidy and premium. Choose and buy your plan.  You can call our office 888-765-5400 to go over the plans, process and confirm deadline dates to enroll.

 

For more information on health insurance coverage in North Carolina, please visit our website at www.nchealthplans.com or call our toll free number 888-765-5400 and speak with one of our professional agents. Our agency provides coverage for health insurance in North Carolina through Blue Cross Blue Shield of North Carolina (BCBSNC). It would be our pleasure to help you navigate through the Health Care Reform changes in accordance with the new regulations of Obama care. Call us for details.

 

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BCBSNC to Offer Family Coverage for Same-Sex Couples and All Domestic Partners in ACA plans

Wednesday, February 12th, 2014
bigstockphoto_hand_shake_147012CHAPEL HILL, N.C. Brad Wilson, president and CEO of Blue Cross and Blue Shield of North Carolina (BCBSNC), has issued the following statement about family coverage for married same-sex couples and domestic partners. “In order to ensure that our technology was ready for the Affordable Care Act, our company chose to postpone a number of product updates until 2015. One of these was to begin making family coverage available to same-sex married couples and domestic partners (same-sex or opposite-sex) in our ACA-approved plans.We should have more thoughtfully considered this decision, with full appreciation of the impact it would have on same-sex married couples and domestic partners. We’re sorry we failed to do so. Our employees have worked with the Centers for Medicare and Medicaid Services and the Department of Insurance over the past week to update our plans in order to make family coverage available sooner. Starting Monday, same-sex married couples and anyone in a domestic partnership may purchase new family coverage on or off the Exchange for an effective date of March 1.  Domestic partners and same-sex married couples who enrolled separately on ACA plans can convert them into family plans retroactive to their original effective date.
This information was Posted By: MEDIA STATEMENT
BCBSNC Online Newsroom: Jan. 29, 2014

For more information on health insurance coverage in North Carolina, please visit our website at www.nchealthplans.com or call our toll free number 888-765-5400 and speak with one of our professional agents. Our agency provides coverage for health insurance in North Carolina through Blue Cross Blue Shield of North Carolina (BCBSNC). It would be our pleasure to help you navigate through the Health Care Reform changes in accordance with the new regulations of Obama care. Call us for details.

 

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Blue Cross – Metallic Levels

Tuesday, February 11th, 2014

bigstock-Aca-Affordable-Care-Act-Metal--51911344Blue Advantage plans are available in all metallic levels: bronze, silver, gold and platinum. The levels differ by how much of your medical costs a plan will pay on average. They are based on approximate values for standard medical expenses.

  • Bronze plans pay 60%
  • Silver plans pay 70%
  • Gold plans pay 80%
  • Platinum plans pay 90%

All plans have a maximum out-of-pocket (OOP) limit of $6,350 for individuals. Some plans have an even lower OOP limit.  If you qualify for a subsidy, this can impact your total OOP.  Click Here to generate your quote and see if you qualify for a subsidy through the Marketplace.

For more information on health insurance coverage in North Carolina, please visit our website at www.nchealthplans.com or call our toll free number 888-765-5400 and speak with one of our professional agents. Our agency provides coverage for health insurance in North Carolina through Blue Cross Blue Shield of North Carolina (BCBSNC). It would be our pleasure to help you navigate through the Health Care Reform changes in accordance with the new regulations of Obama care. Call us for details.

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BLUE CROSS BLUE SHIELD OF NC CATASTROPHIC PLANS

Sunday, February 9th, 2014

bigstockphoto_teens_with_thumbs_up_6006256Catastrophic Plans provide minimum coverage at a lower price.  They are High deductible plans; they provide Essential Health Benefits covered after deductible is met; Preventive care is covered at 100%;  Primary care in-network office visits covered with a $35 copayment for the first 3 visits and you can save as much as 22% over the least expensive bronze plan.   Click Here to generate your rate quote to compare these plans.

These plans have high deductibles that you must meet before BCBSNC pays for Essential Health Benefits. They may be a good option if you do not expect to have many medical expenses.

To qualify for these plans, you must meet one of the following criteria to be eligible for a catastrophic plan.  You must be under 30 years of age when the plan year begins or qualify for a hardship exemption through the federal government.

If you choose a catastrophic plan, you cannot use an advance premium tax credit (federal subsidy). If you do not qualify for or decide to forego a subsidy, you may save money with these plans.

The Essential Health Benefits that are covered include Ambulatory service;Emergency service;Hospitalization; Maternity and newborn care; Mental health and substance abuse services (including behavioral health);Prescription drugs;Rehabilitative and habilitative services and devices; Laboratory services;Preventive/wellness services and chronic disease management;Pediatric services, including dental and vision.

Catastrophic plans are not required to meet the metallic levels that other plans must meet. However, because BCBSNC is committed to quality coverage, the catastrophic plans do meet bronze level requirements.

 

For more information on health insurance coverage in North Carolina, please visit our website at www.nchealthplans.com or call our toll free number 888-765-5400 and speak with one of our professional agents. Our agency provides coverage for health insurance in North Carolina through Blue Cross Blue Shield of North Carolina (BCBSNC). It would be our pleasure to help you navigate through the Health Care Reform changes in accordance with the new regulations of Obama care. Call us for details.

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BCBSNC- Blue Select in 2014

Thursday, January 23rd, 2014

BCBSNC wants to help you save. Consider one of our new low cost plan options.  To help lessen the financial impacts of health care reform, BCBSNC has created several new plan options for 2014.

Blue Select is one of those plan options that provides smart choices and health savings.

Blue Select features a tiered network to help you save money. This plan offers:
+ A large network with two tiers of providers to choose from
+ Prescription drug requirements

For more information on health insurance coverage in North Carolina, please visit our website at www.nchealthplans.com or call our toll free number 888-765-5400 and speak with one of our professional agents. Our agency provides coverage for health insurance in North Carolina through Blue Cross Blue Shield of North Carolina (BCBSNC). It would be our pleasure to help you navigate through the Health Care Reform changes in accordance with the new regulations of Obama care. Call us for details.

Information from a BCBSNC publication on 8/12/13.

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Newly Eligible Customers to Keep their 2013 Plans Will Receive Renewal Notices by Early December

Tuesday, November 19th, 2013

Blue Cross and Blue Shield of North Carolina (BCBSNC) announced today that they have filed the necessary documents with the North Carolina Department of Insurance (NCDOI) to allow most of its non-grandfathered individual customers to keep their current health plans for another year. Customers with Blue Advantage, Blue Advantage Saver, Blue Value and Blue Options HSA policies whose plans were in place as of Oct. 1, 2013 will be eligible to renew their plans.

The NCDOI will be responsible for reviewing and approving rates for these renewed plans. BCBSNC submitted a rate increase of 16.4 percent for its Blue Advantage plans; 22 percent for Blue Value and 23.6 percent for its Blue Saver and Blue Options HSA plans. 2014 plan premiums reflect changes in the cost of care for all non-grandfathered customers with individual BCBSNC plans. This includes the price of care as well as the quantity of services used by this pool of customers. New taxes and fees under the Affordable Care Act (ACA) – which also apply to these plans – also contribute to the increase.

BCBSNC expects to mail revised renewal notices to eligible customers by Dec. 1. These customers will be automatically renewed in their 2013 plan for another year or may choose an ACA-compliant plan, which might come with additional benefits and a subsidy.

Renewing 2013 plans will delay some of the more challenging consumer impacts of the ACA for another year and alleviate concerns of consumers who have had difficulty accessing the Exchange. Non-grandfathered customers will need to move to ACA-compliant plans for 2015.

This information was released by Blue Cross Blue Shield of North Carolina 11/19/13.

For more information on health insurance coverage in North Carolina, please visit our website at www.nchealthplans.com or call our toll free number 888-765-5400 and speak with one of our professional agents. Our agency provides coverage for health insurance in North Carolina through Blue Cross Blue Shield of North Carolina (BCBSNC). Call us for details.

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BCBSNC to Host 2013 dotBlue Conference in North Carolina

Monday, October 7th, 2013

CHAPEL HILL, N.C. – Blue Cross and Blue Shield of North Carolina (BCBSNC) announced today that it will host the 2013 dotBlue conference. The annual symposium focuses on using the latest digital and web strategies to address the health insurance industry’s most pressing challenges. This year’s conference, titled Connecting the Dots, will focus on helping consumers understand and navigate health care reform.

The conference will take place at BCBSNC’s Durham campus from Oct. 23-25, 2013. Conference attendance is limited to Blue Cross Blue Shield Plan professionals.

Participating Blue Plans will be invited to present on relevant topics of their choice. In addition, attendees will participate in presentations about using the latest in web design and digital technology to address the changes coming to health insurance in 2014, including:

  • Pursuit of the Virtuous Quantified Life
    • Presented by Robert D. Furberg, senior clinical informaticist at RTI International’s Center for the Advancement of Health Information Technology (more…)
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