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Special Enrollment Period Qualifications Set by ACA

Monday, March 3rd, 2014

bigstockphoto_puzzled_question_75542Call today and go over questions about Open Enrollment vs Special Enrollment so you do not lose the opportunity to acquire coverage.  To enroll in a Blue Cross Blue Shield of North Carolina health plan, outside of the annual enrollment period, you must qualify under the Special Enrollment guidelines set out below.  Special circumstances for enrolling outside of the open enrollment period include:

Loss of minimum coverage (employer coverage, government plans, etc.)

Adding a dependent through birth

Adoption or marriage

Gaining citizenshipEnrollment/non-enrollment errors by the federal Marketplace or the US Department of Health and Human Services

Qualified health plan violates the material provision of its contract with the individual

Newly eligible for a subsidy or a change in the amount of subsidy you are eligible for

Moving to a new state

American Indian/Alaska Native status (may change once a month)Other exceptional circumstances

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.

 

Affordable Care Act – Tax Penalties

Saturday, March 1st, 2014

bigstock-Insurance-or-Penalty-sign-conc-52884937In 2014, the Affordable Care Act mandates that all taxpayers purchase health insurance or pay a penalty on their tax returns. The penalty will increase every year until 2016.  Get your Free Rate Quote and apply for your coverage today through Blue Cross Blue Shield of North Carolina and avoid these penalties.

  • 2014: a minimum of $95 per year or up to 1% of annual individual income (whichever is greater)
  • 2015: a minimum of $325 per year or up to 2% of annual individual income (whichever is greater)
  • 2016: a minimum of $695 per year or up to 2.5% of annual individual income (whichever is greater)

You can enroll in a plan from 10/1/2013 to 3/31/2014.  Unless special circumstances apply, you will not have the opportunity to enroll again until until 2014 Open Enrollment  for coverage that starts 1/1/2015. That means you cannot wait for a medical need 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.

Blue Cross Blue Shield of NC – How to Apply

Wednesday, February 26th, 2014

bigstockphoto_online_application_2680056Enrolling in a Blue Cross Blue Shield of North Carolina plan is simple and easy. You can enroll online 24/7.

When you get your free, no-obligation rate quote, we will help you estimate any advance premium tax credit (subsidy) or cost-sharing reduction you may be eligible for through the government.  Your quote will outline the estimated subsidy so you can see the reduced rate.

Use the tools and tips on the rate quote results page to compare prices and plan details. Your quote will also provide links to more information about our plans and assistance picking the right plan.  Once you pick a plan, you are ready to enroll.

It all starts with a free rate quote.  Note: You only have a limited time to enroll.The annual enrollment period is from 10/1/2013 to 3/31/2014. You can choose to have your coverage start between 1/1/2014 and 5/1/2014.  Unless special circumstances apply, you will not have the opportunity to enroll again until  the next Open Enrollment starting November 2014 for coverage that starts 1/1/2015. That means you cannot wait for a medical need 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.

 

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.

HSA 2014 Contribution Limits

Friday, February 21st, 2014

bigstock-Dream-Of-The-Bank-Account-3843325Health Savings Account Contributions amounts are updated each year by the federal government to account for inflation. For 2014, the maximum annual contribution is $3,300 for an individual (up $50 from 2013), and $6,550 for a family (up $100 from 2013).    In 2014, those age 55 or older can contribute an additional $1,000 above the maximum to their HSA.

Blue Options HSA is a new way to pay for health care. Blue Cross Blue Shield of North Carolina has taken their most popular plan design’s PPO network and paired it with a High Deductible Health Plan (HDHP) and a health savings account (HSA), which has similar characteristics to a 401(k) or an IRA but for qualified medical expenses. Blue Options HSA offers many advantages.  Get your Free Rate Quote for this plan today and call our office so we can go over the benefits and process to apply and 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.

BCBSNC/Obamacare/Marketplace – LET US WALK YOU THROUGH THE PROCESS

Wednesday, February 19th, 2014

doggiesEnrolling in a Blue Cross Blue Shield of North Carolina plan is simple and easy. You can enroll online 24/7.

When you get your free, no-obligation rate quote, we will help you estimate any advance premium tax credit (subsidy) or cost-sharing reduction you may be eligible for through the government.  Your quote will outline the estimated subsidy so you can see the reduced rate.

Next Step: Register through your free rate quote, click the link in your quote to start your healthcare.gov application process.  We will help you select a plan and guide you through the entire process.  Once your subsidy application is completed, we will guide you through the payment process and provide you the payment coupon so you can mail your payment to Blue Cross Blue Shield of North Carolina to guarantee your coverage starts on the effective date you requested.

NOT APPLYING FOR A SUBSIDY.  Apply today and start coverage immediately.  YOU DO NOT HAVE TO GO TO THE MARKETPLACE and we can walk you through these very simple and easy steps.

You only have a limited time to enroll. The annual enrollment period ends 3/31/2014.   As of today, you will have the option for an April 1st or May 1st effective date.  Unless special circumstances apply, you will not have the opportunity to enroll again until  the next Open Enrollment starting Nov 2014 for coverage that starts 1/1/2015. That means you cannot wait for a medical need 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.

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.

 

Blue Cross Prior Review Certification

Saturday, February 15th, 2014

bigstock--D-Person-Watching-A-Word-rev-57042881Prior Review:  Certain services require prior review and certification from BCBSNC before they can be covered by your health insurance plan. In case of emergency, prior review and certification is NOT required. BCBSNC should be notified of an urgent or emergency admission by the second business day of the admission.

Responsibility for Requesting Prior Review and Certification

For In-Network Providers: North Carolina providers or specialists in the BCBSNC network will request prior review for you. You may want to check with your health care provider to make sure that prior review was obtained before you have the service or procedure in question.

For Out-of-Network Providers:  You are responsible for ensuring that out-of-network doctors have requested prior review and certification from BCBSNC before the service is performed. The physician or her office should request the review from BCBSNC. This also applies to BlueCard providers (out of state providers who contract with another Blue Cross Blue Shield plan) outside of North Carolina. Your Benefit Booklet has more information about prior review and certification that is specific to your policy. (more…)

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.

 

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.

 

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.

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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