Already a Blue Cross Blue Shield individual member? We know you have questions about how to prepare your family for Health Care Reform.  Jerry Ballard & Associates has the perfect personalized tool for you…. BLUE MAP!

Blue Map is on online tool created by BCBSNC to help address your 2014 Health Insurance options.  This tool will help you find the right solution.  Just answer a few simple questions, and get a personalized recommendation based on your member profile that will outline your options.  This interactive, easy-to-use web application is designed to provide you with personal options, explaining the choices you have in choosing a plan.  Check out Blue Map today as you begin to prepare for your 2014 Health Insurance needs.

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). You may qualify for a 15% healthy lifestyle discount if you are in excellent health. Call us for details.

The information in this article was taken from “Health Care Reform is Coming” from BCBSNC on April 2013.

As you begin to prepare for 2014, you will need to be familiar with the following terminology…

Affordable Care Act (ACA)– The law intended to address issues with our health care system by increasing access to health insurance, introducing reform and improving quality  also referred to as the Patient Protection and Affordable Care Act (PPACA).

Health Insurance Marketplace– An online insurance marketplace where individuals can compare, shop for and buy qualified health insurance plans.  Also known as an “Exchange”.

Federal Poverty Level (FPL)– A measure of income level (by family size) that determines eligibility for premium tax credits.  For example, a family of four that makes less than $94,200 a year may be eligible for help.

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). You may qualify for a 15% healthy lifestyle discount if you are in excellent health. Call us for details.

The information in this article was taken from “Health Care Reform is Coming” from BCBSNC on April 2013.

Terminology that you will need to understand as you begin to prepare for the Affordable Care Act.

Premium Tax Credits- These will be made available to low and middle income Americans and applied to health insurance premiums.  Cost Sharing Reductions will limit a plan’s maximum out-of-pocket costs.

Grandfathered- Refers to health insurance plans that were in  effect prior to March 23, 2010 and that have not undergone specific changes.  The ACA allows grandfathered plans to be exempt from some ACA requirements.

Health Care Reform (HCR)- The changes that will occur on January 1, 2014 as a result of the comprehensive health care reform law known as the AFFORDABLE CARE ACT.

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). You may qualify for a 15% healthy lifestyle discount if you are in excellent health. Call us for details.

The information in this article was taken from “Health Care Reform is Coming” from BCBSNC on April 2013.

Trust that Jerry Ballard & Associates will provide you with the tools and resources that will navigate you through the Health Care Reform process!

Blue Map: This is an interactive, easy-to-use web application designed to provide you with a personalized recommendation explaining the options you in choosing a plan.  BCBSNC will be sending you information on how to use Blue Map, so look for it in the mail.  In addition, we will provide support and assistance to you via our website and by calling our office.

Events will be held throughout North Carolina to explain the nuances of health care reform and provide an opportunity for attendees to ask questions. BCBSNC will let you know when we’re coming to a town near you.

A variety of BCBSNC plan options should make finding the right solution easy for each and every member.

The BCBSNC health care reform website has content that clarifies health care reform as well. As your agent, we are ready to assist you.

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). You may qualify for a 15% healthy lifestyle discount if you are in excellent health. Call us for details.

The information in this article was taken from “Health Care Reform is Coming” from BCBSNC on April 2013.

Milestones and Dates that you will want to keep in mind as Health Care Reform comes closer:

June 2013: Blue Map should help you find the right solution. Just answer a few simple questions, and get a personalized recommendation based on your member profile that will outline your options.

Summer 2013: BCBSNC events will be hosted throughout North Carolina. We will let you know when we are coming to a town near you.

September 2013: Enrollment begins in one month. You will receive your renewal/enrollment kit. Will you have changes or need new plan options?

October 2013: New health care reform plans are available for a 2014 effective date. Have you completed your Blue Map? You can review your options and get a quote.

December 2013: Deadline is approaching to make changes to your current plan or sign up for a new one.

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). You may qualify for a 15% healthy lifestyle discount if you are in excellent health. Call us for details.

The information in this article was taken from “Health Care Reform is Coming” from BCBSNC on April 2013.

What is the penalty for noncompliance?

If you do not have health insurance, the penalty is the greater of:

For 2014, $95 per uninsured person or 1 percent of household income over the filing threshold;

For 2015, $325 per uninsured person or 2 percent of household income over the filing threshold, and

For 2016 and beyond, $695 per uninsured person or 2.5 percent of household income over the filing threshold.

There is a family cap on the flat dollar amount (but not the percentage of income test) of 300%, and the overall penalty is capped at the national average premium of a bronze level plan purchases through an exchange.

For individuals under 18 years old, the applicable per person penalty is one-half of the amounts listed above. Beginning in 2017, the penalties will be increased by the cost-of-living adjustment. Who will be exempt from the mandate?  Individuals who have a religious exemption, those not lawfully present in the United States, and incarcerated individuals are exempt from the minimum essential coverage requirement.

Are there other exceptions when the penalty may apply?

Yes. A penalty will not be assessed on individuals who cannot afford health coverage based on formulas contained in the law, anyone who has income below the federal income tax filing threshold, any members of Indian tribes, anyone who were uninsured for short coverage gaps of less than three months; or if they have received a hardship waiver from the Secretary, or are residing outside of the United States, or are bona fide residents of any possession of the United States.

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). You may qualify for a 15% healthy lifestyle discount if you are in excellent health. Call us for details.

Beginning in 2014, the Affordable Care Act includes a mandate for most individuals to have health insurance or potentially pay a penalty for noncompliance. Individuals will be required to maintain minimum essential coverage for themselves and their dependents. Some individuals will be exempt from the mandate or the penalty, while others may be given financial assistance to help them pay for the cost of health insurance.

What type of coverage satisfies the individual mandate?

“Minimum essential coverage”

What is minimum essential coverage?

Minimum essential coverage is defined as:
•Coverage under certain government-sponsored plans
•Employer-sponsored plans, with respect to any employee
•Plans in the individual market,
•Grandfathered health plans; and
•Any other health benefits coverage, such as a state health benefits risk pool, as
recognized by the HHS Secretary.

Minimum essential coverage does not include health insurance coverage consisting of excepted
benefits, such as dental-only 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). You may qualify for a 15% healthy lifestyle discount if you are in excellent health. Call us for details.

We are pleased to announce that Kennon Wainwright has joined our agency as an Authorized Blue Cross Blue Shield Agent.  Kennon grew up on the coast in beautiful Morehead City, North Carolina.  He attended Virginia Episcopal for High School before entering The University of North Carolina at Chapel Hill.  He graduated from UNC-CH with a Bachelor’s Degree in Peace, War and Defense.   He began his insurance career in 2009 with experience in Property and Casualty.  He currently holds insurance licensing in Health & Life, Property & Casualty and is also working towards his Accredited Advisor in Insurance Designation.  Kennon is excited to assist North Carolina residents with their health insurance needs.  He looks forward to sharing the wide range of exceptional Blue Cross Blue Shield Products such as Blue Advantage, Blue Options HSA, and Dental Blue.  Kennon is confident that he can find a plan that best suits your needs and situation.

In his spare time, Kennon enjoys spending time on the water, hunting with his chocolate lab, Goose and cheering for the Tar Heels.  Kennon is a tremendous asset to our agency and brings knowledge about the BCBSNC products to best serve you and your insurance needs.

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). You may qualify for a 15% healthy lifestyle discount if you are in excellent health. Call us for details.

Need Dental Insurance and over Age 65?  Blue Cross Blue Shield has just the perfect product for YOU!

Medical experts have linked periodontal (gum) disease to stroke, heart disease,diabetes and other health issues. Nearly 75 percent of American adults have some form of periodontal disease. But with proper daily dental care, regular dental checkups can help detect, prevent and treat gum disease and related disorders. Choose Dental Blue for Seniors and you can take a big step toward protecting your overall health. Coverage you can smile about With Dental Blue for Seniors, you’re covered for a broad range of dental services, including routine fillings and extractions, plus major services like crowns, bridges and dentures. Coverage also includes preventive care. That means you can get checkups and cleanings twice per benefit period, and that supports better oral health. And there are no waiting periods for cleanings, routine oral exams and other diagnostic and preventive services.

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). You may qualify for a 15% healthy lifestyle discount if you are in excellent health. Call us for details.

The information above is from Dental Blue For Seniors 2013 Blue Cross Blue Shield Product Brochure.

A basic tenet of the Affordable Care Act (ACA) is to expand coverage and accessibility of health insurance to most, if not all, Americans. Coverage is expected to increase by up to 32 million people through expanding Medicaid and offering premium and cost-sharing subsidies to make insurance more affordable for those who do not qualify for Medicaid. In addition to these programs, states will also have the option of implementing a Basic Health Plan (BHP). If states choose to operate a BHP, they will be given 95 percent of what the government would have spent on subsidies for the enrolled population between 133 and 200 percent of the federal poverty line (FPL).

What is a BHP?

Beginning on January 1, 2014, states have the option to offer a BHP to their residents in lieu of individuals receiving federal subsidies. The BHP will have to meet certain criteria:

• Essential health benefits must be covered;
• Premiums must not exceed those of silver-level plans (the second lowest) on the Exchange;
• Certain actuarial minimums must be met; and
• Medical loss ratios may not fall below 85 percent.

The requirements mentioned above are the minimum requirements; states are allowed to offer more generous coverage (examples include that of Medicaid or State Children’s Health Insurance Plans (CHIP)). The Center for Medicare and Medicaid Services (CMS) released a request for information (RFI) on September 1 in an attempt to gather information that may assist in the development of the BHP regulations. If states decide to offer a BHP, they may contract with one or more private insurers or build on existing state-run programs like Medicaid and CHIP. If North Carolina decided to implement a BHP, BCBSNC will need to evaluate how we can best serve that population and our current members.

The BHP in ACA was modeled after a similar program that began in Washington State. The Washington BHP (WBHP) began in 1987 and differs slightly from the federal program. In WBHP, subsidies are distributed to help low-income residents afford insurance premiums. Both residents and the state participate financially and the program is run more like an insurance program than an entitlement program. In November of 2011, Gov. Gregoire of Washington recommended eliminating the WBHP because of a state budget shortfall and the high cost of the program.

Eligibility

To determine eligibility for the ACA-prescribed BHP, an individual must:

1. Be younger than age 65 at the beginning of the plan year;
2. Have a modified adjusted gross income (MAGI) of above 133 percent but below 200 percent of the federal poverty line (meaning, in 2011, an individual with an income from $14,484 to $21,780);
3. Be a legal resident immigrant who has lived in the United States for less than five years whose income falls below 133 percent, but whose immigration status prevents them from being eligible for Medicaid; or
4. Not have access to affordable, comprehensive employer-sponsored coverage.

If a state accepts the federal funds to operate a BHP, these individuals will no longer be eligible to shop on the Exchange and receive subsidies.

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). You may qualify for a 15% healthy lifestyle discount if you are in excellent health. Call us for details.

The information in this article was taken from Nchealthreform.com on 1/13/2012.

Today, health insurance covers a wide range of benefits but exactly what is included can vary based on where someone lives and the policy they purchase. Beginning January 2014, the Affordable Care Act (ACA) will create a more uniform standard, requiring that all health insurance coverage for individuals and small groups includes certain treatments and procedures deemed “essential health benefits.” Large groups are not required to comply with the essential health benefits requirements. The underlying idea is that the “essential benefits package” be equal to the coverage offered under a “typical employer plan.” Ten general categories were identified as essential health benefits:

• Ambulatory patient services;

• Emergency services;

• Hospitalization;

• Maternity and newborn care;

• Rehabilitative and habilitative services and devices;

• Laboratory services;

•  Mental health and substance use disorder services, including behavioral health treatment;

• Prescription drugs;

• Preventive and wellness and chronic disease management; and

• Pediatric services, including oral and vision care.

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). You may qualify for a 15% healthy lifestyle discount if you are in excellent health. Call us for details.

The information in this article was taken from Nchealthreform.com on 3/7/2012.

Subscribers and dependents must satisfy a 12-month waiting period for pre-existing conditions under this health benefit plan. Any waiting period for pre-existing conditions begins on the effective date of this health benefit plan. During a waiting period for pre-existing conditions, neither you nor your dependents will receive benefits for conditions for which medical advice, diagnosis, care or treatment was recommended or received within the 12 months immediately preceding the effective date of this health benefit plan. However, provided there was no significant break in coverage, a waiting period for pre-existing conditions will not apply to any condition first identified, treated and covered under prior creditable coverage. Medical records may be ordered to make this determination. Genetic information [variable] is never treated as a pre-existing condition.

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