Perhaps like so many Americans, you still have questions about the Affordable Care Act and what constitutes an ACA approved health plan.  One common misconception is that the federal government has created its own individual health policies, sometimes referred to as Obamacare plans, but that is not the purpose of the Affordable Care Act.  The Affordable Care Act is a federal program designed to ensure that 10 essential health benefits are a part of every ACA approved insurance plan and to help subsidize the cost of health insurance for those who qualify.  Subsidy qualifications are based entirely on income and the number of people per household and insurance companies do not regulate or control federal subsidies.

Basically, what this means is that consumers can still purchase ACA approved plans, or plans that include the 10 essential health benefits, and they can do so without ever visiting the federal government’s health care Marketplace.  In fact, if you do not qualify for a federal subsidy based on your income level, the application process is really quite simple.  You can apply for an ACA approved BCBSNC health plan in just a few short minutes.

If you do qualify for a federal subsidy based on income level, you will still begin the application process right here, but you will be redirected to the federal Marketplace when it comes time to apply for the subsidy that will be credited to your BCBSNC plan.  Once you have completed your application for subsidy, you may see plans available to you other than Blue Cross Blue Shield of North Carolina because there are multiple companies with insurance plans available on the Marketplace; however, none can offer you and your family the same quality of coverage.

Blue Cross Blue Shield of North Carolina understands that as consumers you have choices, which is why BCBSNC is committed to offering plans that boast the broadest network of providers throughout the state of North Carolina.  In fact, when you become a part of the Blue Advantage Network, you gain affordable access to over 90% of doctors and hospitals in the state.  Even the more limited Blue Value and Blue Local Networks allow you  many exceptional choices when it comes to your healthcare provider. Keep in mind, BCBSNC is the only insurance company that offers plans that are accepted in all 100 counties in North Carolina and because unlike other companies offering plans on the Marketplace BCBSNC is not an HMO, you will still have out of network coverage should you happen to need it.

Furthermore, Blue Cross Blue Shield of North Carolina is so committed to your health and wellness that included in every plan is preventive care covered at 100%.  And if you have a plan that includes co-payments, whatever is coded as part of that doctor’s visit on that particular day will be covered by the appropriate co-payment.  That means you have the confidence of knowing there are are no hidden costs.  Make sure to view your plan’s summary of benefits and coverages for a complete list of covered health services.

Purchasing insurance may be a bit more complicated these days, but with BCBSNC you can still have the assurance of knowing you are getting the best health coverage available to you and the ones you love.

For more information on Blue Cross Blue Shield of North Carolina health insurance coverage, the Marketplace and healthcare gov  to apply for your subsidy, please visit our website at www.nchealthplans.com or call our toll free number 888-765-5400 and speak with one of our experienced and professional agents.  Let us help you navigate through the Health Care Reform changes in accordance with the new regulations of The Affordable Care Act, also known as Obama care.

Annual Enrollment 2015 is rapidly approaching and Blue Cross Blue Shield of North Carolina has you covered.  Every Blue Cross Blue Shield of NC member is a valued customer and as Open Enrollment gets underway there are some things you may need to know.  First of all, if you are happy with the BCBSNC health plan you currently have, you can keep it for another year.  Your plan will automatically renew.  Keep in mind, however, that you may still have a little work to do with regards to the renewal process, depending on the type of plan in which you are currently enrolled.  In order to make this easier for you, BCBSNC has created Blue Map, a tool developed especially for members who purchase individual plans.

If you are not yet a Blue Cross Blue Shield member, but are interested in purchasing a health insurance plan, Annual Enrollment is the time to do it.  The Annual Enrollment Period (AEP) is the once-a-year window when you are able to renew, update, change, or enroll in an Affordable Care Act (ACA) plan.  If you do not do so, keep in mind that you cannot make changes or enroll a new plan once AEP ends unless you have a Qualifying Life Event that makes you eligible for the Special Enrollment Period.  The Annual Enrollment Period ends on February 15th, 2015.

Here are some important dates to keep in mind:

• Late Oct.-Early Nov:
• All BCBSNC members will receive information about your 2015 rate and any other changes to your benefits.
• Nov. 15, 2014:
• The Annual Enrollment Period begins.  This is time to make limited changes to your current plan, change to a new plan, or enroll in a BCBSNC health plan for the first time.
• Dec. 15, 2014:
• This is the deadline to make changes to your plan or enroll in a new plan in order for coverage to begin on January 1, 2015.
• Jan. 1, 2015:
• Coverage and new rates for your 2015 plan begins (provided you met the deadline of Dec. 15).
• Feb. 15, 2015:
• This is the last day you can make changes to your plan before the end of the Annual Enrollment Period.

Annual Enrollment doesn’t have to be overwhelming.  Blue Cross Blue Shield of North Carolina is here to provide not only the best coverage you can buy, but also guidance when you need it most.

For more information on Blue Cross Blue Shield of North Carolina 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 experienced and professional agents.  Let us help you navigate through the Health Care Reform changes in accordance with the new regulations of The Affordable Care Act, also known as Obama care.

If you did not get health coverage previously under the Affordable Care Act, you can enroll in a plan for next year starting Nov. 15. And if you are already covered, you can change or renew your plan for next year. If you don’t sign up by Feb. 15, 2015, you will be without coverage until January 2016 unless you have a qualifying life event .

There are at least three key components to choosing an ACA plan that is right for you and your family: Benefits, premiums and the network of doctors and hospitals.

Benefits:

All ACA plans are required to cover “essential health benefits” as described in the law. And all individual plans must cover preventive health benefits entirely.

Beyond these requirements, consumers have choices when it comes to how much they pay out-of-pocket for covered services. Plans are broken into four categories — bronze, silver, gold and platinum. As these names suggest, bronze plans have the highest deductibles and co-payments, platinum the lowest.

When shopping for a plan, look for the “Summary of Benefits and Coverage” which describes what the plan covers. Also be sure to review each plan’s prescription drug formulary to see what drugs are covered. Or call the plans you’re considering and ask about any specific services you think you might use in the coming year.

Premiums

Health plans across the nation have been preparing customers for changes in rates from current plans for the new ACA enrollment period.  Generally speaking, the higher your out-of-pocket costs, the lower your premiums are. This tradeoff between rates and out-of-pocket costs is an important element to consider when shopping for coverage, CLICK HERE FOR YOUR NEW 2015 RATE.

Federal subsidies help consumers pay for coverage through the ACA. If your household income is between 100% and 400% of the federal poverty level, you do not have coverage through an employer, and you meet certain other requirements, you will be eligible for a federal subsidy to purchase a plan through the exchange.

Networks

Another important consideration for consumers is whether their current physicians and hospitals are in-network. Going outside the plan’s network typically results in higher charges — sometimes significantly higher. And some plans don not cover services provided outside their networks.

If you have had coverage before, or have a current plan, do not automatically assume your doctors will still be in-network for a new or renewed plan. It is best to check each time you go through an open enrollment period. All ACA plans are required to tell consumers which providers are in the plan’s networks. When shopping, look for the link to the provider directory.

For more information on Blue Cross Blue Shield of North Carolina 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 experienced and professional agents.  Let us help you navigate through the Health Care Reform changes in accordance with the new regulations of The Affordable Care Act, also known as Obama care.

Open Enrollment 2015 is just around the corner and Blue Cross Blue Shield of North Carolina is ready!  

Open Enrollment begins November 15th and runs through February 15th, so if you are currently uninsured, you will be able to apply and obtain coverage very shortly.  Although Open Enrollment will not begin until mid-November, you can begin getting prepared even now.  In fact, there are a number of questions you can ask yourself, as well as some important pieces of information you can gather so that you are as ready as BCBSNC to successfully navigate Open Enrollment 2015.

As you are considering applying for health insurance, there are a few important things to consider:

• Are you looking for a policy for yourself or are you including family members on your policy?
• Do you think you will qualify for a government subsidy? (Subsidies are based on your Modified Adjusted Gross Income and the number of people in your household)
• What kind of Blue Cross Blue Shield of NC health plan are you looking for?  Do you prefer a high deductible plan or something with co-payments?
• How important is the size of the network when it comes to health providers in your area?

Also, remember that if you are applying for a government subsidy, in order to secure an effective date of January 1st, you must complete your application by December 15th.

The Affordable Care Act has created a lot of change and because of that you may have a lot of questions.  Don’t let Open Enrollment overwhelm you.  BCBSNC wants to put you and your family members into a health plan that will offer you a large network of providers, preventive care covered at 100% and coverage you can count on in case of emergencies.  Finding the perfect plan is important and BCBSNC offers a variety of health plan options to best fit your family’s needs.

For more information on Blue Cross Blue Shield of North Carolina 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 experienced and professional agents.  Let us help you navigate through the Health Care Reform changes in accordance with the new regulations of The Affordable Care Act, also known as Obama care.

Apply for your Blue Cross Blue Shield of North Carolina coverage today if you have a Qualified Life Event that enables you to enroll during the Special Enrollment Period.  Below we have outlined some examples of these qualified life events.  To generate your quote and get started click here.  BCBSNC offers an array of health insurance plans that will fit any budget and are all ACA compliant.

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.
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.
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
 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.

Contact us today to discuss BLUE CROSS BLUE SHIELD OF NORTH CAROLINA plans.  You need to purchase your new health insurance policy before the Open Enrollment period ends on March 31, 2014. GET YOUR FREE RATE QUOTE AND APPLY TODAY.

We can guide you through all plans offered by BCBSNC, help you determine if you are eligible for a subsidy, guide you through the Marketplace to finalize your subsidy application.  Once the Marketplace process is finalized we will assist you with your enrollment/payment finalization through Blue Cross Blue Shield of North Carolina.  Don’t wait, time is running out.

During the Open Enrollment period, you can buy qualified private health insurance through the government Marketplace. After the Open Enrollment period, you can only sign up for Medicaid and the Children’s Health Insurance Program (CHIPS) through healthcare.gov. Unless, you qualify under Special Enrollment Period that require a change in your health insurance.  Some of these include getting married, moving, getting a new job that pays more, or losing your health insurance.

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.

Call 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

If you applied in the past for Blue Cross Blue Shield Individual insurance or through another carrier and were declined due to medical ineligibility, we wanted to make you aware of new 2014 underwriting regulations through the Affordable Health Care Act, also known as Obamacare.  Under these new regulations, applicants who apply for coverage with a January 1^st or later effective date will no longer be underwritten with regards to their health or pre-existing conditions and therefore will be guaranteed issued with no rate increase for health conditions. The law also requires insurance companies to cover all applicants within new minimum standards and offer the same rates regardless of pre-existing conditions or gender.  Beginning October 1^st, we will be enrolling new customers into Blue Cross Blue Shield plans for 2014 effective dates.  Please give us a call or go online to generate your free rate quote on or after October 1^st and secure your Blue Cross coverage for 2014. If you would like to get your free rate quote and/or apply on line for Blue Cross Blue Shield coverage, please CLICK HERE and complete the information to generate your quote.

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.

Executive Brief
Prepared by BCBSNC Health Policy Office
Overview
The Affordable Care Act (ACA) changes the very foundation of the way health insurance is purchased with the introduction of public health insurance Exchanges, a standardization of health insurance plans, and the creation of new financial assistance programs call subsidies. Each American may have a different experience with many of the reforms depending on factors such as their income, health status, and how they currently obtain their insurance. One group that received special attention under the ACA are American Indians and Alaska Natives (AN/AIs). Of particular note to health insurance issuers is the fact that these groups will have unique rules regarding subsidies and enrollment.
Subsidies
Two types of subsidies exist under the ACA: premium tax credits and cost-sharing reductions. Only available through the public Exchanges, the premium tax credits reduce the cost of the premium to individuals and families while the cost-sharing reductions reduce the out-of-pocket costs once a member has enrolled. For AI/ANs, the premium tax credits are applied just like anyone else who qualifies on the Exchange. However, the cost-sharing reductions have been modified for AI/ANs. For most individuals without access to other affordable coverage, the (more…)

Let’s get to the question on everyone’s minds: What does this mean for me?  The people most affected financially by Obama Care are those who purchase individual policies or get their insurance through a small-business employer.  Of those affected, some customers will pay less than they do now, but many will pay more. Federal subsidies will offset the rates for some people – but many will be eligible for only a partial subsidy.  Here’s how health insurance premiums will be impacted for different people choosing a mid level plan.

But how will Blue Cross and BlueShield of North Carolina’s individual and small business customers be affected specifically?

Because of the impacts of the Affordable Care Act, about half of our customers will see their premiums increase by 50 percent or more before federal subsidies. We expect about half of our customers will qualify for subsidies, which will help off set their costs – though the amount of those subsidies can vary greatly. Of course, subsidies don’t actually reduce the cost of coverage. They simply shift it to someone else. The federal government pays for the subsidies and the cost share shifted to taxpayers.

The above information is from “The Cost of Change” from Blue Cross Blue Shield of North Carolina.

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.

There are two types of federal subsidies to help reduce health care costs in 2014.They are Advanced Premium Tax Credits and Cost-Sharing Reductions.

+ Advanced Premium Tax Credits lower your monthly premium.

+ Cost-Sharing Reductions help lower out-of-pocket expenses including deductibles, co-pays and coinsurance at the place of service, like doctor and hospital visits. Subsidies are only available on new 2014 plans for those who qualify. Subsidies cannot be applied to Grandfathered Plans, but it may be worth it to switch.

+ Advanced Premium Tax Credits are only available to individuals who are ineligible for public coverage and are unable to get qualified health insurance through an employer.

+ Advanced Premium Tax Credits are determined by income and family size in relation to established Federal Poverty Levels (FPL). Many Americans will qualify for Advanced Premium Tax Credits, including the middle class. Those that qualify must have a household income between 100% and 400% of FPL for their family size.

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Federal and NC Definitions Now Aligned

Date: 08/23/2013

Recently, the North Carolina (NC) legislature passed House Bill 649, which made changes to NC’s Small Employer Group Health Coverage Reform Act in order to align federal and NC definitions related to small employer group health plans – specifically, those definitions included as part of the Affordable Care Act.

Important changes affecting BCBSNC employer groups beginning January 1, 2014 include:

Sole Proprietorship Change

Self-employed individuals (or sole proprietors) with no common-law employees are no longer eligible for non-grandfathered small employer health plan coverage; conversely, a sole proprietor is eligible for group coverage if there is at least one common law employee (e.g., non-family member, etc.) employed.

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