Immediate Press Release: September 20, 2010

Information below is from the North Carolina Department of Insurance Press Release

Insurance Commissioner Goodwin and Blue Cross announce policyholder refunds and lower than requested rate adjustments.

RALEIGH — Insurance Commissioner Wayne Goodwin and Blue Cross and Blue Shield of North Carolina President and CEO Brad Wilson today announced a decision on individual policyholder rates for BCBSNC customers and a unique, one time refund that will return $155.8 million to more than 215,000 individual BCBSNC customers as a result of the Affordable Care Act.  The refunds will be issued by the end of the year to policyholders who had Blue Advantage or Blue Options HSA for Individuals policies in force as of March 23, 2010, the date the federal law was enacted. Refunds will be proportional to premiums paid and will be equivalent to more than 1.5 months of premiums. Customers may receive lower or higher amounts depending on their specific premium rates. For example, for an average policyholder’s monthly premium of about $380, the refund would be approximately $690.

“I’m pleased that the Department and Blue Cross were able to identify a way for $155.8 million to go back into consumers’ wallets,” said Commissioner Goodwin. “I’m also glad that we were able to negotiate a lower than requested rate adjustment that will save $14.5 million in future premiums for policyholders.”

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Beginning in 2014, businesses with 50 or more employees that do not offer coverage and have at least one full-time employee who receives a federal tax credit to purchase health insurance on his own through an Exchange, must pay the federal government a $2,000 per-employee penalty. The first 30 employees would be excluded from this assessment.

Employers with 50 or more employees that do provide coverage, but have at least one full-time employee who receives a federal tax credit to purchase health insurance on his own through an Exchange, will be assessed a penalty that will be the lesser of $3,000 per employee receiving a premium tax credit or $2,000 for each full-time employee, excluding the first 30 employees.

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Many small business owners have questions about how the Health Care Reform will effect them….

“I own a small business and want to provide health insurance for my employees and their families. Are there subsidies or other assistance to help me afford to coverage?”

Many small businesses will be eligible for tax credits of up to 35 percent. Businesses that employ fewer than 25 employees, pay average annual wages of $50,000 and pay at least half the cost of single coverage for their employees may be eligible to receive a tax credit.

Employers with 10 or fewer employees that pay annual average wages of $25,000 or less per year may be eligible for up to a 35 percent tax credit in 2010.

In 2014, the tax credit for eligible small businesses will increase to 50 percent of premiums paid.

Full eligibility details will be provided by the Internal Revenue Service. You should review and discuss the full criteria with a tax professional to determine whether your business will qualify.

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As Health Care Reform takes effect, many are asking how and when they will obtain health insurance in the future.  Blue Cross and Blue Shield companies already offer low-cost health insurance options that you may be able to enroll in today. You can find coverage options through your local Blue Cross and Blue Shield company.

Beginning in 2014, state health insurance exchanges will enable consumers to compare benefits, prices and networks of providers and purchase coverage.

Prior to the establishment of state exchanges in 2014, a temporary high risk pool program will be created by the federal government to provide coverage to high-risk individuals who have not been covered during the prior 6-month period or do not have access to coverage, to purchase coverage. A majority of states already have high-risk pools for their residents.

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Beginning in plan years after Sept. 23, 2010, the new law allows dependents up to age 26 to obtain coverage under their parents’ plans that offer dependent coverage. In April 2010, the nation’s 39 independent Blue Cross and Blue Shield companies recognized that many young people could lose their coverage because of their age, student status, graduation from school or other factors prior to when the new law goes into effect for plan years beginning September 23, 2010. The BCBS companies proactively announced in April that they will offer to their accounts continued overage of these hundreds of thousands of young adults under age 26 on the health insurance policies their parents purchase through the individual marketplace effective June 1. Young adults may be eligible regardless of whether they are financially dependent on their parents. This extension of coverage is also being offered to employer accounts for their members.

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The term “health care reform” is being used a lot these days. Health care reform became a reality with the passage of two related bills:

The Patient Protection and Affordable Care Act (PPACA), signed into law on March 23, 2010  and  The Health Care and Education Reconciliation Act, signed into law a week later on March 30, 2010. Because these two bills work together, we often refer to health care reform as a single “new law” for the sake of simplicity.  Health care reform law has many separate provisions that will come into effect at different times over the next eight years. Here are some of the most important ones: (more…)

There are a number of factors that are driving health insurance premiums. Increasing utilization attributable to an aging population, obesity and chronic illnesses; new treatments; prescription drugs and expensive new technologies are the biggest causes of increasing healthcare premiums. The new law establishes a few pilot programs, but does not aggressively attempt to control rising healthcare costs. 

We believe that premiums will increase as a result of provisions in the reform legislation that will guarantee richer levels of benefits than most consumers who obtain their own insurance purchase today. Insufficient discounts for the young and healthy will encourage many of them to forgo coverage. New fees and taxes mandated by the new law will also likely increase the cost of premiums as they are phased in. 

Blue Cross and Blue Shield companies will continue to work with doctors, hospitals, employers and consumers to rein-in costs and insurance premiums while improving access to quality healthcare. In doing this, many of the Blue Cross and Blue Shield companies have initiatives to reduce unnecessary hospital readmissions, eliminate infections acquired during hospital visits and promote paying doctors and hospitals for quality outcomes to help achieve this goal.

The above information is from a post by BCBSNC in 2010 and located at bcbsnc.com.

 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 qualified 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.

WHEN WILL THESE NEW REFORMS BECOME EFFECTIVE:

Beginning in July 2010 – Consumers with health problems who have been uninsured for 6 months may be eligible to obtain coverage through a new high risk pool program. And a temporary reinsurance program will help employers who provide coverage to their retirees in maintaining this coverage. 

Beginning in plan years on or after September 23, 2010 – Pre-existing condition exclusions are prohibited for children under 19, dependents up to age 26 will be able to obtain coverage through parents’ health plans, routine preventive care will be covered without cost-sharing, limits on lifetime coverage will be eliminated along with other changes. 

In 2014 – Individuals and small businesses will be able to purchase coverage through state-based exchanges. Consumers will be able to purchase health insurance regardless of health status and premiums cannot vary because of health status. Individuals will be required to purchase health insurance or pay a penalty. Subsidies will be available on a sliding scale to help individuals or families with incomes up to 400 percent of the federal poverty level to purchase insurance through new state-based exchanges.

The above information is from a post by BCBSNC in 2010. 

 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 qualified 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.

From J. Bradley Wilson, president and CEO of Blue Cross and Blue Shield of North Carolina:  Mark Twain wrote, “Always do right. This will gratify some people, and astonish the rest.” It might astonish many people that Blue Cross and Blue Shield of North Carolina stands ready to implement what is likely to be the first of several waves of health care reform. 

For the past 14 months, insurance companies have been poster children for what’s wrong with health care. In the face of relentless attacks by politicians, abetted by the news media, health insurers have not done a good job of explaining the value of health insurance.  (more…)

Health care reform became a reality when President Obama signed into law the Patient Protection and Affordable Care Act (PPACA) on March 23rd, 2010. A reconciliation bill, which made changes to PPACA, was signed into law one week later.

Health care reform will extend access to millions of people who need health insurance. It’s a historic step in the right direction. But there’s still a lot of work to do to give Americans a health care system that they can both depend on and afford.

In keeping with the needs of North Carolinians, Blue Cross and Blue Shield of North Carolina is preparing for the many changes the new law requires. However, because it’s more than 2,000 pages long, there’s a process to “translate” legislative language to best serve our customers. Federal regulations will also be required to implement many aspects of the law. When those regulations will be finalized is uncertain. (more…)

For the last year, the nation’s attention has been fixed on reforming our healthcare system. On behalf of our nearly 100 million members, Blue Cross and Blue Shield companies are committed to working with the Administration and all other parties to implement this new law.

As we have done throughout our 80-year history, we will continue to help people navigate the healthcare system, especially at this time when many people are confused and unsure of what reform means to them. Being a part of the Blue Cross and Blue Shield family is about so much more than a simple membership card. It is a commitment to service excellence regardless of where you live or what kind of health plan you have. It is financial security in times of healthcare necessity. It is investments in the communities where you live, work and play. (more…)

The federal health care reform legislation, known as the Patient Protection and Affordable Care Act, signed by the President on March 23, 2010, and the Health Care and Education Reconciliation Act approved by Congress, signed by the President today, will expand the availability of health care coverage to millions of Americans. While some of the measures will be implemented this year, many do not take effect until 2014 and some extend out to 2020.

Below is information we have received which is a high-level overview of the timeline.  It is important to note that many of these reforms and their effective dates are subject to the rules and regulations process both at the state and federal levels – which could alter the intended timing of implementation.  Also, keep in mind, anything is subject to change.

2010

New Programs:
* Temporary retiree reinsurance program is established
* National risk pool is created, small business tax credit is established
* $250 rebate for Medicare members who reach the ”doughnut hole”

Insurance Reforms:
* Prohibits lifetime benefit limits – based on dollar amounts
* Allows restricted annual limits on the dollar value of certain benefits
* Coverage rescissions/cancellations are prohibited (except for fraud or intentional misrepresentation)
* Cost-sharing obligations for preventive services are prohibited
* Dependent coverage up to age 26 is mandated
* Internal and external appeal processes must be established
* Pre-existing condition exclusions for dependent children (under 19 years of age) are prohibited
* New health plan disclosure and transparency requirements are created

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