fbpx

New IU65 plan rate-up tier expands range of premium options

Based on your feedback, BCBSAZ implemented a new rate-up tier for IU65 plans on Oct. 19, 2011. With this change, underwriting now applies one of four rate-up tiers for applicant underwriting, in contrast to the three previous rate-up tiers.

The additional tier allows for a broader range of premiums depending upon the outcome of underwriting.

The new rate-up structure is as follows:

Current Rate-up
Tier 1 15%
Tier 2 35%
Tier 3 80%
New Rate-up
Tier 1 15%
Tier 2 35%
Tier 3 55%
Tier 4 80%

Although BCBSAZ uses a rate-up process, we expect that the majority of our applicants will receive the Preferred rate. Under the new structure, we expect that around 3 to 7 percent fewer applicants will be subject to the highest rates.

BCBSAZ appreciates the insight and feedback we receive from brokers like you and we’re pleased to implement this change to assist you in building your book of business.

If you have questions, please contact your field broker representative for more information.

TOP OF MIND

Individual under-65 plan rates updated for first quarter 2012

Rates for Blue Cross Blue Shield of Arizona (BCBSAZ) Individual and Family plans increased 2.9 percent on average effective Jan. 1, 2012. The new premium rates are applicable only to those customers who apply for coverage in the first quarter, 2012, and to BCBSAZ members renewing in the first quarter of 2012.

First quarter 2012 premium rates will be effective from Jan. 1, 2012, through March 31, 2012. The new rates are currently available for viewing online at azblue.com and via your Broker Marketing website.

Transfer Options for Renewing Members on Grandfathered Plans Extended Through March 2012Effective Oct. 1, 2011, BCBSAZ began allowing Suite A (grandfathered) members looking for a lower premium option to move up in deductible within their current plan without going through underwriting. This allowed members to retain their grandfathered status while reducing their monthly bill. On a trial basis, we have also been allowing Suite A members to move to lower-premium Suite C (non-grandfathered) plan options without underwriting, although this move does result in the loss of grandfathered status.

We are extending this trial for plan transfers effective through March 2012 and will continue to assess the impact as we decide whether to continue to allow the expanded transfer options later into the year.

If your client is interested in moving to a plan with a lower premium, you can review options and, on or before March 31, 2012, submit the transfer using the Change My Plan tool on azblue.com via the broker portal, or your client can make the transfer at azblue.com/ChangeMyPlan.

TOP OF MIND

New renewal report helps brokers track and manage upcoming individual plan renewals

A new broker renewal report available on the BCBSAZ broker portal provides a fast and easy snapshot of upcoming renewals to assist brokers in managing their books of business.

The new report assists brokers by listing information for clients who are approaching their renewal date within the upcoming 90 days and includes such helpful information as the current premium, new premium for renewal of the same plan and percentage increase of the new premium compared to the previous rate. In addition, the report provides two plan options that the broker can make available to the client without medical underwriting to help the client choose another BCBSAZ plan option should the client decide not to continue on the existing plan.

The new report is available on the BCBSAZ broker portal and can also be exported to Excel to assist in integration with broker-generated tracking reports.

The new report can be accessed under the Client Management>Broker Reports>Individual IU65 renewals tab on the Broker Marketing Web site.

TOP OF MIND

Start the New Year in the green with our Small Group Broker Bonus

Boost your earning potential with the expanded BCBSAZ Small Group Broker Bonus. There are two ways to win a $5,000 bonus:

  1. Sell or renew a group with 51-99 enrolled employees with an effective date between Jan. 1, 2012, and March 15, 2012.
  2. Sell or renew any combination of three groups of 26-50 enrolled employees with effective dates between Jan. 1, 2012, and March 15, 2012.

Plus, earn an additional $5,000 for our full replacement bonus! You can add an additional $5,000 to your original bonus if the above qualifying groups choose to offer any of our three qualifying high-deductible health plans (ideal for pairing with an HSA) as a full replacement to their existing coverage.* There is no limit to the bonuses you can earn based on number of groups, so start the New Year off right and bring in your extra earnings today!

Contest Rules:

  • All products qualify for the initial $5,000 bonuses (both groups with 26-50 and 51-99 enrolled employees).
  • For the additional $5,000 bonus, your client must offer one or more of the following products exclusively: HSA Plus $4,000 (90 percent), HSA Plus $3,000 (90 percent) or HSA Plus $2,600 (90 percent).
  • Broker Bonuses are one-time payouts at the end of the second month after the effective date.
  • Final underwriting must show qualifying number of employees (single groups with 51-99 enrolled employees or three groups with 26-50 enrolled employees).
  • Groups must continue to pay premiums for 12 months or recoupment of bonus applies.
  • Broker must make full contest disclosure of the bonus to groups prior to sale.
* For the full replacement bonus, your client must offer one or more of the following products: HSA Plus $4,000 (90%), HSA Plus $3,000 (90%) or HSA Plus $2,600 (90%).

TOP OF MIND

Joann Cipiti Joins BCBSAZ as Government Strategic Executive

Blue Cross Blue Shield of Arizona (BCBSAZ) is pleased to announce JoAnn Cipiti as the company’s Government Strategic Executive. In this newly created role, Cipiti will establish the company’s sales acquisition and retention strategy for government and municipal businesses.

The creation of this new role demonstrates BCBSAZ’s commitment to continuing and strengthening a market position that meets the unique requirement of administering health insurance to government businesses. Additionally, BCBSAZ will leverage Cipiti’s strategic account management experience to further shape the company’s best in class sales organization.

“I’m thrilled to have JoAnn join the BCBSAZ team in developing the future structure and strategy for acquiring and retaining the government and municipal businesses we serve,” says Senior Vice President of Strategy, Sales and Marketing, Jeff Stelnik. “JoAnn will play a vital role in collaborating with her fellow colleagues to propel BCBSAZ forward in all efforts related to attracting and serving this important business sector.”

Prior to joining BCBSAZ, Cipiti worked for more than 25 years in the insurance industry. Most recently she served as a principal in the Buck Consulting business, a leading human resources and benefits consulting firm in Phoenix. In addition, she has worked in sales and consulting capacities at Aon, Mercy Health Services and Blue Cross Blue Shield of Michigan.

PRODUCTS & BENEFITS

Medicare Advantage disenrollment period generates new opportunities for Medicare Supplement, PDP sales

The 2012 Medicare Annual Enrollment Period is now over, but there are still great opportunities to transition your clients to a BCBSAZ Medicare Supplement or Blue MedicareRx (PDP) plan.

Between Jan. 1 and Feb. 14, enrollees of Medicare Advantage Plans can leave their plans and switch to Original Medicare. Prospects who want additional protection from costs not covered by Original Medicare can add a Prescription Drug Plan or Medicare Supplement plan during the Medicare Advantage Disenrollment period from Jan. 1 to Feb. 14, 2012.

As a reminder, during the Medicare Advantage Disenrollment period, prospects can not do the following:

  • Switch from Original Medicare to a Medicare Advantage Plan.
  • Switch from one Medicare Advantage Plan to another.
  • Switch from one Medicare Prescription Drug Plan to another.
  • Join, switch or drop a Medicare Medical Savings Account Plan.

It is important to advise prospects that they will lose their current prescription drug coverage if they disenroll from a Medicare Advantage Plan that has drug coverage.

Coverage for enrollees will begin the first day of the month after BCBSAZ receives the member’s enrollment form.

If you have questions about Medicare, we have answers. Call us at (888) 264-1612 or visit YourAZMedicareSolutions.com.

PRODUCTS & BENEFITS

New BluePreferred® HSA Plus Health Plan coinsurance options expand range of choices for pooled (2-99) groups, provide additional opportunity to cash in on broker bonus program

In response to your feedback, BCBSAZ has introduced new health savings account (HSA)-eligible health plan coinsurance options to broaden our range of affordable health plans for pooled groups.

BluePreferred HSA Plus 70 and BluePreferred HSA Plus 80 are the latest new high-deductible plan options that can be paired with the integrated HSA solution from HealthEquity and BCBSAZ. These plans provide a lower price point for employer groups seeking more cost effective solutions for their workforce.

The new 70 percent and 80 percent coinsurance options have an April 1, 2012 effective date but can be quoted, at your request, first quarter renewals. They are also eligible for the 1Q 2012 small group broker bonus program, through which you can:*

  • Earn a $5,000 bonus for each new 51-99 group sold or renewed with an effective date between Jan. 1 and March 15, 2012.
  • Earn a $5,000 bonus for selling or renewing any combination of three groups of 26-50 enrolled employees with effective dates between Jan. 1 and March 15, 2012.
  • Earn an additional $5,000 for selling any qualifying BCBSAZ HSA-eligible health plans as a full replacement to the group’s existing coverage. The new 70 percent and 80 percent plan options give you additional opportunities to earn this full replacement bonus. Any HSA plan with 70, 80 or 90 percent coinsurance qualifies.

And there’s more good news. BCBSAZ is reducing its rates for those same qualifying HSA-eligible plans when they are offered as a full replacement. You can expect, in most cases, to see a decrease of 7 to 8 percent.

Contact Your BCBSAZ Account Executive to request updated bids including the new 70 and 80 percent plans as well as full replacement discounts.

Coming Soon

At-a glance updates for BluePreferred HSA Plus 100 and 90% coinsurance options for groups effective on/after April 1, 2012:

  • Out-of-pocket Maximums Reduced – reduced to match in-network deductibles (HSA Plus 100 only)
  • Skilled Nursing Facility Member Cost-sharing Reduced – reduced from 50% member coinsurance to 10% or 0% coinsurance (plan pays 90% or 100% coinsurance) for days 91-180 (each calendar year)
  • Extended Active Rehabilitation Member Cost-sharing Reduced – reduced from 50% member coinsurance to 10% or 0% coinsurance (plan pays 90% or 100% coinsurance) for days 61-120 (each calendar year)
  • Long-term Acute Care Member Cost-sharing Reduced – reduced from 50% member coinsurance to 10% or 0% coinsurance (plan pays 90% or 100%) coinsurance for days 101-365 of the benefit maximum

* See broker sales contest flyer for complete contest rules and eligibility information

HealthEquity, Inc. is an independent and separate company contracted with BCBSAZ to administer health savings accounts. HealthEquity does not provide BCBSAZ products or services and is solely responsible for any products and services that it offers.

PRODUCTS & BENEFITS

HSA plan pricing now available

Pricing for BCBSAZ high-deductible health plans that can be paired with a health savings account (HSA) with HealthEquity is available from your BCBSAZ Account Executive.

Brokers can further reduce the pricing by 7 to 8 percent below the standard plan pricing for clients who choose full-replacement of their existing plan offerings with a BCBSAZ high-deductible health plan that can be paired with a HealthEquity HSA.

HealthEquity, Inc. is an independent and separate company contracted with BCBSAZ to administer health savings accounts. HealthEquity does not provide BCBSAZ products or services and is solely responsible for any products and services that it offers.

INDUSTRY INSIDER

Legislative update

Federal

Republicans continue to talk about repealing the federal healthcare reform law. Given the gridlock in Washington, D.C. however, we do not expect much to happen until after the 2012 Presidential election. In the meantime, the U.S. Department of Health and Human Services continues to distribute thousands of pages of guidance on various aspects of the law for insurers, providers and businesses to try to interpret and implement.

Meanwhile, the Supreme Court decided to review the federal healthcare reform law and rule on its constitutionality. Some of the issues the justices will consider include:

  • Whether Congress acted within its constitutional powers by requiring all Americans to have health insurance by 2014 or pay a penalty.
  • Whether other parts of the law can go forward if the individual mandate is found unconstitutional.
  • Whether Congress improperly coerced states to expand Medicaid.

The Supreme Court will hear oral arguments on this case in March with a ruling expected in June, at which time the presidential election campaign will be in full swing.

State

The Arizona Legislature convened its regular session Jan. 9, 2012. Significant leadership changes occurred since the end of the 2011 legislative session. Speaker of the House Kirk Adams resigned his seat to run for Congress. Taking his place as Speaker is Representative Andy Tobin, former Majority Leader. Representative Steve Court is the new House Majority Leader and Representative Debbie Lesko remains House Majority Whip.

With the successful recall of President Russell Pearce, the leadership in the Senate has changed as well. The new Senate leadership team consists of President Steve Pierce, Majority Leader Andy Biggs and Majority Whip Frank Antenori. In addition, Jerry Lewis replaced Russell Pearce as state Senator representing West Mesa.

For the first time in several years, the state budget has a small surplus. However, with the continued economic uncertainty, pending litigation over some of the Legislature’s budget decisions, 2014 Medicaid obligations and the imminent expiration of the temporary sales tax hike, the state is still in turbulent budget times. We expect job creation to be a top priority at the Legislature again this year.

One of the most significant issues facing the healthcare community again this year is the establishment of a state health insurance exchange. The federal healthcare reform law calls for new health insurance marketplaces called “exchanges.” An exchange is a web portal intended to simplify the shopping experience for individuals and small groups by enabling consumers to compare policies and purchase health insurance online, many with significant federal subsidies. Each state has the choice of creating and running its own exchange or deferring to the federal government.

Blue Cross Blue Shield of Arizona (BCBSAZ) strongly supports the creation of a state-based health insurance exchange. Arizona can craft an exchange that is competitive, free market-oriented and offers consumers many choices, while keeping regulation and administrative costs to a minimum. Conversely, a one-size-fits-all federal exchange run by Washington bureaucrats will likely offer consumers fewer choices and be heavily regulated and less responsive to Arizonans.

Arizona Governor Jan Brewer is fighting to stop the federal takeover of Arizona’s insurance market by implementing a state exchange. While she is opposed to the federal law and is a plaintiff in the litigation against it, the Governor recognizes the state must be prepared in case the litigation fails. Having a state-based exchange is in the best interests of Arizona businesses and consumers.

With anti-federal government sentiment still pervasive at the Legislature, we expect lawmakers to introduce a bill prohibiting the state from enacting an exchange. BCBSAZ strongly opposes this measure, which will limit the state’s ability to put a free market-oriented, competitive exchange in place.

Other healthcare-related bills we expect to see this session include:

  • Sale of insurance across state lines: Allows health insurers from another state to do business in Arizona without obtaining a license here if they are subject to the jurisdiction of another state’s insurance department. These out-of-state companies would sidestep Arizona benefit mandates and other consumer protections. In addition, this proposal severely disadvantages Arizona-based insurers, such as BCBSAZ, that do business only in Arizona and are subject to statutory mandates and requirements that would not apply to out-of-state insurers. The Governor vetoed this bill last session. (BCBSAZ opposes)
  • Small group insurance pooling: Authorizes two or more employers to enter into contracts or agreements to establish a nearly unregulated small business health benefits plan or pool. This bill was introduced last session but did not pass. (BCBSAZ opposes)
  • Disclosure of health insurance claims information: Requires health insurers to provide detailed claims information, including an employee’s or dependent’s diagnosis and prognosis, to business customers upon request. This bill was introduced last session but did not pass. (BCBSAZ opposes)

Other bills we anticipate include mandating health insurers to cover smoking cessation and prohibiting health insurers from changing the drug tier for multiple sclerosis-related drugs during the contract period.

With 2012 being an election year and with the issues surrounding redistricting, we expect legislators to limit the length of the session as much as possible so they can begin their re-election campaigns.

INDUSTRY INSIDER

Blue Cross Blue Shield of Arizona Ranked No. 1 PPO by Ranking Arizona

Ranking Arizona: The Best of Arizona Business 2012 has ranked Blue Cross Blue Shield of Arizona as the “No. 1 PPO” in its annual list of Arizona businesses.

The accolade marks the sixth time BCBSAZ has topped the PPO rankings list.

According to the publication, this year’s rankings are the result of the largest business opinion poll taken in the state of Arizona. Results of the poll are determined by votes submitted by residents of Arizona via www.RankingAZ.com. Participants who vote are asked to base their opinions on the quality of products, services and people. More than 15,000 businesses in more than 200 different business and leisure sub-categories are included in the poll.

Ranking Arizona is a tradename of Arizona Business Magazine, a publication of AZ Big Media. AZ Big Media is an independent company that is not affiliated with BCBSAZ.

CUSTOMER CORNER

New look and functionality for BCBSAZ’s website

The BCBSAZ website, azblue.com, has been updated with a new look and color scheme as well as significant functionality changes for the member portal. The new design was unveiled to members in November. Updates to the broker portal will be coming soon.

One of the more notable enhancements is easier-to-use navigation features. For example, once members log in to the BlueNetSM member portal they find the following convenient buttons/links on the left side of the screen:

  • View Benefits
  • View Claims
  • Account Profile
  • Deductible Balances
  • Health and Wellness
  • Health Care Providers
  • Go Green

By clicking these buttons, members see features and tools organized in ways that make it easier for them to get the information they need.

Other enhancements to BlueNet give members easy access to important information they need. For example, the “Benefits Quick View” feature allows members to easily check their individual and family deductibles.

We’re working to make azblue.com a comfortable and convenient tool for members to access many elements of their health insurance benefit plan with BCBSAZ.

Visit azblue.com to see the latest website changes to serve you and our members better.

CUSTOMER CORNER

It’s flu season again

H1N1. Swine. Avian. Influenza. It’s a fact that the flu can take a huge bite out of a company’s workforce and employee productivity.

It’s estimated that between 5 and 20 percent of Americans get the flu every year.* The illness costs businesses approximately $10.4 billion in direct costs for hospitalizations and outpatient visits for adults.*

Employers are looking at employees missing anywhere from three to five days of work if they come down with the flu. And even when employees return to the job, individual productivity can be adversely affected for weeks following an infection.

Flu season traditionally starts in October and can continue into late May, so now is the perfect time for employers to be thinking about proactive steps to keep their workforce healthy and the flu bug away.

Consider some of these helpful tips companies can incorporate into their workplace wellness plans:

  • Host a flu vaccination clinic in the workplace to offer low- or no-cost flu shots to employees.
  • Have an adequate supply of tissues, soap, paper towels, alcohol-based hand rubs and disposable wipes readily available for employees.
  • Clean frequently touched surfaces, such as copy machines, telephones, computer keyboards, conference tables, etc., on a regular basis to remove germs.
  • Update employees on your sick leave policy and emphasize preventive actions to avoid spreading the virus.
  • Cross-train employees in job functions so that you’re not left short-handed should employees be out with the flu for several days.
* Sources: http://www.flumist.com/flu-symptoms-and-you/ MolinariNA, Ortega-Sanchez IR, Messonnier ML, et al. The annual impact of seasonal influenza in the US: measuring disease burden and costs. Vaccine. 2007; 25(27):5086.96.

CUSTOMER CORNER

Go Green campaign winners

As of Jan. 1, 2012, five BCBSAZ members can now read their Explanation of Benefit (EOB) statements online on a brand new Apple® iPad® they won via the “Go Green” campaign to encourage electronic document delivery of EOB documents.

In addition, employees of TriWest, Go Daddy, the City of Phoenix and City of Chandler also earned the opportunity to participate in a random drawing of an iPod Touch® among the employees at their company who signed up for the Green Options initiative. These groups qualified for drawings because more than 25 percent of eligible employees who have BCBSAZ as their health insurance provider opted to receive their EOBs via email.

Prizes were earned through participation in the Go Green campaign, a five-month long campaign to encourage BCBSAZ members to choose Green Options, the earth-friendly choice that lets members receive their electronic EOB statements conveniently online instead of in printed form via mail.

Apple® , iPad® , iPod® and iPod touch® are registered trademarks of Apple, Inc. Broker Notes Online is an independent publication and has not been authorized, sponsored or otherwise approved by Apple, Inc.

TOOLS & TIPS

Blue365® – more than just discounts

Blue365® is an affinity program available to BCBSAZ members that provides exclusive discounts and health and wellness products and services such as fitness clubs, nationally recognized nutrition programs, vision and hearing products and more.* But discounts are only one component of the value that Blue365 offers to members. Blue365 also provides access to a broad range of information designed to help members make healthy choices.

Through the Blue365 website, members can access information and support tools such as:

  • Family care, including how to choose a caregiver or a long-term care insurance provider. Eligible individuals can also access emotional support to deal with care of a family member from companies like Seniorlink Care.
  • Insurance tips, including information to help plan for healthcare in retirement and learn about Medicare and long-term care insurance.
  • A National Doctor and Hospital Finder to locate healthcare providers within the U.S., Puerto Rico and U.S. Virgin Islands.
  • Articles videos and other tools from Consumer Reports to help members be informed consumers.
  • Tips from the American Dental Association can help members find the right dental practitioners for their needs.
  • A directory of Blue Distinction Centers, which are designated facilities that meet rigorous clinical criteria for bariatric surgery, cardiac care and transplant services.
  • Education pointers from the U.S. Department of Health and Human Services to help members manage their use of medication for safety and effectiveness, and tips from the U.S. Food and Drug Administration for buying medicines, medical devices and other products online.
  • Destination and travel tips from the Centers for Disease Control and Prevention including staying healthy abroad, outdoor safety tips, information on destinations and prevention techniques, as well as destination-specific information on safe food and water, mosquito and tick protection and safe travel advice.

Learn more about these great resources by visiting azblue.com/discounts.

* Independent companies that do not provide Blue Cross and/or Blue Shield products or services and are solely responsible for the services provided.

Blue365® offers access to savings on items that members may purchase directly from independent vendors, which are different from items that are covered under your BCBSAZ policy or its contracts with any other applicable federal healthcare program. To find out what is covered under your policy, call BCBSAZ. Blue Cross and Blue Shield Association (BCBSA) and local Blue companies may receive payments from Blue365 vendors. Neither any local Blue company nor BCBSA recommends, endorses, warrants or guarantees any specific Blue365 vendor or item.

Discounts may be rescinded or canceled at any time without notice. There is no guarantee of the percentage or level of savings on services or products. Lower prices may be available on the same products or services through other programs or vendors. Limitations and restrictions apply to each program

TOOLS & TIPS

Time to update your BlueNet/Broker marketing website profile

Have you changed offices, telephone numbers or your e-mail address lately?

Has it been more than 90 days since you last checked your BlueNetSM/Broker Marketing website profile?

If so, you may be missing important information such as Broker Alerts on the latest information and updates from BCBSAZ.

BlueNet provides a variety of online tools and services exclusively for authorized insurance brokers that can help you increase your productivity.

If you are already registered for BlueNet, the New Year is a great time to check your account profile information to ensure that all of the data is up to date. You can also change your password.

Through BlueNet, you can:

  • Spend less time on paperwork and more time growing your BCBSAZ business.
  • Get information about how to connect to our authorized Broker Marketing website where your customers can find our online application, which can help speed the application process.
  • View commission reports, manage prospect reports, monitor applications to drive sales.
  • Browse the BCBSAZ individual underwriting guidelines as well as access online reports, forms and resources all from your computer.

Find out more and register for BlueNet at azblue.com.

TOOLS & TIPS

Organizational Update

BCBSAZ values our brokers and strives to deliver excellent service and to collaborate on issues that affect your business and the health insurance market. In order to further improve our service to brokers, BCBSAZ has expanded the role of Kathryn Mattson, Director of Individual Sales. Her new responsibilities include working with the broker community to promote and sell BCBSAZ’s individual health insurance products and overseeing contracted brokers who are certified to sell Blue MedicareRxSM (PDP).

Brokers can reach Kathryn Mattson at (602) 864-5651 or kmattson@azblue.com

Based on your feedback, BCBSAZ implemented a new rate-up tier for IU65 plans on Oct. 19, 2011. With this change, underwriting now applies one of four rate-up tiers for applicant underwriting, in contrast to the three previous rate-up tiers.

The additional tier allows for a broader range of premiums depending upon the outcome of underwriting.

Website | + posts

Jesse Smedley is the Principal Broker for iHealthBrokers and the founder, president, and CEO of Smedley Insurance Group, Inc. and iHealthBrokers.com. Since the inception of SIG in 2007, Jesse has been dedicated to helping people save money on their health insurance by providing them with resources to educate themselves on all their health insurance options, both under age 65 and Medicare beneficiaries. He is featured in many publications as well as writes regularly for expert columns regarding health insurance and Medicare.

Skip to content