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Blue Cross Blue Shield Announces MAJOR Network Changes

Posted: September 29, 2015

Open Enrollment this year will be November 1st-January 31st.  During this time, Blue Cross Blue Shield has already announced major network changes.  The biggest being the elimination of their broad PPO network.  Those with a plan in this network will receive a letter and or phone call from BCBS stating that their policy will expire 12/31.  You will need to pick a new plan by 12/15 to ensure there is no gap in coverage. 

 

Those with the Blue Choice, the HMO network, or on an employer plan will NOT be affected by this change. 

 

BCBS has also announced that there will not be a cap on out of network charges, making it extremely important to stay in your plans network.  What this means is that a service that costs $10,000 at an out of network facility will cost you $10,000.  Nothing will be applied towards your deductible.

Open Enrollment AGAIN??

A Special Election Period (SEP) for individuals and families that did not have coverage in 2014 and qualify for assistance, can apply for coverage March 15th-April 30th.  In order to qualify…

*You must not be enrolled in a plan currently

 

*Attest that when you filed your 2014 tax return you paid the penalty for not having health coverage (1% of your income or $95/adult in the household and $47.50/child)

 

If you apply during this time, coverage will take effect May 1st.

 

The End of Open Enrollment

On March 31st, 2014 the historic 1st year of the Health Care Reform Act enrollment will come to a close.  As a last reminder, if you are eligible for enrollment this is what you can expect…

 

IF YOU ENROLL IN A PLAN

  • If you currently have a health insurance plan, you will NOT be able to make ANY changes until the next open enrollment.  Generally the open enrollment period will be each year between October-December.  Any changes made during this time will take effect January 1, 2015.
  • If you are still planning to enroll, policies applied for by March 15th will take effect April 1st.  Policies applied for between March 16-March 31st will take effect May 1st.  As long as you make a decision by March 31st you will avoid the penalty.
  • If you qualified for a subsidy (via the marketplace) be sure to check your results.  MANY require that you send additional documentation by the end of open enrollment in order to keep your subsidy.  The additional requirements can be sent via mail or uploaded to your marketplace account.  If you plan on mailing the documents I suggest sending it certified so you have proof that it was received.

 

IF YOU DO NOTHING

  • You will be locked out of being able to join a plan…unless you fall into a special election period (marriage, child birth, loss of coverage, etc).  If you’ve chosen this option I recommend purchasing a critical illness/accident plan. It is NOT the same as health insurance but in the event you injure yourself or are diagnosed with a critical illness, the plan will pay you an allotted amount ($5,000-$50,000). The plans start as low as $2 per month for critical illness and $15 per month for accident coverage.
  • You can expect to receive a $95 per person ($47.5 per child under the age of 18) penalty on your 2014 federal tax return (this will increase in 2015)

How to Offset High Deductibles Associated with Healthcare Reform

Have you heard about Critical Illness Insurance and Accident Coverage?

  • Critical illness insurance is an insurance product, where the insurer is contracted to typically make a lump sum cash payment if the policyholder is diagnosed with one of the critical illnesses listed in the insurance policy (usually cancer, heart attack, or stroke).
  • Accident Coverage is an insurance product, where the insurer is contracted to typically make a lump sum cash payment if the policyholder is involved in an accident at work or play (examples include: broken bones, stitches, sports related injuries and general clumsiness).

 

Since preventative services come standard with ALL plans you are more likely to use your deductible due to a critical illness or injury. The purpose of these plans are to use the funds towards your deductible.

 

Rates depend upon age and amount of coverage but can start as low as $2.75 per month with $10,000 in coverage.

Questions
Questions

Feel free to email or call me with any questions or comments about my services or if you have any insurance related inquires.

Contact
Contact

Phone: 708.444.0050
Email: kelly@kellyburkeinsurance.com

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