BCBS HOT TOPICS: Tips and Reminders


News Alert – Nov. 5, 2015
Individual/Consumer Market
Hot Topics for Thursday, Nov. 5, 2015
Here are today’s hot topics related to the under 65 market segment. As a reminder, we encourage you to reach out to your Blue Cross and Blue Shield of Texas (BCBSTX) clients to share relevant information.
•    2016 Open Enrollment Tips
•    Reminder: 2016 Changes to BCBSTX Product Offerings
•    Step-by-Step Retail Producer Portal Guides Available

2016 Open Enrollment Tips
Open enrollment is here, and BCBSTX is ready to help. You will find that BCBSTX consistently offers among the lowest cost products this enrollment season. And, as always, our products are backed by our commitment to help you and your customers through the enrollment process.
Here are a few things to remember:

Use Express Link

  • Use Express Link to begin the application process. A client will receive a link in an email that connects the client to the Retail Shopping Cart. Using the link ensures you stay attached to your client’s enrollment.
  • A shopper using your Express Link should not close out of the browser prior to creating a shopping account. Doing so will cause the client to return to an “anonymous” status, meaning that your producer number will not stay tied to a submitted application.
  • If you need to set up your personal Express Link, see Pages 13-14 of the Retail Producer Portal Guide.

Remind Clients about Provider Finder

  • Clients can find out which doctors and hospitals are in-network for the plans they are considering by using the Provider Finder® tool.

Have Clients Set Up Retail Shopping Cart Accounts

  • Remember that clients can determine eligibility for federal financial assistance through our Retail Shopping Cart.
  • Each client should create an account and add the plan(s) of interest. Setting up an account ensures you are assigned as the producer of record and get credit for the sale once the client completes the online application process.
  • The information used to set up a shopping account also doubles as a Blue Access for MembersSM account when a client becomes an active member. For security purposes, only the client’s email address should be used. Your email address should never be used to set up a client’s shopping account.
  • For more details on helping your clients create shopping cart accounts, see Pages 23-25 of the Retail Producer Portal Guide.

Remember Enrollment Deadlines

  • New or renewing clients must enroll or change plans by Dec. 15, 2015, to have new coverage begin Jan. 1, 2016.
  • Discontinued members have until Dec. 31, 2015, to make changes for a Jan. 1, 2016, effective date. If a discontinued member enrolls in a new plan (other than the mapped plan) after Dec. 15, 2015, the member will need to indicate the loss of Minimum Essential Coverage (MEC) on the application in order to receive a Jan. 1, 2016, effective date.

Take Advantage of Marketing and Educational Materials

  • New sales kits and marketing materials for our 2016 ACA individual products, including applications and outlines of coverage, are now posted in the Producer Supply Portal for your use.
  • In addition, the supply portal includes new consumer education pieces. The producer versions don’t include BCBSTX phone numbers or URLs, and have a panel for you to add your producer contact information.
  • Summaries of Benefits and Coverage are on our public site via the Retail Shopping Cart and are available during the quoting process in the Retail Producer Portal.

Reminder: 2016 Changes to BCBSTX Product Offerings
There are some changes in the plans we are offering in 2016:

  • We are again offering individual health insurance products, both on and off the Health Insurance Marketplace.
  • Our Blue AdvantageSM HMO is again being offered statewide.
  • We are offering a new product, Blue Advantage PlusSM. Blue Advantage Plus is a Health Maintenance Organization (HMO) plan with added Point of Service (POS) benefits. These added benefits give members more flexibility when they need care.
  • The Blue ChoiceSM PPO that was offered for the individual market in 2014 and 2015 is not being offered in 2016. To help ensure there is no gap in coverage for our members currently enrolled in the PPO, we will transition them to a Blue Advantage Plus plan at the same metallic level, effective Jan. 1, 2016. This transition includes members enrolled in Blue Cross and Blue Shield multi-state plans that use the Blue Choice PPO network. They can stay in the plan we transitioned them to, or they can pick a new plan during open enrollment. If they don’t pick a new plan by Dec. 31, the transition plan will take effect Jan. 1. Subsidy-eligible members will have their plan mapped over with their subsidy.
  • If a policyholder enrolls with another insurer, the policyholder will need to cancel BCBSTX coverage to prevent having duplicate coverage. Here are additional guidelines:
    • If a policyholder has an off-exchange plan with us and chooses another insurer during open enrollment, the policyholder should call us to terminate BCBSTX coverage.
    • If a policyholder has a Marketplace plan with us and picks another insurer, we will receive a cancellation transaction from the Marketplace.
    • If a policyholder has a Marketplace plan with us and selects an off-exchange plan with another issuer, the policyholder needs to call the Marketplace to cancel the current policy.

Step-by-Step Retail Producer Portal Guides Available
The Retail Producer Portal is a comprehensive business management and client service tool. The portal enables you to design and deliver quotes, enroll members in Blue plans, manage prospects, and serve and support active clients with a host of features.