Covered California has released their 2017 Regional Rate and Plan Information summary. This summary has a more in-depth focus specific consumer market information than does their 2017 Health Plan Booklet. While the target audience is Certified Application Counselors and Agents, there is also some very useful information for consumers.
Blue Shield of California has sent notices to 2,062 consumers of their grandfathered health plans notifying them they will be automatically enrolled in Obamacare plans for 2017. Blue Shield will no longer be offering 17 of their grandfathered individual and family plans in 2017. Blue Shield stated that the grandfathered plans are being withdrawn from the market place due to low enrollment.
We are pleased to share that Blue Shield of California will be offering these services at no cost to eligible health plan members and their dependents on May 2, 2016.
We are writing to let you know that due to a system error, one or more of your Blue Shield of California customers received two different 1095-A forms from Covered California. The information in the first form they received was correct.
On January 6, 2016, we sent letters to off-exchange plan members who did not provide their Social Security numbers (SSNs) upon enrollment. The letter requests completion of a form as required by an ACA mandate. The ACA mandate requires insurers, including Blue Shield of California, to provide annual reporting of Minimum Essential Coverage (MEC). We sent the January 6, 2016, mailing only to new members with missing SSNs who joined during open enrollment and were not included in the previous mailing.
Blue Shield will notify certain ON and OFF Exchange Individual & Family Plan members that they are eligible to resubmit out-of-network claims for covered services received in 2014 for review if they feel that they were led to believe that their provider was in their plan’s network by Blue Shield or the provider. Should their claims qualify under the settlement, Blue Shield will reprocess and pay the claims as if they were from an in-network provider.
We are writing to advise you that some Blue Shield Medicare Advantage HMO members have not received their Explanation of Benefits (EOB) for medical or hospital services (Part C) for June, July, August, or September of this year, which includes their total out-of-pocket expenses to date.
We will be notifying all Blue Shield 65 Plus (HMO), Blue Shield 65 Plus Choice Plan (HMO) and Blue Shield Medicare Prescription Drug Plan members by mail of their automatic enrollment in Cal INDEX. The notification letter explains the purpose and value of Cal INDEX, its privacy practices, and the opt-out process.
List Billing: A New Option
If your client can’t afford coverage or wants to cancel their Small Business health plan in 2016, you can offer another option for their employees to have access to quality Blue Shield coverage. Called List Billing, it begins with you helping their employees choose on-exchange or off-exchange Individual and Family Plans (IFP).
The California Department of Managed Health Care (DMHC) announced today that it issued a $350,000 fine against Blue Shield of California (Blue Shield) and a $250,000 fine against Anthem Blue Cross (Anthem) for inaccurate provider directories.