Guide to your renewal

Transcription

1 Guide to your renewal 19214GAEENBGA Rev. 3/13

2 Your Health Plan Renewal Summary Enjoy another year of: Better health More value Greater satisfaction Keep your current plan. It couldn t be easier. Sit back and relax. If you want to renew the plan you have, just sign your current rate sheet and return it to your insurance producer or your Blue Cross and Blue Shield of Georgia (BCBSGa) account team. Then you ll enjoy another year of great value and employee satisfaction. With our large network, you get savings, quality, a range of choices and: Your employees can visit the hospitals and doctors including specialists they choose and trust. That makes it easier for them to stay in network. Help saving money. When your employees visit a network doctor, their share of the cost is lower even before they ve satisfied any deductible so they can save from day one of their coverage. Coverage that goes where members go, thanks to the BlueCard program. Members get care whether they re traveling around the country or around the world. You and your employees also enjoy: Preventive care benefits offer 100% coverage for check-ups, flu shots and more for your employees and their families. Round-the-clock, no-cost access to a registered nurse through Anthem s 24/7 NurseLine. Discounts on health-related products and services, such as fitness center memberships, weight-loss programs, chiropractors and more. Online resources help your employees compare costs, make well-informed care choices and more: Your employees will enjoy using our handy online resources to get the most from their BCBSGa health care plan. Compare costs for local doctors, hospitals, procedures and treatments. Our tools help employees compare costs for health care procedures, treatments and other services so they can maximize their health care dollars. Employees will also find a broad spectrum of choices for high-quality health care locations, which could lead to out-of-pocket savings on services such as lab work. Discover lower-cost alternatives to emergency rooms (ERs). Employees can go online to find locations for many alternative service providers that can offer care after doctor s office hours. These options may often cost less than an ER and can be more appropriate for nonemergency situations. Use mobile access to find a doctor. Using their smartphones, your employees can search, 24/7, for network doctors by location, specialties, language spoken and more. They can also find local maps and get driving directions to providers.

3 Add dental, vision, disability and life coverage. Now is a perfect time to add coverage because you can enroll right along with your health renewal. BCBSGa offers a wide range of products that, by themselves, deliver outstanding value. Connect them with your health plan, and they can help improve the health of your employees and your organization s productivity. Sounds good, but you just can t afford to spend more on benefits? You have the option of employer-paid or employee-paid (voluntary) plans for disability and life. With our employee-paid option, you can offer these highly valued benefits to your employees at no cost to your business. You pick the plan and your employees pay at a group discount rate. What s more, you only need 10 enrolled employees (or 20% participation, whichever is greater) to participate for disability and life.

4 Choose from these options: Dental. Our dental plans offer a balance of quality coverage and flexible plan designs. Employees get: 100% coverage for preventive care. Convenient access to care, so they may visit any dentist, any time. Access to emergency dental treatment while traveling or working outside the U.S. Vision. Adding Blue View Vision SM to your plan is easy and inexpensive. With more stores, more hours and more doctors including the most popular national chains like LensCrafters, Pearle Vision, Sears Optical SM, Target Optical and JCPenney Optical. It s no wonder 96% of our members stay in-network when they can get what they want, where they want, from the top designers they want. Impact-resistant and Transitions lenses are fully covered for children under 19. Disability. Your employees can expect prompt benefit payments, and dedicated support services and tools. Short-term disability claim services are integrated with our Health and Wellness ConditionCare and Future Moms programs. This way, employees can make the most of their benefits plan. Life. Count on prompt, convenient benefit payments, excellent service and more. The Resource Advisor program offers support services and tools your employees and their beneficiaries can use now, such as online will preparation and identity theft resolution. After a loss, beneficiaries receive face-to-face counseling and 24/7 telephone support. Contact your producer or BCBSGa representative to learn more. The Employer section of bcbsga.com has information you ll need to successfully complete your renewal. We have summarized that information in this booklet.

5 Make the most of our health and wellness programs. See how they could help improve the lives of your employees and lower the overall cost of care for your company. Some of your employees are managing a health condition. Others may want to stay healthy, eat better or get in shape. Whatever your employees needs, BCBSGa s plan gives them a choice of programs to help them meet personal goals in a way that fits their lifestyle. Our personalized, proactive approach to health care is also good for your business. Employers using our programs will see a 4.1% decrease in medical costs compared with those who don t have these programs. These are just a few of the programs that come with your plan: 24/7 NurseLine. This resource gives your employees access to trained registered nurses any time of the day or night -- and can help determine the right care at the right time. ConditionCare. This program helps identify and assist those living with chronic conditions such as heart disease, diabetes and asthma. It guides and supports those who need it most to adopt healthier behaviors, and offers 24/7 access to health professionals, such as dieticians and nurses. Healthy Lifestyles. This is a comprehensive suite of health improvement programs that encourages high participation rates. Results may include improved health, reduced absenteeism and increased productivity. MyHealth Advantage. This tool uses member information to identify opportunities for improving health and saving money. The program includes the early identification of potential health issues; highlighting potential pharmacy and out-of-pocket cost savings; and monitoring and responding to dangerous drug issues or interactions. Discounts online. Your employees get reduced rates online for products and services that promote better health and well-being. Weight Watchers. Your employees get special discounts on valuable and convenient weight loss solutions through this program. To learn more about these and other options, talk to your producer.

6 Take advantage of online resources for you and your employees. Plan administration s a snap at bcbsga.com. Spend more of your valuable time managing your business instead of your health plan. With bcbsga.com, it s all about giving you a simple, convenient way to enroll employees, pay bills and more. To sign up, go to bcbsga.com, and click Employers. Need help registering? Call us at the number on your BCBSGa bill and we ll get you signed up! Important renewal resources Benefit summaries Online benefit summaries will help answer any questions you have about the enclosed benefit options. Member enrollment application Use this form to enroll your employees in their Blue health plan. Group master application Use this form if you re adding more plans to your group coverage, or to make plan changes. Notice of special enrollment rights Complete this form for each of your employees who decline coverage for themselves or dependents. You do not need to return this form to us; it s just for your records. Member enrollment change form Report any changes for your covered employees on this form. For example, use this form when an employee gets married, adds a child to the family through birth or adoption, or has a change in coverage. Miscellaneous Include Health Insurance Portability and Accountability Act (HIPAA) annual re-enrollment information. Get your dental, disability and/or life quote today it s quick and easy. Two ways to get a quote: contact your producer or BCBSGa. Call your account manager. Ask for a quote at bcbsga.com/specialty.

7 Additional online information for employers Provider directories (updated weekly) Downloadable forms for members and employers Certificate booklets Benefit summaries Prescription drug formulary EmployerAccess If you re not already using EmployerAccess, call your agent or sales representative to learn how you can do the following quickly and easily: Add, change and delete employee eligibility information. View your bill. Pay your bill. To view a demo or log in to EmployerAccess, visit bcbsga.com/employeraccess. Online tools empower employees to make informed health care decisions MemberAccess Members can view their benefits, doctor information, claims, medical history, prescriptions and more. They also can access useful health improvement tools and resources. Estimate Your Cost Employees can make informed decisions and save money by comparing actual costs for common procedures at hospitals and facilities nearby. They can also view quality comparisons that gauge performance and safety at each facility. Zagat Health Survey Your employees can view doctor recommendations from fellow BCBSGa members. We ve developed the Zagat Health Survey to let members share feedback about their experiences with doctors and see what other consumers say about their own experiences.

8 Use your renewal checklist if you re making plan changes. If you want to keep the new plan we have chosen for you, there s nothing you need to do. However, if you want to choose a different plan, please remember to use this checklist to complete the necessary steps for a smooth renewal: }To make sure your benefit changes are implemented at your renewal date, we must get any changes to your current group health plan no later than the 15th of the month before your renewal date. For Lumenos products, we must get any changes 30 days before your renewal date. For 2-50 groups: You will need to fill out a group master application. Your agent and BCBSGa account manager will help you. You can fax your master application to For groups: You will need to fill out a group master application. Your agent and BCBSGa account manager will assist you. In addition, you will need to return your signed Renewal Rate Confirmation page. }Consider offering a comprehensive suite of benefits by adding dental, vision, disability and life to your existing plan. When adding these products, be sure to use a new application and single case agreement form. }Hold an annual re-enrollment meeting with your employees. Employees who have previously declined coverage for themselves or dependents may enroll at this time by completing an application or change form, along with a medical questionnaire. Tell your employees about any benefit and/or rate changes. }Completed member applications should be sent (in one package) no later than the 15th of the month before the renewal date to (fax) or mail to: Blue Cross and Blue Shield of Georgia Membership Department, GAG P.O. Box 4445 Atlanta, GA In addition, you may submit your completed member applications to EmployerAccess. }Review the supply request order form found in the Employer section of bcbsga.com for any supplies you may need. To order supplies, [email protected].

9 Guidance through health care reform As health care reform continues to evolve, you ll have important choices to make. We stay current on the new and shifting rules, and can help you make sense of what they mean for your business. We ll send you helpful newsletters about the latest changes and you can review updates, tools and information through our dedicated health care reform website, at bcbsga.com/healthcarereform. As an employer, you are responsible for sending an electronic or printed copy of the Summary of Benefits and Coverage (also known as an SBC ) to your plan participants and beneficiaries. For more information on how to obtain the SBC for your fully insured plan, please visit Government mandate information Consumer Choice Option Georgia Law (Senate Bill 210) requires that you offer this option to your employees at each annual enrollment. The following resources are available online: Information About the Consumer Choice Option brochure Instructions for completing the Consumer Choice Option Provider Nomination Consumer Choice Option Provider Nomination form COBRA administration As an employer, you need to keep your employees, as well as their dependents, fully informed of their right to continue their group health plan coverage provided under, and strictly regulated by, the Consolidated Omnibus Budget Reconciliation Act (COBRA). Trying to understand this complex, ever-changing law and ensuring your company s continued compliance can be a full-time job. But, if you re like most busy professionals, dealing with COBRA s rules is not the only major task on your plate. We can help. The BCBSGa COBRA administration program provides a complete and efficient method for managing the risk, expense and burdens associated with COBRA and HIPAA administration. Our web-based solution simplifies processes, gets rid of paperwork, and provides 24-hour access to real-time account and participant information. To learn more, visit benefitadminsolutions.com. Questions? Call your broker or a BCBSGa sales representative.

10 Blue Cross and Blue Shield of Georgia 3350 Peachtree Road, N.E. Atlanta, GA bcbsga.com Life and Disability products are underwritten by Greater Georgia Life Insurance Company (GGL) using the trade name Anthem Life. Blue Cross and Blue Shield of Georgia, Inc., Blue Cross Blue Shield Healthcare Plan of Georgia, Inc. and GGL are independent licensees of the Blue Cross and Blue Shield Association. ANTHEM is a registered trademark of Anthem Insurance Companies, Inc. The Blue Cross and Blue Shield names and symbols are registered trademarks of the Blue Cross and Blue Shield Association.