Transcript Working with Blue Cross/Blue Shield

Working with
Blue Cross Blue Shield of Texas
Presentation format:
• Type your question in the GoToMeeting “Questions” area located in
the toolbar on your right side of the screen
• If time allows, the Moderator will answer the questions verbally at
the end of the presentation
• There will not be a live Q&A session
• This webinar is being recorded and will be posted 30 minutes after
the presentation at www.TheBrokerageInc.com
Agenda
• Certifications
• Submission Deadlines
• Understanding Your BCBS Producer Portal
• Quoting/Online Submission
• Dental Requirements
• Estimating Tax Subsidies
• Resources
Read your News from the Blues!
Questions
I spoke with a provider yesterday that is in the BCBSTX HMO network,
but they are not taking the Advantage HMO network.
Therefore when you are online and doing a HMO provider search on
BCBS and the provider is indicated to be in the HMO network it may
not really be indicating that they will take the HealthCare Reform plans.
Therefore if you enroll someone in an HMO network then they will
have even more limited network than what is implied on the BCBS
website.
ACA
Training
BCBSTX
Training
Completing
•You ARE required to take the Marketplace Certification if you are working “On Exchange” (helping
your clients apply for tax subsidies/cost sharing).
•You Are Not required to take the Marketplace Certification if you are working “Off Exchange”
(clients are enrolling without tax subsidies/cost sharing).
• You ARE required to complete the Marketplace Matters training on the BCBS website if you are
selling “On or Off Exchange” plans
• On Exchange – Complete Option A
• Off Exchange – Complete Option B
• You ARE required to send in training forms to BCBS regardless of which option you are selling.
All certification instructions can be found on our website at www.TheBrokerageInc.com under
Products/Individual Major Medical
Submission Deadlines
3/1/2014
• Apps must be submitted no later than 2/15/14
Effective Dates
4/1/2014
Effective Dates
5/1/2014
Effective Dates
• Apps must be submitted between 2/16/14 and
3/15/14
• Apps must be submitted between 3/16/14 and
3/31/14
March 31st is the final deadline to submit business until November 15,
2014 for a 1-1-15 effective date (QEP excepted).
Qualifying Events
• He loses minimum essential coverage, including through divorce.
• He gains a dependent or becomes a dependent through marriage, birth, adoption or placement for
adoption or foster care.
• He becomes a citizen, national or lawfully present individual.
• He is eligible to enroll but didn’t because of a mistake, misrepresentation or inaction of an officer,
employee or agent of the Marketplace.
• The plan he enrolled in substantially violated a material provision of its contract with the individual.
• He becomes newly eligible for premium tax credits or cost-sharing assistance.
• He becomes ineligible for premium tax credits or cost-sharing assistance.
• He makes a permanent move and has access to new health plans.
• He is a member of an American Indian tribe (American Indians can enroll in a plan or change plans
one time each month).
• He demonstrates to the Marketplace that he has other extenuating circumstances that qualify him
for special enrollment.
• When any of these situations happen, he will have 60 days to go to the Marketplace to enroll in a
health insurance plan or change plans.
Need Answers for
After Lock In?
Short Term
Major
Medical
Here Are Your Solutions!
Hospital
Indemnity
Critical
Illness
Accident
Commission
• 6% - Years 1-3
• 4% - Years 4 +
• Based on full premium, not subsidized premiums
Payment
• BCBS will be releasing commissions for January 1, 2014 effective dates between
February 18 – 20th
Bonus
• Snapshot Bonus Program
• On 11/30/13 BCBS take a snapshot of your business for small group and
individual business.
• On 5/1/2014 BCBS takes a 2nd snapshot of your business.
• The difference between the two snapshots will receive $50 per app up to
$25,000.
Agent Assignment Confirmation Form
• Fill out the Agent Assignment on
all applications submitted to BCBS
to make sure you are recognized as
the Agent of Record
• Send your forms to
[email protected]
Understanding Your Producer Portal
Login to
www.bcbstx.com
• Click on Producer
Tab
• Enter your
Username and
Password
Now you are at
Blue Access for
Producers
Use Your Producer Portal To Access
Product and Forms
• Product Overviews, Comparison Charts, Dental Information
Marketing and Sales
• Advertising Materials, Compensation Schedules
Training and Administration
• Access the Market Place Matters Training
Other Information
• Legislative Updates
• Provider Finder
• Commission Statements
Use your Quote and
Enroll button to quote
Off Exchange
Applications. You can
save and email your
quotes when quoting
Off Exchange.
Generate a formal
proposal and your
clients can enroll from
the email you send.
Online Tools @ BAP
Individual Tools
Use your Express Link Button when
quoting On Exchange Applications.
You will need to copy and paste your
Express Link into a new internet browser if
you are working on the quote.
You can also email your Express Link to
your client and let them do the work
Individual Tools
Use your Track Application Status
button to track applications and
find out the status of your clients.
Quoting and Enrollment
On Exchange
Key Points to Remember
When Quoting On The Exchange Be Prepared
• Make sure your clients have all information needed to go to the
Marketplace
• Names, Birthdates, Household Income, Social Security Numbers
• Make sure you have your FFM & NPN numbers to enter in
Healthcare.gov.
Consumers Need To Create Their Own Usernames
and Passwords
• Agents will be out of compliance if creating for their clients
• Make sure your client records their usernames and passwords as they
will need them at a later date.
Eligibility Results
• Make sure your clients either print or save the results letter for future
use.
Your Express Link
Put in your client
information
If you select yes you will then have the
option to either get an estimate or get
an official tax credit amount
If you select yes
This is for an estimate only
Amount of Estimate
If you select yes to get an official tax
credit amount
You will need to create an
account
You will get this screen to go
to the exchange
The Marketplace
First page of the
application
You will need to log
into your email
account and click
the link to confirm
your email
You will now
log in
Select what type
of coverage you
need
Click Next
1st step
Market Place – More Information
• Once identity questions are verified you will be prompted to enter
household information and income amount.
• After all information is entered the eligibility results will be available
• Open the pdf to view the eligibility results and either save and email or print
the letter for your clients. They will need to keep this information for tax
purposes.
• Find the Return to Issuers Website button to return to the BCBS
website.
• After returning to the BCBS website tax subsidies and/or cost sharing
will reduce the premiums and benefits in order for your client to
determine which plan to enroll in.
Application Submission
Select your plan
Select a dental option
Page shows plan and
premium
First page of the
application
Applicant information
Additional Information
Credit card option will take
you to a 3rd party vendor
(May charge $9.99 for this
service in the future.)
Or you can have the
client sent a bill for
the premium
Applicants signatures
There will be a
button here that you
will click to submit
the application
Checking Status on your Business!
•
•
•
•
•
For Underwriting Status and other New Business forms
Open your web browser and visit www.HSCIL.com
Click on the button labeled "Producer Services".
Click on the button labeled "Register".
Complete the simple form being sure to provide your Tax ID (SSN or EIN) and your BCBS
writing number listed above in this email. Once you have completed the form, click
"Continue".
• You will receive a notice stating that you should check your e-mail to validate your
account.
• Check your email and look for a message. Follow the instructions contained in the email,
clicking the link to validate your account.
• After validating your account, you will receive a message stating that "You have
successfully validated your e-mail address and account. Please log in." Click the "log in"
link.
Dental
Pediatric and Adult
Things to Know about Dental Plans
Pediatric dental is required to
be offered on all ACA Plans.
Consumers can add a stand
alone dental plan from Blue
Cross Blue Shield
Dental follows the same open
enrollment period as medical
Estimating Tax Subsidy
Calculating subsidies is very easy!
Use the Kaiser Family Foundation subsidy calculator!
Instant results
Family of 4,
$60,000
expected
income in 2014,
Subsidies cover
41% of annual
premium
Open the “Notes” when you scroll down this page
Scroll down further for important FAQs
Things To Know
Provider Issues
• Providers not accepting plans get name
and phone of providers office and send to
[email protected]
Premium
Payments
•
•
•
•
•
Payment
Deadlines
• BCBSTX Clients have until 2/28/14 to pay
their January and February
HealthCare.gov
Enrollment
EFT
Pay By Mail
Pay in Person
Credit/Debit Card Option
Check By Phone
• Clients that enrolled directly on the
exchange can only make changes by
contacting The Marketplace.
Important News From The Marketplace
System Maintenance Will Affect Feb. 15 Applications
On Feb. 15, the Social Security Administration (SSA) is taking down its
website for regularly scheduled systems maintenance activities.
This will affect people applying for coverage on the healthcare.gov site,
since eligibility verification with the SSA is part of the application process.
Applications for March 1 coverage will need to be submitted before 2
p.m. CT in order to find out if the applicant qualifies at the time of
application.
Any applications received after 2 p.m. will be processed beginning on
Tuesday, Feb. 18.
The Brokerage Inc. - ACA Contacts
Belynda Diciaccio
[email protected]
469-635-6715
Cristin Hopkin-Bishop
[email protected]
469-635-6707
Dana Ragsdale
[email protected]
469-635-6746
Melissa Lopez
[email protected]
210-887-7754
Other Resources
BCBS Agent Support Line – 855-782-4272
Market Place Call Center – 800-318-2596
Market Place Agent Support – 855-267-1515
Medicaid – Medicaid.gov
CHIP – 877-KIDSNOW
Find valuable tools in our Individual Health section
at www.TheBrokerageInc.com
Q&A
• To ask a question, type your question in the GoToMeeting Q&A box
• If we cannot answer all questions with certainty, we will include the
answer in our follow up, after additional research has been done
• All answers during this segment will be provided as a follow up to you
via email.