HEALTH

INSURANCE

NEWS

May 2021

BCBS has a class action lawsuit happening now, for groups and members covered from Feb 2008 to October 2020 (or any portion of that time).  Employers and employees should click the link below to be included in the settlement.  It’s super easy to do, but members will need to have their BCBS ID Number handy.  They can click "File a claim here" below where it says “I don’t have a unique ID?”

What is this Settlement about?

This settlement, arising from a class action antitrust lawsuit called In re: Blue Cross Blue Shield Antitrust Litigation MDL 2406, N.D. Ala. Master File No. 2:13-cv-20000-RDP (the “Settlement”), was reached on behalf of individuals and companies that purchased or received health insurance provided or administered by a Blue Cross Blue Shield company. Class Representatives (“Plaintiffs”) reached a Settlement on October 16, 2020 with the Blue Cross Blue Shield Association (“BCBSA”) and Settling Individual Blue Plans. BCBSA and Settling Individual Blue Plans are called “Settling Defendants.”

Plaintiffs allege that Settling Defendants violated antitrust laws by entering into an agreement not to compete with each other and to limit competition among themselves in selling health insurance and administrative services for health insurance. Settling Defendants deny all allegations of wrongdoing and assert that their conduct results in lower healthcare costs and greater access to care for their customers. The Court has not decided who is right or wrong. Instead, Plaintiffs and Settling Defendants have agreed to a Settlement to avoid the risk and cost of further litigation.

If approved by the Court, the Settlement will establish a $2.67 billion Settlement Fund. Settling Defendants will also agree to make changes in the way they do business that Plaintiffs believe will increase the opportunities for competition in the market for health insurance.

HSAs are the most powerful tax-advantaged savings tools available. And now savvy health savers are taking advantage of an HSA “hack” that brings even more value and flexibility: Delayed reimbursement. The trick is that you don’t have to reimburse yourself right away. In fact, the IRS does not stipulate a required reimbursement timeframe. So, you can effectively “bank” your receipts and save them to pay yourself back down the road.

January 28, 2021

President Biden signed an executive order to reopen the federal marketplace selling Affordable Care Act plans.

Key Points

  • The Special Enrollment Period (SEP) will go into effect February 15, 2021, through May 15, 2021, which is when consumers will be able to begin enrolling in plans on www.healthcare.gov.

  • The intent of the SEP is to give consumers who need health care coverage during the pandemic the opportunity to sign up. 

  • The executive order directs the U.S. Department of Health and Human Services (HHS) to take action to open a new COVID SEP.  Further guidance from HHS and the Centers for Medicare & Medicaid Services is expected as a result with more details.

  • Plan effective dates will be the first of the month following enrollment, and no qualifying special enrollment reason will need to be given.

  • Current members have an opportunity to change their current plan to another marketplace plan as well as add dependents if needed.

  • Enrolling through our agency does NOT affect your monthly premium or subsidy amount.  We are here to assist with enrollment, individual healthcare laws and procedures, and customer service throughout the plan year.

  • Please contact us for more information or to sign up!!  828-318-8762 Susan Morgan / susan@skysthelimitllc.com

The BerniePortal connects the fragmented HR ecosystem in a comprehensive all-in-one HR tool, allowing employers to spend less time on administration, and more time building the businesses they love. This button is linked to a PDF document with more information.

March 8, 2020

Effective immediately, Aetna members will have access to the following resources:

Aetna will waive co-pays for all diagnostic testing related to COVID-19. This policy will cover the test kit for patients who meet CDC guidelines for testing, which can be done in any approved laboratory location. Aetna will waive the member costs associated with diagnostic testing at any authorized location for all Commercial, Medicare and Medicaid lines of business. Self-insured plan sponsors will be able to opt-out of this program at their discretion.

 

For the next 90 days, Aetna will offer zero co-pay telemedicine visits for any reason. Aetna members should use telemedicine as their first line of defense in order to limit potential exposure in physician offices. Cost sharing will be waived for all video visits through the CVS MinuteClinic app, Aetna-covered Teladoc offerings and in-network providers delivering synchronous virtual care (live video-conferencing) for all Commercial plan designs.

March 6, 2020

DURHAM, N.C. – Blue Cross and Blue Shield of North Carolina (Blue Cross NC) announced
that it will cover members’ cost for COVID-19 (Coronavirus Disease -19) testing and will not
require prior approval for COVID-19 testing and will speed access to other medically necessary
services for any members who are diagnosed with the disease.


These changes apply to Blue Cross NC’s fully insured, Medicare Advantage and Federal
Employee Program members. Self-funded employer groups will be given the option to apply
these changes to their employees’ plans.

February 2020

There are many beneficial reasons to purchase health insurance for your small business. However, health insurance products and services are certainly not “one-size fits all.” Choosing the right insurer and the right plan are essential for making the most of your small business’s investment.

This article explains the four main factors our small business clients usually consider before they purchase insurance.