BlueCross Dental Product Portfolio for 2015

Transcription

1 BlueCross Dental Product Portfolio for 2015 Producer Communication #684 Issued October 6, 2014 Message Our BlueCross Dental product portfolio continues to offer PPO and HMO dental plans to both groups and individuals, with a few changes for For 2015 effective dates, BlueCross Dental products will no longer be offered on SHOP. In addition, small group (less than 51 employees) and individual dental plans will see a reduction in the pediatric innetwork Out of Pocket Maximum (MOOP). Details Small Groups - Not on SHOP For 2015 effective dates, BlueCross Dental will no longer offer standalone dental plans on SHOP. Groups that currently have a SHOP dental plan will be renewed into the same plan design but under an off exchange plan/product ID. Federal Mandate Small Groups and Individuals As mandated by the Centers for Medicare and Medicaid Services (CMS), effective 1/1/2015, the pediatric in-network Out of Pocket Maximum for individual and group dental plans will be reduced from $700 per child ($1,400 per policy covering two or more children) to $350 per child ($700 per policy covering two or more children). This benefit change will be implemented effective 1/1/2015 for new and renewing individuals as well as for new small groups. Renewing groups will receive this benefit change at their renewal. Since small group business renews throughout the year, this benefit change resulted in creating new dental plan and product IDs for 2015 effective dates. Groups with 51+ Employees Our BlueCross Dental product portfolio for groups with 51+ employees will remain the same as our 2014 portfolio. Our dental portfolio consists of a robust range of PPO and HMO plans, including two voluntary PPO plans (i.e., 100% subscriber paid). Large Groups with 100+ Employees Large groups will continue to have the same dental HMO portfolio as in 2014 as well as the flexibility to customize their dental PPO plans. Large groups may also purchase our BlueCross Dental PPO Preferred Product. Refer to Producer Communication 663-BlueCross Dental PPO Preferred Product for more information. Multi-Coverage Credit A multi-coverage credit continues to be available on the PPO dental rates for fully insured groups with 51+ employees when both a medical product and a qualifying PPO dental product are purchased through Capital BlueCross. Individuals As a reminder, producers can assist their prospects with purchasing a dental policy, PPO or HMO, from Capital BlueCross or via the Federal Marketplace. New for 2015, members that enroll in an off exchange Capital BlueCross individual medical and/or dental plan (members are enrolled into Facets) may also purchase BlueCross Vision s Healthy Vision Plan 1. Refer to Producer Communication #683- BlueCross Vision Product Portfolio for 2015 for more information. Health care benefit programs issued or administered by Capital BlueCross and/or its subsidiaries, Capital Advantage Insurance Company, Capital Advantage Assurance Company and Keystone Health Plan Central. Independent licensees of the Blue Cross and Blue Shield Association. Communications issued by Capital BlueCross in its capacity as administrator of programs and provider relations for all companies.

2 Our Blue Individual Dental Program website and corresponding brochure will also continue as a distribution channel in 2015 for individual consumers. This web-based program markets BlueCross Dental s PPO and HMO dental plans alongside Dominion s Discount Dental Program and the Vision Plan Members that enroll through this program are not enrolled into Facets. Rather, Dominion Dental administers the enrollment, billing, fulfillment, etc. for these members. Refer to Producer Communication #648-BlueCross Dental Product Portfolio for 2014, for more information on how Health Care Reform requirements impacted our small group (less than 51 employees) and individual dental plans beginning with January 2014 effective dates. Attachments Attachment A 2015 BlueCross Dental Group Portfolio Summary with Plan IDs Attachment B 2015 BlueCross Dental Individual Portfolio Summary with Plan IDs Questions Contact your Preferred Agency with any questions. Thank you. 1 Vision Plan 6030 is underwritten and issued by Avalon Insurance Company. Dominion Vision Services and National Vision Administrators, LLC (NVA) provide administrative services to Avalon. Avalon, Dominion, and NVA are independent companies. Health care benefit programs issued or administered by Capital BlueCross and/or its subsidiaries, Capital Advantage Insurance Company, Capital Advantage Assurance Company and Keystone Health Plan Central. Independent licensees of the Blue Cross and Blue Shield Association. Communications issued by Capital BlueCross in its capacity as administrator of programs and provider relations for all companies.

3 2015 BlueCross Dental Group Product Portfolio Summary with Plan IDs Plan Name HMO Pediatric 702xs HMO Basic HMO Classic HMO Select 703 HMO Select 703x HMO Select 703xs HMO Select 703s HMO Select 705 HMO Select 705x HMO Select 705xs HMO Select 705s HMO Select 707 HMO Select 707x HMO Select 707xs HMO Select 707s HMO Select 708 HMO Select 708x HMO Select 708xs HMO Select 708s HMO Select 709 HMO Select 709x Small Group 2-50 Off Exchange BPDC0216 BCDC0222 BCDC0223 Group Size and ASO 20-99* BCDC28 Solution BPDC0216 BCDC0222 BCDC0223 Solution Solution 100+ BCDC29 BCDC29 BCDEX5 BCDC30 BCDC31 BCDC32 BCDC33 BCDC33 BCDEX6 BCDC34 BCDC35 BCDC36 BCDC37 BCDC37 BCDEX7 BCDC38 BCDC39

4 Plan Name HMO Select 709xs HMO Select 709s PPO Pediatric PPO Pediatric Plus PPO Value 75 PPO Basic PPO Basic Voluntary Voluntary Plus Enhanced Small Group 2-50 Off Exchange BPDC0214 BPDC0215 BCDC0219 BCDC0217 BCDC0224 BCDC0218 BCDC0225 BCDC0220 BCDC0221 Group Size and ASO 20-99* Solution BPDC0214 BPDC0215 BCDC0219 BCDC0217 BCDC0218 BCDC0220 BCDC0221 Solution Solution 100+ Value Plan 75 BCDC6 BCDC6 BCDEX3 Value Plan 80 BCDC7 Basic Plan 100/80 BCDC1 BCDC1 BCDEX1 Voluntary Basic BCDC4 Plan 100/80 Classic Plan BCDC2 BCDC2 BCDEX2 100/80/50 Voluntary Classic BCDC5 Plan 100/80/50 Plus Plan 100/80/50/50 BCDC3 BCDC3 BCDEX4 * ASO the dental product must be fully insured.

5 2015 BlueCross Dental Individual Product Portfolio Summary with Plan IDs Plan Name On Exchange Off Exchange PPO Pediatric BPDI0106 BPDI0107 PPO Plan 1 BCDI0102 BCDI0103 PPO Plan 2 PPO Plan 3 BCDI0104 BCDI0105 HMO Pediatric 702xs BCDI0108 BCDI0109 HMO Basic BCDI0106 BCDI0107