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Women's Preventive Health Services

Effective at renewals and for new contracts beginning August 1, 2012, Blue Cross of Idaho will provide coverage with no cost sharing for specific preventive health services for women.

If you have any questions about these benefit changes, please select this link or contact your local Blue Cross of Idaho District Office.

Brokers & Agents

What does it mean to me?

Information for your clients (updated October 4th, 2013)

Information about the impact of the Affordable Care Act on health insurance for families and individuals, small employer groups (companies with few than the equivalent of 50 full-time employees) and large employer groups (companies with the equivalent of 50 or more full-time employees)

Healthcare reform affects everyone differently. As Blue Cross of Idaho continues to analyze the new law, we will post relevant frequently asked questions so you can better understand what healthcare reform changes to expect. These questions and answers are informational and not the equivalent of legal advice. Consult legal and tax experts to understand how the law will affect your individual or business circumstances.

Presentations:

Questions and Answers

How will PPACA affect my clients who are Blue Cross of Idaho members?

March 2012 PPACA update.

Though the Patient Protection and Affordable Care Act (PPACA) largely outlines healthcare changes taking affect over the next several years, it also calls for a number of near term provisions that take effect September 23, 2010. To help you understand what changes we are making to comply with the PPACA, we prepared general summaries of how we interpret the new regulations and how we anticipate it will impact fully-insured group products , grandfathered individual products, new individual products. If you have questions regarding these changes, please call your local district office at 800-365-2345.

How does the role of agents change?

The ACA requires all brokers to create a user ID, take online training and get certification through CMS to sell insurance on YourHealthIdaho.org. First, you need to register on the Medicare Learning Network (MLN)®. Required courses include the ACA Marketplace Basics Course, ACA Marketplace Basics Exam, and the Individual Marketplace Course, Exam, and Agreements. The SHOP Marketplace Course, exam, and agreements are optional, however these are suggested if you sell small group products. Next, you’ll need to create a Federally-Facilitated Marketplaces (FFM) user ID and complete identify proofing through the CMS Enterprise Portal.

The Blue Cross of Idaho online training portal is now LIVE and available for Blue Cross of Idaho brokers and sales agents. There are currently two ACA courses available: Affordable Care Act Basic, and Blue Cross Products & Services Basic. Two additional courses, Individual Products Sales & Processes and Group Products & Sales Tools, will be launched later this week. However, you can preview the courses now by clicking on the “Print Slides” link under the titles. If you are a Medicare Advantage broker, you will have access to required online certification and training on this site as well.

Simply click the following link to access the portal: Blue Cross of Idaho Online Training. Registration is simple and only takes a few moments. You can download and/or print the Online Training User Guide by clicking on the link provided.
You need to use Internet Explorer versions 6-10, Safari, or Chrome to access all of the training programs. Firefox is not compatible at this time.

What provisions in the healthcare reform law pertain to agents?

Health and Human Services plans to establish procedures under which the state of Idaho can allow agents and brokers to enroll individuals and small groups in products on the exchange when it becomes available in 2014. The law also says agents can assist individuals in applying for premium tax credits and cost-sharing reductions for plans sold through an exchange.

Information and Updates

Grant Information Mailing to Employers - April 2011

In a continuing effort to keep you and our employer groups informed about components of healthcare reform, we are sending employers with 100 or fewer contracts this letter and flyer with information about the wellness program employer grants established under the Patient Protection and Affordable Care Act (PPACA).  There are a number of ways employers can meet the criteria to receive these grants, including numerous programs and services offered through Blue Cross of Idaho.

While the federal government has yet to appropriate the funds and develop grant application guidelines and program criteria, we want to ensure employers are well prepared to apply for grants when available. Once we know more about the grant application process, we will reach out to employers to let them know about the new developments.

Implementation Timeline Chart

To help illustrate how grandfathered and new healthcare policies and plans need to comply with the Patient Protection and Affordable Care and Health Care and Education Reconciliation Act (PPACA), the Blue Cross Blue Shield Association created this reference chart.  The guide breaks down healthcare reform provisions by applicable market segment (individual, small group and large group) and provides a timeline for their implementation.  We are providing this guide for general reference only, please do not construe anything in the document as legal advice.

 Dependent Age Change

To comply with PPACA, Blue Cross of Idaho will do the following for our fully insured groups and non-group individuals:

  • Retain coverage for young adults currently on their parents' policies until the child turns age 26.  This is effective on a go-forward basis only, effective June 1, 2010.
  • We will not reinstate children who were dropped off their parents' policies prior to age 26, regardless of reason (marriage, age, dependent status, etc.) until the open enrollment period.  This includes children who were dropped effective May 31, 2010.

The PPACA provision takes full effect on September 23, 2010, and at that time Blue Cross of Idaho will cover young adults in the following way:

  • Children previously dropped from their parents' policies who become eligible again, or who were not previously eligible but become eligible under the new law, will be able to join their parents' policies during an open enrollment period, using the same rules Blue Cross of Idaho has in place for such additions:
    • For groups, the effective date for adding new dependents under this coverage will be the first renewal date of the group occurring after September 23, 2010.
    • For individual non-group coverage, the first effective date will be October 1, with an open enrollment period during September.  After this open enrollment period, members will be able to add dependents at any time, just as individuals can today.  We will also be following our current procedure and medically underwriting all dependents added to individual policies.

On June 3, 2010, we mailed letters that highlighted our strategy for addressing the change to anyone affected.  PDF copies of the brokergroup administrator, and member letters are available for your reference.

We appreciate your patience while awaiting our decisions regarding this new coverage issue and will be happy to answer any questions you may have about how this will affect your customers.  Please feel free to call any of our district offices for additional clarification.