*BCBSTX Negotiating New Contracts with Allergy Partners
Applies to all groups
We received a termination notice from Allergy Partners, a nationwide allergy and asthma group with 15 providers in Texas serving 11 locations. The group plans to leave our networks on Sept. 30, 2023, unless we agree to its demands for higher rates.
Blue Cross and Blue Shield of Texas (BCBSTX) is trying to reach an agreement that protects our members’ access to quality care at affordable rates. Get all the facts.
News from the Blues
News from the Blues
*BCBSTX, Cogdell Memorial Hospital Extend Blue Advantage HMOSM Contracts Through Oct. 4
Applies to all groups, Individual & Family
We’re in active negotiations for the Blue Advantage HMO network with D M Cogdell Memorial Hospital (Cogdell) in Snyder. The hospital submitted a termination notice for the hospital and the D M Cogdell Memorial Hospital Medical Group effective Sept. 6, 2023. To continue working toward a new contract with no interruption for our members, Cogdell extended the termination to Oct. 4, 2023.
Member notices were mailed on Aug. 4. We will notify those members with the updated information.
More information: Please contact your BCBSTX representative with any questions or concerns.
News from the Blues
News from the Blues
Group
News from the Blues
Best Practices for a Successful Renewal Cycle with Account Management
Applies to small groups What you Need to Know: Go to the microsite for all your renewal, fliers and account management needs. We update the site continuously. Get the details.
News from the Blues
News from the Blues
*Coming Soon — Membership Message Center: Improving Communication, Data Security
Applies to all groups
We are launching a new “Membership Message Center” within Blue Access for EmployersSM (BAESM). This change solidifies our commitment to prioritizing data security and mitigating risks to protect customer information. Zoom in.
News from the Blues
News from the Blues
Affordable Care Act (ACA) 2022 Medical Loss Ratio (MLR) Rebates
Does not apply to self-insured group health plans (ASO)
We filed our MLR reports on Aug. 14 with the U.S. Department of Health and Human Services (HHS) for the 2022 MLR reporting year.
Wewill not provide MLR rebates for the 2022 MLR reporting year in relation to any market segments.
Reminder: What Is the ACA’s MLR?
In general, ACA’s MLR is the percentage of insurance premium dollars that a health insurer spends on health care services and expenses reported as activities to improve health care quality.
ACA set MLR standards for health insurers. For the 2022 MLR reporting year, ACA’s MLR standard for the large group market of a state is 85%. ACA’s MLR standard for the individual and small group markets of a state is 80%.
ACA’s commercial MLR standards apply to certain fully insured health insurance coverages in the group and individual markets. They don't apply to self-insured group health plans (ASO) or to Medicare and Medicaid.
If an insurer’s MLR doesn’t meet or exceed ACA’s MLR standard in a certain market segment of a state, the insurer may provide MLR rebates in that market.
News from the Blues
News from the Blues
Individual & Family
News from the Blues
Now Open: PY2024 Health Insurance Marketplace® Registration and Training
Download steps, tips for new and returning producers
The Centers for Medicare & Medicaid Services (CMS) has opened Plan Year 2024 Marketplace registration and training on the Marketplace Learning Management System (MLMS) for new and returning agents and brokers. Don’t forget, agents and brokers must register annually prior to helping consumers enroll in or renew Marketplace policies.
Reminder: No need to send us your registration and training certificates. We’ll check your registration status against the registration completion list.
ICYMI: Don’t forget the Department of Health and Human Services and CMS have finalized two rules that affect agents, brokers and web-brokers who enroll clients through the Health Insurance Marketplace or a state-based exchange that uses the Marketplace platform. These rules went into effect on June 18, 2023. For types of verification or consent, click here.
The 2024 Blue Cross Medicare OptionsSM certification curriculum will once again be housed on the AHIP/CMP platform.
Producers who use the certification link below to access and complete their assigned tasks will receive the discounted rate of $50 off the normal $175 AHIP fee (and pay $125). Get certified now.
News from the Blues
*This article, or a similar version, is being shared with employer groups in the BlueVISIONSM newsletter or news alert.
File is in portable document format (PDF). To view this file, you may need to install a PDF reader program. Most PDF readers are a free download. One option is Adobe® Reader® which has a built-in screen reader. Other Adobe accessibility tools and information can be downloaded at http://access.adobe.com.
By clicking this link, you will go to a new website/app (“site“). This new site may be offered by a vendor or an independent third party. The site may also contain non-Medicare related information. In addition, some sites may require you to agree to their terms of use and privacy policy.
Blue Cross and Blue Shield of Texas, a Division of Health Care Service Corporation,
a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association
