Friday, June 15, 2012

BCBSNC Releases Health Care Reform Update: Uniform Coverage Documents

Blue Cross Blue Shield of North Carolina released a statement concerning the government ruling for complying with the Uniform Coverage Documents (UCD) regulations under the Patient Protection and Affordable Care Act.

An important point in the UCD requirements is that BCBSNC is responsible to meet the notice requirements for our fully-insured groups.  On the other hand, ASO groups are responsible for meeting their member notice requirements. 

BCBSNC will meet their obligations by providing the following notices for fully-insured groups:
  • Send Summary of Benefits and Coverage (SBC) to group administrator within prescribed time frames after any of these events occurring after September 23, 2012:
    • Upon application for coverage
    • By first day of coverage (if information has changed)
    • Upon enrollment of Special Enrollees (participants/beneficiaries only)
    • Upon renewal
    • Upon request
  • Post SBCs to the Member Services section of bcbsnc.com
  • Send postcards to all employees telling them the SBC is posted on-line and the location (this is a notice requirement)
 The group is responsible for providing SBCs to new hires, to special enrollees and to eligible employees who are not enrolled. 

The group is responsible for providing paper SBCs to employees who do not have reasonable online access in the workplace, to new hires, and to special enrollees.

A document summarizing these requirements is attached, including an overview and frequently asked questions.

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