Friday, August 31, 2012

UHC: New Enrollment Tool

Effective Sept. 17, Employer eServices®will release a new streamlined enrollment tool for customers with 2-100 employees. The enhanced tool will provide customers with a simplified eligibility transaction experience, enabling them to manage (add, change and/or inquire) a member and all dependants within one simple process flow. 

Benefits of this enhancement include:
  • Reduce transactional processing time
  • Drive additional sales and membership growth
  • Decrease support calls to the customer support center

Monday, August 27, 2012

UHC: 2012 Flu Shot Program

UnitedHealthcare has annouced their 2012 Flu Shot Program available to members. Member cost for flu shots is the same for either walk-in vaccine or client sponsored flu clinics. Member copayments and deductibles may apply. For more information and to view a list of 2012 UnitedHealthcare Flu Shot Providers please see attached flyer from UnitedHealthcare.

Helpful Health Reform Flow Charts

The Kaiser Family Foundation has released two helpful health reform flow charts. To view please follow the links below.

Requirement to Buy Coverage Under the Affordable Care Act

Penalties for Employers Not Offering Affordable Coverage Beginning in 2014

UHC: Discounted Hearing Aids

UnitedHealthcare members can now take advantage of hearing aid discounts, saving thousands of dollars in out–of–pocket costs. Hearing aids can cost over $3,000 each, but members pay a discounted rate of between $479 and $679 per hearing aid through hi HealthInnovations depending on the model chosen.

hi HealthInnovations uses several approaches to offer hearing aids at more affordable prices, including leveraging UnitedHealthcare Group’s scale and purchasing power. As a result, the cost savings are transferred to consumers. There is no cost to the employer or employee to access the savings on hearing aids. Plus, the discounted pricing is available even if the health care plan through UnitedHealthcare does not have hearing aid coverage. However, members may be able to further reduce their costs for hi HealthInnovations’ hearing aids, if their health care plan has a hearing aid benefit.

To learn more about the program, visit the hi HealthInnovations website at and follow the simple instructions or view the consumer brochure.

Webinar on Family and Medical Leave Act

Please join us for a webinar on the Family Medical Leave Act (FMLA) on September 27th from Noon - 1:30 PM EST.

Reserve your seat now at:

The Family and Medical Leave Act (FMLA) will be 20 years old in 2013, yet employers struggle every day to comply with its complicated rules. This session will review FMLA basics, but will focus on compliance issues which create the greatest challenges and risks to employers. Topics will include:
• How to handle the required FMLA notices at the time of a leave
• Dealing with intermittent FMLA leave
• Properly administering benefits during an FMLA leave

Presented by: Fritz Hewelt, Principal Consultant, Benefit Comply, LLC
Fred W. (“Fritz”) Hewelt brings over thirty years of experience to his clients, assisting them with a broad range of issues related to the evaluation and remediation of employee benefit and human resource compliance challenges.  Fritz has also assisted numerous clients with welfare benefit plan due diligence in merger and acquisition situations.  Fritz holds a BS in Business Administration from Elmhurst College, Elmhurst, Illinois.  He also has earned designation as a Chartered Life Underwriter (CLU), a Certified Employee Benefits Specialist (CEBS) and a Fellow, Life Management Institute (FLMI). 

BCBSNC: Online EOB Enhancement

On June 8th Blue Cross Blue Shield of North Carolina (BCBSNC) advised members of the availability of online Explanation of Benefits (EOB) documents. In addition to being able to access EOBs online the following enhancements are also available:
  • Access EOBs associated with a specific claim.
  • Plan subscribers can access ALL EOB's from 01/01/2012 and beyond.
EOBs can be accessed by logging into and navigating to the "Explanation of Benefits" link in the claims section.

Monday, August 20, 2012

Aetna to Acquire Coventry Health Care, Inc.

Aetna announced this morning that it has entered into a definitive aggreement to acquire Coventry Health Care, Inc. For more information or to view the press release please click here.

UHC: New Resources Provide Clarification to SBC Effective Dates

UnitedHealthcare has been receiving a high level of early Summary of Benefits and Coverage (SBC) requests to be delivered for open enrollments occurring prior to the Sept. 23, 2012 effective date. Therefore, they are providing guidance on the requirements on issuing an SBC to fully insured and self-insured groups with an October 1 and/or Nov. 1, 2012 effective date.

Fully Insured SBC Delivery Dates and Process:
The SBC effective date applies to open enrollment periods beginning on or after Sept. 23, 2012.
  • For new business, applications, sold cases or renewal confirmations submitted on or after Sept. 23, 2012, UnitedHealthcare will create an SBC.
  • For renewals, the first effective date UnitedHealthcare will create SBCs will be November 1. This is based on the assumption that most Oct. 1, 2012 groups will have committed to their renewal and their open enrollment period will have begun prior to Sept. 23, 2012.
  • If an Oct. 1, 2012 group commits to renew with UnitedHealthcare on or after Sept. 23, 2012, then we will create an SBC for them. For groups with an Oct. 1, 2012 or Nov. 1, 2012 effective date, please reference the grid below for clarification on SBC requirements.

Friday, August 17, 2012

BCBSNC: Employer Groups Receiving Letters from CMS

This year, the Centers for Medicare & Medicaid Services (CMS) has begun mailing information to many Blue Cross Blue Shield of North Carolina (BCBSNC) employer group customers about a data matching project led by the Social Security Administration, CMS and the Internal Revenue Service (IRS). Letters titled “Requirement to Submit the Group Health Plan Report for the IRS/SSA/CMS Data Match” instruct employer groups to complete a data match questionnaire.

As the letters indicate, it’s important for employers to complete this questionnaire, in order to comply with the law and prevent paying civil monetary penalties associated with non-compliance. BCBSNC is unable to complete this questionnaire on the group's behalf.

Since 2009, BCBSNC has worked to ensure their compliance with Section 111 of the Medicare Modernization and SCHIP Extension Act. This work includes obtaining employer tax ID and group size information, and obtaining the Social Security Numbers (SSNs) for members age 45 plus and those with Medicare coverage. As required by law, they also share this information with CMS.

BCBSNC will continue to do the work associated with Section 111 compliance, but they are unable to complete the data match questionnaire on employer groups’ behalf. CMS has issued employer-specific personal identification numbers (PINs) for these questionnaires, and employer groups must use these PINs to complete the questionnaires.

BCBSNC: 25 Years of Service to State Employees

Blue Cross Blue Shield of North Carolina (BCBSNC) announced that they will continue to administer most of the State Health Plan. The following key points regarding the decision were released:
  • BCBSNC will continue to serve all members of the State Health Plan who are actively employed with the state and their participating dependents.
  • Another vendor (or vendors) will serve those Medicare-eligible state retirees who opt for a Medicare Advantage plan.
  • Medicare-eligible state retirees may transition to a Medicare Advantage plan on January 1, 2014.
  • BCBSNC's current contract with the state will remain in effect until June 30, 2013.

BCBSNC: COBRA services move back to Ceridian

Effective October 1, 2012 Blue Cross Blue Shield of North Carolina (BCBSNC) will no longer administer COBRA services in-house. They will transition in-house COBRA services back to Ceridian. Ceridian will be able to handle COBRA services for all products including ancillary products such as FSA's and HSA's. Ceridian also offers online COBRA administration. These are services BCBSNC was not able to handle in-house.

This change was communicated to groups on August 16th. Beginning August 20th, BCBSNC will begin mailing letters to members. BCBSNC is working with Ceridian to make this a smooth transition.

Friday, August 10, 2012

UHC: New SBC and W-2 Videos Released

UnitedHealthcare has added two new videos on Summary of Benefits and Coverage (SBC) and W-2 Reporting. These videos are available for view through the United for Reform Research Center and Health Care Lane. You may also follow the links below to view the videos.

Summary of Benefits and Coverage Video

W-2 Reporting Video

Thursday, August 9, 2012

UHC: Sweepstakes

UnitedHealthcare members may be eligible to receive more than 250 health and wellness prizes from the sweeptakes going on now through October 25, 2012. These prizes include treadmills, elliptical trainers, exercise bikes, wireless activity trackers and video game consoles. Click here to learn more about this opportunity.