BluesMarketplace – Update

What you need to know
We confirmed with the Department of Insurance and Financial Services that groups who have 51 to 100 full-time equivalents and are renewing in January 2016 through October 2016 can:

   * Change their products and plan designs during 2016 and

   * Maintain their large group status until their renewal date in 2017

Carrier changes are not permitted to qualify for this transition. BCN and Blue Cross are included in the definition of a carrier change; if a group offers only PPO products and wishes to offer a HMO option (or vice versa), this is considered a carrier change.

Groups making a carrier change in 2016 would:

    * Violate the transition rules and

    * Be required to move to the small group market on their 2016 renewal date

Where can agents go for more information on the 51-to-100 FTE transition?
The group transition tool has been updated with 2016 data and will include groups with 51 to 100 full-time equivalents. Agents can view:

  1.  The 2016 small group renewal projection and product menu

  2.  The 2016 renewal projection for groups with 51 to 100 FTEs, including:

        * The renewal increase or decrease for groups who want to maintain their large group status (excluding taxes and fees, and mandated benefit changes)

        * The renewal increase or decrease for customers who are moved to a small group plan based on closest benefit design

  3. Additional information about renewal strategies for groups with 51 to 100 FTEs

We’re in the process of updating all training and marketing materials to clearly state that product and plan design changes are allowed for these groups in 2016.

How can groups switch their renewal month?
Groups renewing their plans in January through September have the option of moving their renewal month to October. Moving their renewal date to October would allow groups to maximize the amount of time they can remain a large group before having to transition to small group status at their 2017 renewal effective date.

Interested groups must submit their request form to their managing agent or sales representative by July 24.

Background information about Transition 2.0
On Jan. 1, 2016, the Affordable Care Act regulations are expanding the definition of a “small group employer” to include all employers with up to 100 full-time equivalents.

Blue Cross and BCN have established Transition 2.0, which allows large group customers with up to 100 FTEs to delay their transition into the small group market until their plan renewal date in 2017. We will renew all January 2016 to October 2016 groups as large groups unless notified by an agent. November 2016 and December 2016 groups will be renewed as small groups.

Questions? Contact your Blues sales representative or managing agent.