Transition 2.0 Updated For Groups Affected By Small Group Definition Change In 2016

BCBS has developed product, rating and renewal strategies that will assist group customers who have 51 to 100 full-time-equivalents and are transitioning into the small group market in 2016. BCBS previously discussed this information in a Dec. 17, 2014, Blue Alert.

In March, BCBS hosted webinars for their sales team and agents to roll out strategies. These strategies will assist groups with their decision-making in 2015 as it relates to the small group definition change.

On March 26, 2015, the Department of Insurance and Financial Services issued an order clarifying two key parts of Transition 2.0:

•    Policies in effect on or before Dec. 31, 2015, are eligible for Transition 2.0 for a renewal occurring between Jan. 1, 2016, and Oct. 1, 2016.
•    A large group cannot maintain transition status for more than one year.

The Dec. 31, 2015, date is consistent with BCBS’s interpretation. The second statement limits renewal month strategy but still allows groups to maintain large group products and rating for up to 12 months.
 
As a reminder, Blue Cross Blue Shield of Michigan and Blue Care Network have several options available to help customers through this transition:

1.    Transition 2.0: BCBS can allow groups to maintain large group products and rating. Blue Cross and BCN will renew all January 2016 to October 2016 groups as large groups unless notified by an agent.
2.    Renewal month shift: BCBS can allow groups to transition to the small group market sooner or remain a large group longer. More details about this subject can be found in the webinar slides, which were updated to reflect what is allowable under the DIFS order.
3.    2015 alternative product offering: BCBS can allow groups to modify current benefits or introduce a lower cost plan.
4.    Self-funding: BCBS can allow groups to shift to self-funded coverage to avoid small group product and rating changes.
5.    Transition to small group: BCBS can allow groups to transition to a small group if they benefit from small group rating and have minimal product disruption.
6.    Private exchange: Employers may choose a defined contribution approach on GlidePathSM (for large groups) or Coverage for CompaniesSM (for small groups).

For more information, visit your managing agent’s website, where you’ll find:

•    The webinar slides and questions and answers from the webinars
•    The full-time equivalent calculator, which has been updated to accommodate the small group definition change
•    Renewal month shift and small group forms for groups requesting to move to the small group market or change their renewal month

Questions? Contact your Blues sales representative or managing agent.