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Working with Blue Cross Blue Shield of
Texas
Presentation format:
• Type your question in the GoToMeeting “Questions” area located in the toolbar on your right side of the screen• If time allows, the Moderator will answer the questions verbally at
the end of the presentation• There will not be a live Q&A session• This webinar is being recorded and will be posted 30 minutes after
the presentation at www.TheBrokerageInc.com
Agenda
• Certifications• Submission Deadlines• Understanding Your BCBS Producer Portal• Quoting/Online Submission• Dental Requirements• Estimating Tax Subsidies• Resources
Read your News from the Blues!
Questions
I spoke with a provider yesterday that is in the BCBSTX HMO network, but they are not taking the Advantage HMO network.Therefore when you are online and doing a HMO provider search on BCBS and the provider is indicated to be in the HMO network it may not really be indicating that they will take the HealthCare Reform plans.Therefore if you enroll someone in an HMO network then they will have even more limited network than what is implied on the BCBS website.
ACA Traini
ng
•You ARE required to take the Marketplace Certification if you are working “On Exchange” (helping your clients apply for tax subsidies/cost sharing).•You Are Not required to take the Marketplace Certification if you are working “Off Exchange” (clients are enrolling without tax subsidies/cost sharing).
BCBSTX
Training
• You ARE required to complete the Marketplace Matters training on the BCBS website if you are selling “On or Off Exchange” plans• On Exchange – Complete Option A• Off Exchange – Complete Option B
Completing
• You ARE required to send in training forms to BCBS regardless of which option you are selling.• All certification instructions can be found on our website at www.TheBrokerageInc.com under
Products/Individual Major Medical
• Apps must be submitted no later than 2/15/143/1/2014Effective Dates
• Apps must be submitted between 2/16/14 and 3/15/14
4/1/2014Effective Dates
• Apps must be submitted between 3/16/14 and 3/31/14
5/1/2014Effective Dates
Submission Deadlines
March 31st is the final deadline to submit business until November 15, 2014 for a 1-1-15 effective date (QEP excepted).
Qualifying Events
• He loses minimum essential coverage, including through divorce.• He gains a dependent or becomes a dependent through marriage, birth, adoption or placement for adoption or foster care.• He becomes a citizen, national or lawfully present individual.• He is eligible to enroll but didn’t because of a mistake, misrepresentation or inaction of an officer, employee or agent of the Marketplace.• The plan he enrolled in substantially violated a material provision of its contract with the individual.• He becomes newly eligible for premium tax credits or cost-sharing assistance.• He becomes ineligible for premium tax credits or cost-sharing assistance.• He makes a permanent move and has access to new health plans.• He is a member of an American Indian tribe (American Indians can enroll in a plan or change plans one time each month).• He demonstrates to the Marketplace that he has other extenuating circumstances that qualify him for special enrollment.• When any of these situations happen, he will have 60 days to go to the Marketplace to enroll in a health insurance plan or change plans.
Short Term Major
Medical
Critical Illness
Hospital Indemnity
Accident
Need Answers for After Lock In? Here Are Your Solutions!
Commission
• 6% - Years 1-3• 4% - Years 4 +• Based on full premium, not subsidized premiums
Payment
• BCBS will be releasing commissions for January 1, 2014 effective dates between February 18 – 20th
• Snapshot Bonus Program• On 11/30/13 BCBS take a snapshot of your business for small group and
individual business.• On 5/1/2014 BCBS takes a 2nd snapshot of your business.• The difference between the two snapshots will receive $50 per app up to
$25,000.
Bonus
Agent Assignment Confirmation Form
• Fill out the Agent Assignment on all applications submitted to BCBS to make sure you are recognized as the Agent of Record• Send your forms to
Login to www.bcbstx.com
Click on Producer TabEnter your Username and
Password
Now you are at Blue Access for Producers
Understanding Your Producer Portal
Product and Forms
• Product Overviews, Comparison Charts, Dental Information
Marketing and Sales
• Advertising Materials, Compensation Schedules
Training and Administration
• Access the Market Place Matters Training
Other Information
• Legislative Updates• Provider Finder• Commission Statements
Use Your Producer Portal To Access
Online Tools @ BAP
Use your Quote and Enroll button to quote
Off Exchange Applications. You can save and email your
quotes when quoting Off Exchange.
Generate a formal proposal and your
clients can enroll from the email you send.
Individual Tools
Use your Express Link Button when quoting On Exchange Applications. You will need to copy and paste your Express Link into a new internet browser if you are working on the quote. You can also email your Express Link to your client and let them do the work
Individual Tools
Use your Track Application Status button to track applications and find out the status of your clients.
Quoting and Enrollment
On Exchange
When Quoting On The Exchange Be Prepared
• Make sure your clients have all information needed to go to the Marketplace• Names, Birthdates, Household Income, Social Security Numbers• Make sure you have your FFM & NPN numbers to enter in Healthcare.gov.
Consumers Need To Create Their Own Usernames and Passwords
• Agents will be out of compliance if creating for their clients• Make sure your client records their usernames and passwords as they will need
them at a later date.
Eligibility Results
• Make sure your clients either print or save the results letter for future use.
Key Points to Remember
Your Express Link
Put in your client information
If you select yes you will then have the option to either get an estimate or get an
official tax credit amount
If you select yes
This is for an estimate only
Amount of Estimate
If you select yes to get an official tax credit amount
You will need to create an account
You will get this screen to go to the exchange
The Marketplace
First page of the application
You will need to log into your email
account and click the link to confirm
your email
You will now log in
Select what type of coverage you need
Click Next
1st step
Market Place – More Information
• Once identity questions are verified you will be prompted to enter household information and income amount.• After all information is entered the eligibility results will be available
• Open the pdf to view the eligibility results and either save and email or print the letter for your clients. They will need to keep this information for tax purposes.
• Find the Return to Issuers Website button to return to the BCBS website.• After returning to the BCBS website tax subsidies and/or cost sharing
will reduce the premiums and benefits in order for your client to determine which plan to enroll in.
Application Submission
Select your plan
Select a dental option
Page shows plan and premium
First page of the application
Applicant information
Additional Information
Credit card option will take you to a 3rd party vendor
(May charge $9.99 for this service in the future.)
Or you can have the client sent a bill for
the premium
Applicants signatures
There will be a button here that you
will click to submit the application
Checking Status on your Business!
• For Underwriting Status and other New Business forms• Open your web browser and visit www.HSCIL.com • Click on the button labeled "Producer Services".• Click on the button labeled "Register".• Complete the simple form being sure to provide your Tax ID (SSN or EIN) and your BCBS
writing number listed above in this email. Once you have completed the form, click "Continue".
• You will receive a notice stating that you should check your e-mail to validate your account. • Check your email and look for a message. Follow the instructions contained in the email,
clicking the link to validate your account.• After validating your account, you will receive a message stating that "You have successfully
validated your e-mail address and account. Please log in." Click the "log in" link.
Dental Pediatric and Adult
Pediatric dental is required to be offered on all ACA Plans.
Consumers can add a stand alone dental plan from Blue Cross Blue Shield
Dental follows the same open enrollment period as medical
Things to Know about Dental Plans
Estimating Tax Subsidy
Calculating subsidies is very easy!
Use the Kaiser Family Foundation subsidy calculator!
Instant results
Family of 4, $60,000 expected
income in 2014,Subsidies cover 41% of annual
premium
Open the “Notes” when you scroll down this page
Scroll down further for important FAQs
• Providers not accepting plans get name and phone of providers office and send to [email protected]
Provider Issues
• EFT• Pay By Mail• Pay in Person• Credit/Debit Card Option• Check By Phone
Premium Payments
• BCBSTX Clients have until 2/28/14 to pay their January and February
Payment Deadlines
• Clients that enrolled directly on the exchange can only make changes by contacting The Marketplace.
HealthCare.gov Enrollment
Things To Know
Important News From The Marketplace
System Maintenance Will Affect Feb. 15 Applications On Feb. 15, the Social Security Administration (SSA) is taking down its website for regularly scheduled systems maintenance activities.
This will affect people applying for coverage on the healthcare.gov site, since eligibility verification with the SSA is part of the application process. Applications for March 1 coverage will need to be submitted before 2 p.m. CT in order to find out if the applicant qualifies at the time of application.
Any applications received after 2 p.m. will be processed beginning on Tuesday, Feb. 18.
Belynda [email protected] 469-635-6715
Cristin [email protected] 469-635-6707
Dana [email protected] 469-635-6746
Melissa Lopez [email protected] 210-887-7754
The Brokerage Inc. - ACA Contacts
BCBS Agent Support Line – 855-782-4272
Market Place Call Center – 800-318-2596
Market Place Agent Support – 855-267-1515
Medicaid – Medicaid.gov
CHIP – 877-KIDSNOW
Other Resources
Find valuable tools in our Individual Health section at www.TheBrokerageInc.com
Q & A
• To ask a question, type your question in the GoToMeeting Q&A box• If we cannot answer all questions with certainty, we will include the
answer in our follow up, after additional research has been done• All answers during this segment will be provided as a follow up to you
via email.
