Important Administrative Information (IAI) is a quarterly mailing that delivers the latest news about Blue Cross Blue Shield of Massachusetts products and services to employers and consultants.
Current Editions:
Health Plan Updates for 2020
Effective January 1, 2020, and upon renewal, we’re making changes to our health plans to ensure that we continue to meet the ongoing requirements of health care reform, while providing the high-quality, affordable coverage you and your employees expect from Blue Cross. Learn more.
Blue Cross Blue Shield of Massachusetts Surpassed 2018 Medical Loss Ratio Requirements
In 2018, Blue Cross Blue Shield of Massachusetts won’t need to issue account rebates, as we exceeded the state and federal medical loss ratio (MLR) requirements for all market segments. Learn more.
Important Employer Surveys
In July, some accounts received at least one of two surveys in the mail from us that require a timely response: the Patient Protection and Affordable Care Act (PPACA) survey, and the federal Medicare Secondary Payer (MSP) survey. These surveys help us determine if an account is eligible to receive a rebate for 2019 (to be issued in 2020), and ensure that employees are enrolled correctly and their claims are properly adjudicated.
Learn more about these surveys, medical loss ratios, and national health care reform.
Smart90®´ Now Included in Core Benefits for Self-Insured Accounts with Pharmacy Benefits
Starting January 1, 2020, upon renewal, self-insured accounts with pharmacy benefits will include the Smart90 program, which allows members to get a 90-day supply of certain maintenance medications through the mail order pharmacy, or from the more than 9,800 CVS PharmacyTM retail locations nationwide. Learn more.
Introducing RationalMed®´for Self-Insured Accounts
Effective January 1, 2020, we’re adding RationalMed, a new medication safety solution, as a core benefit to our pharmacy program for self-insured accounts. Learn more.
Introducing ScreenRx®´ for Self-Insured Accounts
To help our members manage chronic conditions and stay on track with their medications, we’re offering ScreenRx to self-insured accounts, starting January 1, 2020. Learn more.
Updates to Our Pharmacy Formulary
Beginning January 1, 2020, we're updating our list of covered medications for medical plans with pharmacy benefits, as well as Medex®' plans with a three-tier pharmacy benefit. As part of these updates, certain medications may:
- No longer be covered (exceptions may be granted)
- Be excluded from coverage (exceptions won’t be granted)
- Switch tiers
- Have new quantity or dosing limits
Complete details about these changes will be available by October 18, 2019, on bluecrossma.com/employer in the Plan Updates section under What’s New.
Updates to Our Dental Blue® Total Health Solution
Effective September 1, 2019 for new and renewing accounts, we’re expanding our list of chronic conditions that qualify members for Enhanced Dental Benefits. Learn more.
Upcoming Changes to Member ID Card Distribution
Beginning November 1, 2019, we’re changing the timeline for when we send new Member ID cards to members in certain plans for Small Group (under 50) accounts. Learn more.
New Self-Service Reporting Tool for Accounts with 100+ Employees
We’re introducing a new self-service claims analytics tool later this year called BlueInsights. It will be available to all employers with 100+ employees. At that time, we’ll also retire the current ReportBlue system. Learn more.
Member Months Coverage Report Available for ASC Accounts at No Cost
We’re offering a Member Months Coverage Report to our ASC accounts for the 2019 tax year at no cost. This service must be requested prior to November 1, 2019. Learn more.
Enhancements to Our Find a Doctor & Estimate Costs Tool
Find a Doctor and Estimate Costs tool is now available within MyBlue, making it even easier for members to take control of their health care. Learn more
Enhancements to the MyBlue App
Throughout 2019, we’ve been making several enhancements to the MyBlue App that offers our members a better user experience, improved performance, and full integration with the MyBlue website. Learn more
New Federal Medicare Mandate (MACRA)
A federal law will change Medicare Supplement plan options for those who are newly eligible for Medicare on or after January 1, 2020. As of that date, we’ll no longer offer our Medex®´ Bronze plan to people who are newly eligible for Medicare. However, benefits for our current Medex Bronze, Choice, or Core plan members won’t change. Learn more.