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:
Announcing Upcoming Webinars
We’re excited to announce upcoming webinars in our account webinar series, which allow your organization’s leadership and human resources teams to learn more about your health plan benefits from our subject matter experts. Learn more.
Health Plan Updates for 2022
Effective January 1, 2022, 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.
Upcoming Changes to the Blue Cross Blue Shield of Massachusetts Formulary, Effective January 1, 2022
Beginning January 1, 2022, we’re updating our formulary (list of covered medications) for medical plans with pharmacy benefits, as well as Medex®´* plans with a three-tier pharmacy benefit. Learn more.
Sunsetting Identity Protection Services
We’ll be sunsetting our Member Identity Protection Services offered through Experian as of November 2021. Learn more.
HMO Blue Select Network Update
As a result of favorable improvements in certain physician group and hospital cost performance, we are adding them to the HMO Blue Select Network. Learn more.
Three New Personal Spending Account Vendors Offer Choice and Flexibility
We’re excited to announce that we have added three new vendors to our personal spending account portfolio: Fidelity, London Health Administrators, and WEX (formerly Discovery Benefits, Inc.). Learn more.
Prior Authorization Change for Outpatient Services for EPO and PPO Plan Members
We're adding prior authorization requirements for certain outpatient services for EPO and PPO plan members, effective January 1, 2022. Learn more.
We’re Expanding Site-of-Care Coverage for Delivery and Maternity Care
On January 1, 2022, we’ll expand our coverage of routine deliveries and maternity care to include standalone birthing centers that aren’t affiliated with or attached to a hospital. Learn more.
We’re Making Telehealth Services More Accessible
Effective January 1, 2022, we’ll be expanding access to telehealth services for members. Learn more.
Expanded Coverage for Treatment of PANDA/PANS
As of January 1, 2022, Blue Cross Blue Shield of Massachusetts will expand coverage for the treatment of pediatric autoimmune neuropsychiatric disorders and pediatric acute-onset neuropsychiatric syndromes (PANDAS/PANS). This includes, but it is not limited to, intravenous immunoglobulin (IVIG) therapy. Learn more.
Blue Cross Blue Shield of Massachusetts Surpassed 2020 Medical Loss Ratio Requirements
In 2020, Blue Cross Blue Shield of Massachusetts exceeded the state and federal medical loss ratio (MLR) requirements for all market segments. As a result, we won’t issue account rebates for 2020. Learn more.
Transparency in Coverage Rule (TCR) and Consolidated Appropriations Act (CAA)
On Aug. 20, 2021, the Departments of Labor (DOL), Health and Human Services (HHS), and the Treasury jointly released guidance in the form of Frequently Asked Questions (FAQs) to clarify the requirements and timelines for implementation of certain provisions within the Transparency in Coverage (TCR) and Consolidated Appropriations Act (CAA). Learn more.