BCBS Texas Updates

News Alert – Oct. 23, 2015

Individual/Consumer Markets
Hot Topics for Friday, Oct. 23, 2015

Here are today’s hot topics related to the individual, retail market segment. As a reminder, we encourage you to reach out to your clients to share relevant information.

•   Short-term Plans Not Available Beginning Oct. 29
•   BCBSTX Releases New Commission Schedules for Retail Markets, Rates Unchanged
•   REMINDER: Producer of Record Transfer Hold Begins Tomorrow
•   FFM Registration for Plan Year 2015 Expires on Nov. 12
•   Plan Year 2016 Product Training Now Available

Short-term Plans Not Available Beginning Oct. 29
On the evening of Oct. 26, 2015, short-term or temporary health plans in the under 65 market will not be available for quoting/enrollment in either the Retail Producer Portal or the Retail Shopping Cart. We will continue to accept paper applications for short-term plans through Oct. 28. Beginning Thursday, Oct. 29, applications for short-terms plans will not be accepted.

Blue Cross and Blue Shield of Texas (BCBSTX) short-term plan applications can be submitted 30 days prior to the desired effective date. With Oct. 28 as the last day we’ll accept short-term plan applications, your clients can have an effective date up to Nov. 26.

As a reminder, short-term plans can provide immediate basic health care coverage, but they do not meet the Affordable Care Act’s minimum essential coverage requirements. As a result, depending on your short-term plan clients’ circumstances, they may be subject to pay a tax penalty. Clients who are currently in short-term plans will continue to be enrolled in those plans until their termination dates; however, they should consider enrolling in a Qualified Health Plan (QHP) during the open enrollment period (OEP). Remember that reporting functions in the Retail Producer Portal will help you find these clients to aid in outreach efforts.

We will announce when quoting and enrollment for short-term plans are once again available.

BCBSTX Releases New Commission Schedules for Retail Markets, Rates Unchanged
BCBSTX is formally releasing to its contracted producers and agencies new commission schedules for retail plans with effective dates of Jan. 1, 2016, and later.

Our commission rates for under 65 policies are not changing. The new schedule includes clarifying language only. Below is a summary:

If a new under 65 Affordable Care Act (ACA) policy replaces another under 65 ACA policy within 60 days of the previous policy’s termination date, the new or replaced policy retains the original effective date; it is not considered a new or year one sale.
When an existing under 65 policy is assigned to a new producer of record, the original policy effective date is used to determine the commission rate.
Producers and subproducers must complete the Centers for Medicare & Medicaid Services’ Federally Facilitated Marketplace annual training and registration process in order for commissions to be issued for new or renewing Marketplace policies.

Please see the updated 2016 commission schedules for details, which can be found in the Blue Access for Producers site. After logging in, locate “Texas Compensation Schedule Consumer Markets” under the PDFs & Related Information section of the commission statement page.

REMINDER: Producer of Record Transfer Hold Begins Tomorrow
In preparation for the beginning of the OEP, Producer of Record Transfer forms for retail policies will not be accepted after today, Friday, Oct. 23, 2015, and throughout the OEP. Any Producer of Record Transfer forms submitted after Oct. 23 will not be processed. During the OEP, all enrollment applications should be submitted by the new writing producer/subproducer. If policies are being rewritten by a new producer/subproducer, use online tools such as Express Link, the Retail Producer Portal or the Retail Shopping Cart while logged in with your own personal account (not your agency’s).

We will notify you when the Producer of Record Transfer process resumes for under 65 policies, typically about 30 days after the end of the OEP.

FFM Registration for Plan Year 2015 Expires on Nov. 12
Producers and subproducers helping individuals enroll in QHPs on the Federally Facilitated Marketplace (FFM) must register annually with the Centers for Medicare & Medicaid Services (CMS), a process that includes completing required training, prior to helping clients enroll in Marketplace policies.

If you completed the FFM registration process for plan year 2015, note that your registration expires on Nov. 12, 2015.

You should complete FFM registration for plan year 2016 by Oct. 31, 2015, in order to help consumers enroll in 2015 plans during remaining special enrollment periods, as well as help consumers enroll in 2016 plans during the OEP.

Plan Year 2016 Product Training Now Available
Individual product training is now available in Blue Access for Producers. The training includes an overview of major medical products available in the under 65 market for the 2016 plan year. It also covers plan structure, network information, pharmacy benefits, rating information and much more. To access the training, follow these steps: