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March 14, 2011  
In This Issue
Reminder on RIF
NC HealthSmart Calls
Claims Recovery Vendors
Tasty & Light Recipe of the Month! 
 cheese ball

Keep Those Addresses and Phone Numbers Updated 

 

With the upcoming Annual Enrollment, please remind your employees about the importance of keeping their addresses and phone numbers updated.

This will ensure that Blue Cross and Blue Shield of North Carolina has the most up-to-date member information - and that members receive all State Health Plan materials promptly.

Please note: Annual Enrollment dates have not yet been set.

 

Healthy Activity

Exercise for High Blood Pressure 

Quick Links...
 
Reminder on RIF and Health Coverage  

 

Employees who lose their jobs as a result of a reduction in force (RIF) will continue to have coverage under the State Health Plan for up to 12 months, as long as the employee has 12 or more months of service and the employee was covered by the Plan at the time of separation from service - or completed a contract term of employment of 10 or 11 months as an employee of a local school administrative unit.  Employees are not eligible for RIF health coverage if the employee is provided health coverage on a non-contributory basis by a subsequent employer.

 

Employees may continue coverage for their eligible dependents during this 12-month period. Employees who elect not to continue coverage under RIF immediately following separation from employment may not obtain RIF coverage at a later date.

 

As a reminder, the Plan created an Application for Reduction in Force Health Coverage Benefit form that RIF employees must complete.  The application explains the RIF health coverage benefit and is included in COBRA offers that are sent to former employees.  The RIF application also states that these employees must notify the Plan if they become eligible for other group health plan coverage, on a non-contributory basis by a subsequent employer, while they are receiving the RIF health coverage benefit. HBRs should follow the appropriate RIF process below for their agency:

  • eBenefitsNow agencies - HBRs should term RIF employees using the reason code "left employment" in eBN. This is a COBRA qualifying event and will generate a COBRA offer.  The HBRs should explain RIF benefits in their employees' exit interviews, noting that the Application for Reduction in Force Health Coverage Benefit form will be included with their COBRA offer.   Employees who wish to elect RIF coverage should complete the application and submit it to their former HBR for approval.  The HBR should, in turn, forward the approved form to BCBSNC for enrollment on the employer-sponsored RIF group.  The RIF enrollment will not appear in eBN.    
  • BEACON agencies - HBRs should provide the RIF employee with the Application for Reduction in Force Health Coverage Benefit form to complete, copy and keep for their records.  The HBR does not need to send the application to BCBSNC. The employee and any dependents will remain on the employing unit's billing statement while receiving the 12 months of RIF benefits. The employing unit is responsible for collecting and remitting applicable premiums for dependent coverage.
  • Paper agencies - HBRs should provide RIF employees with the Application for Reduction in Force Health Coverage Benefit form when they are terminated.  The HBR should send the completed application to BCBSNC.  BCBSNC will enroll the member, and if applicable, any covered dependents on the RIF subgroup.

After one year (12 months), the former employee and their eligible dependent(s) may continue health coverage on a fully contributory basis. Former employees who choose to continue their coverage after the initial 12-month period will be direct-billed by BCBSNC.

 

Employees who do not have the required months of service to qualify for RIF benefits may continue health coverage for themselves and their qualified dependents at full cost under COBRA.

 

 
Members Receiving NC HealthSmart Calls


State Health Plan members may be receiving calls from the Plan's NC HealthSmart program. Through this outreach, the Plan is working to inform members about the new and improved NC HealthSmart program and its new website. The website features articles, videos and other resources for up-to-date information on health conditions and topics, a health assessment, health coaches, a place to securely store medical information and access to a 24-hour nurse line.

If the member isn't available to take the call, a message will be left informing him or her to call 866-841-4069 and enter a personal message code that will be provided to them in the message. Please help share the word with Plan members that these calls are legitimate and worth their response. 

 

 
Vendors Authorized for Claims Recovery  

 

Connolly and the Rawlings Company are Blue Cross and Blue Shield of North Carolina's claims recovery vendors. They have been authorized by the State Health Plan to investigate and obtain information from appropriate sources, including Plan members, to ensure proper payment of claims, including coordination of benefits. They are also authorized to pursue and collect overpayments. A representative from Connolly or from the Rawlings Company may contact you to verify the employment status of a Plan member.  Thank you, in advance, for your assistance.