Here is the latest edition of Model Consulting's Week in Review Newsletter. We
hope you find the Newsletter informative and helpful.
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Model Consulting would like to extend our heartfelt
condolences to our friends at Altman Management Company. You are in our
thoughts and prayers during this very difficult time. |
Aetna: New Underlying Plan
Disclosure
Aetna recently issued revised
underwriting guidelines regarding "underlying plans". They define an underlying plan as: any
plan or arrangement that either partially or completely subsidizes any member
cost-sharing including but not limited to co-pays, deductibles and/or member
coinsurance balances (excluding Flexible Spending Accounts).
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Capital Blue Cross: ECERTS (Online Certificates of Coverage)
Beginning August 1, 2009, Certificates of Coverage (COC) will
be available online to employer groups and members according to a staggered
implementation schedule. This initiative is part of our ongoing efforts to keep
administrative costs low while providing electronic information for the
convenience of both accounts and members. Groups will be notified by letter
when the electronic version of their contract documents and COCs are available
online.
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Capital Blue Cross: Extended Eligibility for Over Age Dependents
On June 10, 2009, Governor Rendell signed legislation
expanding insured group health insurance coverage to adult unmarried children
until they reach age 30. The new Pennsylvania Law (Act 4 of 2009) requires
health insurers to continue coverage of unmarried children through age 29 at
the option of the employer. This law (which applies to group health
insurance contracts issued or renewed 180 days after the date the law was
signed) will go into effect for group policies renewing on or beginning January
1, 2010.
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Capital BlueCross - Important eBasics Update
In order to ensure that our eBasics customers are
fully aware and informed of the requirements for the Group Check-It-Out
program, Capital will not be offering this payment feature for 9/1/09 effective
dates. However, eBasics groups still have two options for ePayment under the
eBasics product suite. Groups can use the bill payer feature from their bank or
financial institution's online Web site or can send a payment via ACH Wire to
Capital BlueCross. We will advise you once the Group Check-it-Out option is
available for use.
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Horizon BCBSNJ: Update on Bayonne Medical Center
Lawsuit
Horizon
Blue Cross Blue Shield of New Jersey would like to inform you about an
important issue concerning our company and our efforts to support affordable
health care for the people of New Jersey, and, in particular, the citizens of
Hudson County.
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Independence Blue Cross: Managing Care & Costs for Diabetes
Diabetes is a complex illness that can pose serious risks
to the people and communities we serve. We are communicating to groups and
members how IBC is working to improve the lives and manage health care costs
for our members affected by diabetes, and providing them with information on
new preferred vendors for blood glucose test strips and 10/1/09 formulary
changes.
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UnitedHealthcare:
Federal Mental Health Parity Act Update
The Federal Mental Health Parity Act was signed
into law on October 3, 2008, as part of the economic recovery
package. United Healthcare (UHC) are actively preparing and working
on its fully insured benefit plan designs to help ensure that they will meet
the requirements for parity legislation by the October 3, 2009, compliance
date.
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