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The Blues will continue effort to transition small groups and individuals to reform compliant plans instead of continuing non-compliant plans

November 23, 2013

Article courtesy of Blue Cross Blue Shield of Michigan

The Blues will continue effort to transition small groups and individuals to reform compliant plans instead of continuing non-compliant plans.

Blue Cross Blue Shield of Michigan and Blue Care Network today announced that they will continue transitioning small groups and individuals into health plans that meet the benefit requirements of the Affordable Care Act instead of continuing current non-compliant plans.

The decision to continue transitioning small groups and members into reform compliant products was based on a number of factors — all affecting the short- and long-term affordability of coverage for small groups and individuals.

Small groups

  • Small group customers offered options to keep 2013 plans — Small groups had an opportunity earlier this year to change their “plan year” to November or December thereby keeping their current Blues plan through 2014. The majority of small groups are transitioning into compliant plans.
  • Avoiding increased rates in current plans — Since the ACA was signed into law in 2010, the Blues have planned for legacy policies to no longer be available as of Jan. 1, 2014. Keeping the plans open in 2014 would require a “catch-up” premium rate increase.

Individual members
Subsidies help lower costs for many businesses and individuals — Individuals can’t apply for subsidies if they remain in their non-reform plan. The Blues estimate that about 50 percent of its current individual product membership is eligible for ACA subsidies that could get them better coverage at lower prices.

Individual members offered option for non-compliant plan

  • Some time ago we made a decision to offer Keep Fit for 2014. Individuals currently enrolled in either our Keep Fit (PPO) or Personal Plus (HMO) plan can keep it through 2014.
  • Any member who enrolled in a new, qualified health plan on the Marketplace, or through an agent, an HPA, or online is not affected by this. They have coverage beginning Jan. 1.
  • Those who have not enrolled in a new plan will be transitioned to a Keep Fit plan effective on Dec. 31, 2013. They will receive a letter with their options to stay covered after their plan closes. They can accept this option simply by paying the premium bill they will receive in mid-December. Individuals who choose to stay in a non-reform plan are not eligible for subsidies.
  • They also have the option to enroll in our new products that are compliant with the Affordable Care Act and contain the full array of essential health benefits provided for by federal law until Dec. 15, 2013.
  • The goal is to ensure that no one goes a day without coverage and we are taking the steps necessary to make that happen.

Avoiding increased rates in current individual plans — Since the ACA was signed into law in 2010, the Blues have planned for non-reform policies to no longer be available as of Jan. 1, 2014. In the individual market, Blue Cross has not increased rates on those plans since 2011. Keeping the plans open in 2014 would require a “catch-up” premium rate increase approximating 30 percent.

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