BCBSTX Small Group Quote and Recommendation

Send this to the client to share the BCBSTX quotes you’ve collected and to make a recommendation.

Subject

BCBSTX Small Group Quote

Body

Dear ________,

Attached is the BCBSTX quote for _______. Below is some information you may want to pass on to your client.

Thank you for allowing our agency to provide health insurance quotes for your company.  We’re only providing quotes from Blue Cross Blue Shield of Texas because BCBSTX has the most competitive group rates in the small group market and provides flexibility in designing your benefits package.

There are three attachments to this email:

• Provide information on the attachments included

BCBSTX Plan Highlights:

• You can offer up to 6 plan options to your employees, even if no one enrolls in all of these plans at initial enrollment. Offering multiple plan options does facilitate annual open enrollment for you and your staff.
• You can mix PPO and HMO plans. Employees who want a wider selection of providers and out-of-network benefits can select the PPO. Those who want to pay a lower monthly premium for themselves and their dependents can select the HMO. The BCBSTX Blue Advantage HMO Network has the lowest price point in Texas when compared with other carriers’ plans with similar benefits.
• Within each network type you can offer HSA-compatible plans and copay plans. The HSA plans provide a lower price point and allow employees to pay for eligible expenses with tax-free dollars if they establish and contribute to a Health Savings Account. The copay plans give members copayments for doctor consultations and prescription drugs.

How to read the quote

The first two pages of the BCBSTX quote contain the quoted rates for plans that use the large BCBSTX Blue Choice PPO network (CHC behind the plan name indicates that the plan uses the PPO network). The next two pages are similar plans but they use the BCBSTX Blue Advantage HMO network (ADT behind the plan name indicates the plan uses the HMO network).

The Blue Choice PPO network:

• Allows members to go to any provider in the network without a referral
• Is very large and includes the UTSW hospital system, MD Anderson, etc.
• Includes out-of-network benefits

The Blue Advantage HMO network:

• Is a more narrow network of doctors and hospitals
• Requires the member to select a Primary Care Physician (PCP) and get a referral from the PCP to see a specialist or receive other non-emergency care
• Has no out-of-network benefits

All of the plans quoted are ACA-compliant.  They all provide similar coverage; the main differences are the provider networks and cost sharing (annual deductible, max out-of-pocket, and copays) between the member and BCBSTX.

Contribution and Participation Requirements

Employer contribution is based on a minimum of 50% of the employee only rate of the lowest cost plan being offered. Employees who want to buy up to a higher-cost option would pay the difference in premium between the base plan and the plan option they select.

BCBSTX requires at least 75% of eligible employees who do not have other creditable coverage (like Medicare, individual major medical, or coverage through a spouse) to enroll.

I will call to talk with you about these options.

Attachments

(Be sure to attach a copy of the quote)