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Small Group Medical Policy Termination Process
Under the Affordable Care Act, when employers cancel medical coverage, they must provide adequate notice to all covered employees that the group medical policy will terminate on a chosen date. (Applies to fully insured small groups.)
RxDC Fully Insured Average Monthly Premium Data Collection
Last month, we shared our approach to support group customers with Prescription Drug Data Collection (RxDC) reporting for the 2024 reference year. As indicated, fully insured group customers need to provide their average monthly premium data for inclusion in our submission. (Applies to fully insured groups.)
Help your Small Group Clients Request an Account Reinstatement, if Needed
To qualify for reinstatement after missed payments, small group clients must have no more than two delinquency-related cancellations in the past 12 months, submit the request within two months of the cancellation date, and pay all outstanding balances in full. (Applies to fully insured small groups.)
Client One-Time Payment — Help Out When Needed
You can make one-time payments on behalf of active clients in the Retail Producer Portal, offering them flexibility to pay any amount each time. Have your client’s personal and banking information ready to set up the payment (see pages 6–9 of the guide), and use the portal to track payments once set up (pages 10–11). (Applies to Individual Market.)
Keep Track of Policyholders and Download Your Book of Business
Track your policyholders by downloading your book of business directly from the Retail Producer Portal. Log in, go to the Client Info tab under Reporting, select the Book of Business link, enter your nine-digit producer number, filter as needed, and export the Excel file. For step-by-step instructions, see pages 13–14 of the latest Retail Producer Portal Guide. (Applies to Individual Market.)
Share with Your Groups: Importance of Proper Dental Care for Children
February is Children’s Dental Health Month—a perfect time to share BlueCare Dental Wellness resources with clients. The program offers proactive emails and a Dental Wellness Center with tips for kids and pre-teens, reinforcing the importance of early prevention for lifelong oral health. (Applies to all groups.)
Form 1099s Were Mailed by End of January
Here is everything you need to know about Form 1099s from Blue Cross and Blue Shield of Texas.
Reminder: Express Links No Longer Exist
Express Links in the Retail Producer Portal were disabled last November for Individual & Family Markets (under 65) business. To keep your NPN associated with your client’s application, you’ll now need to use the Enhanced Direct Enrollment pathway through the White Label Solution. You’ll also need the White Label Solution’s direct link to send quotes to clients. For off-exchange policies, the Off-Exchange Enrollment Tab on the Retail Producer Portal remains the fastest and easiest way to enroll clients. It is not being replaced by the HealthSherpa White Label Solution off-exchange option, which simply works in addition to the existing Enrollment Tab. We continue to recommend using the Enrollment Tab on RPP for submitting off-exchange applications.
Integrated Supplemental Health and Medical Claims Now Available
As of Jan. 1, medical and supplemental health claims are integrated for groups providing membership data, allowing most qualifying medical events to automatically trigger supplemental claims with member permission for a simpler, more seamless experience. (Applies to all groups.)