Small Group

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.)

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.)

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.)

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.)

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.)

The deadline for Prescription Drug Data Collection (RxDC) Reporting for the 2024 reference year is June 1, 2025. BCBSTX will continue to work with Prime Therapeutics® to support group customers with this No Surprises Act requirement. (Applies to all groups.)

Email solicitation for active and cancelled fully insured groups with 15–250 employees begins this week, while groups without a valid email address will receive a mailed letter instead. (Applies to all groups.)

BCBSTX members can now see how well dentists in the BlueCare DentalSM network score compared to other dentists in their specialty or geographic area with a new rating system through DentaQual. (Applies to all groups.)