Grandfathered Plans Expiring December 31, 2017

BCBSNC will no longer offer its grandfathered health plans as of January 1, 2018.  If you have kept your grandfathered plan, you will need to transition to an Affordable Care Act (ACA) plan during open enrollment beginning November 1, 2017.

BCBSNC will attempt to match you to a plan with similar benefits.  Depending on your area, you may find yourself with a limited network moving forward.  In the Charlotte Metro area, there are two networks - Blue Local with Carolina's Healthcare System and Blue Value which includes Novant and other participating providers.  In the Raleigh-Durham area, there are two networks - Blue Local with Duke Health and WakeMed and Blue Value which includes UNC Health Care, REX Healthcare and other participating providers.

You can also expect rate increases which you'll be notified about in writing.  You may be eligible for a subsidy depending on your household size and income.

If you'd like assistance navigating your options, feel free to reach out to me if there is no agent listed on the notices you receive from BCBSNC.

 Schedule a PHONE CALLwith Tara O'Neill

Open Enrollment Ended January 31st

The next open enrollment begins November 1, 2017.  As I receive updates on new legislation, I will keep you posted.

You can still enroll in a BCBSNC_® plan as long as you qualify for a Special Enrollment Period (SEP) due to a Qualifying Life Event (QLE).  Here are a few examples:

• Getting married
• Having a baby, adopting a child or placing a child for adoption or foster care
• Losing other health coverage
• Moving to a new residence
• Gaining citizenship or lawful presence in the US

If you’re not eligible for the special enrollment period, consider enrolling in a short term plan.  Short term plans do not provide minimum essential benefits required by the Affordable Care Act, but many of my clients use this option if they missed open enrollment or if they only need it as a stop gap before their employer coverage begins.  Coverage can begin within 48 hours and there are a number of plans to choose from including ones with copayments to see primary care physicians.

Reminder:  Without an ACA plan, you may have to pay a shared responsibility payment (penalty) when you file your tax returns next year. Please speak with your accountant for further details.

Open Enrollment Ends January 31st

Open Enrollment ends January 31, 2017.  If you haven't already enrolled in a plan for 2017, there is still time.  Without credible coverage, you will be responsible for paying the tax penalty.  You must have your plan for 10 of 12 months in 2017 to avoid paying the penalty.

• New plans chosen by January 15th will have a February 1st start date.
• New plans chosen between January 16th and the 31st will have a March 1st start date.

After January 31st, open enrollment is over and you can only get a plan if you are eligible for a "special enrollment period."

Schedule a call with Tara O’Neill

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It may not be too late for a January 1st start date

If you have a plan that ends 12/31/16 because it is no longer being offered to you, then you are eligible for a Special Enrollment Period which allows for a January 1st start date.  However, we must complete your application before the end of the year.  You will be asked to provide information regarding your existing policy at the time of the application.  If you don't qualify based on the special enrollment period guidelines, we can get you a February 1st start date as long as we apply by January 15th.

Schedule a call with Tara O’Neill

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Pharmacy Update

We received an update this week.

Harris Teeter and Costco are now in network for the limited network plans in North Carolina in 2017.  Blue Select, Blue Value, & Blue Local

Publix is not in network.

Phone Appointment – schedule here

Pharmacy Changes for limited networks in 2017 - WALMART no longer in network

Beginning 2017, if you have a Blue Value, Blue Select, Blue Local- Carolinas Healthcare System or Blue Local - Duke Medicine and WakeMed network plan, you will see several participating pharmacy changes.

• Walgreens will now be in-network.
• CVS will continue to be in-network.  However not if you go to a CVS outside of NC.
• Walmart will be out-of-network.
• Rite-Aid will be out-of-network.
• Harris Teeter will be out-of-network.

Affected existing members will receive a letter in early November advising of the changes.  
And as always, networks are subject to change due to new mergers and other negotiations.

CaroMont Health - Approved Networks in Gaston, Cleveland and Lincoln

BCBSNC_® offers three networks in Gaston, Cleveland and Lincoln Counties. 

• Blue Advantage
• Blue Select
• Blue Local - Carolinas Healthcare System.  (not in network with CaroMont)

If you are in one of these counties and want to go to CaroMont Health and CaroMont Regional Medical Center,  you must be in in the Blue Advantage or Blue Select network.  
While the hospital can't turn you away, if you have Blue Local, you will be out of network with higher out of pocket maximums.

CLICK HERE TO CHECK YOUR NETWORK.

IMPORTANT:  Anyone who had an Aetna or United Healthcare plan through the marketplace (healthcare.gov) will be automatically mapped to Blue Local in 2017.

If you need to make a change or have questions about your options, call me or make an appointment by clicking on the link below.

Schedule a call with Tara O’Neill