Monthly Archives:October 2015

Switching plans resulted in significant savings for Marketplace consumers

28 Oct , 2015,
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Per a CMS news release today, we have learned that for 2015, switching plans resulted in significant savings for Marketplace consumers!Switch Plans South Carolina

Full-year enrollees saved nearly $400 on premiums after tax credits for the same level of coverage in 2015
Health and Human Services Secretary Sylvia M. Burwell announced today the findings of a new report that shows that consumers who reenrolled in the Health Insurance Marketplace last year and who switched to a plan with the same level of coverage saved nearly $33 per month after tax credits, or almost $400 annually, relative to what they would have paid had they remained in the same plan as in 2014. Those who also switched issuers within the same level of coverage were able to save $41 per month, or over $490 annually after tax credits.

Today’s report shows Marketplace consumers were active shoppers last year, with about one third (31 percent) of re-enrollees from 2014 switching to a new plan for 2015.

During Open Enrollment in the Marketplace this coming year, if all consumers switched from their current plan to the lowest-cost premium plan in the same metal level, consumers could save an average of $610 annually before tax credits and the total savings – to consumers and taxpayers (in premiums and tax credits) – would be more than $4 billion. For 2016, more than 8 in 10 current Marketplace enrollees can find a lower premium plan in the same metal level before tax credits by returning to shop. Last year, HHS projected that if all returning consumers who bought a silver plan in 2014 switched to the lowest-cost silver plan in 2015, they would have saved an average of $492 annually. If all returning consumers had switched to the lowest-cost plan within their metal level, across all metal levels, the total savings in premiums would have been over $2 billion before tax credits.

“Our message to returning Marketplace customers is simple: Shopping may save you money,” Burwell said. “Consumers who visited HealthCare.gov last year to comparison shop for the best plan saved almost $400 a year in premiums for the same level of coverage, and we expect people to be able to find similar deals for 2016. Consumers can visit HealthCare.gov today to preview plans in their area before Open Enrollment begins on November 1.”

Today’s findings underscore that the Marketplace offers a competitive insurance market from which consumers can choose affordable health plans based on their specific needs and budget. It also shows that consumers using HealthCare.gov are smart shoppers, who pay close attention to plan costs when making selections.

According to the report, historical estimates of plan switching among enrollees in employer sponsored insurance (2.8 percent), the Federal Employee Health Benefits Program (12 percent) and Medicare Drug Plans (13 percent) are low compared to Marketplace consumers.

Today’s report also finds that more consumers switched issuers than metal level, suggesting they preferred to keep the same level of coverage. Specifically, 57 percent of switchers changed issuers in 2015, while only 38 percent changed metal level.

(Health insurance plans on the Marketplace are classified by metal level, which range from bronze, with the lowest premiums but the highest deductibles and co-pays, to platinum with the highest premiums and lowest deductibles and co-pays.)

HealthCare.gov offers detailed information about each health insurance plan sold in an area, including out-of-pocket costs, customer service and more. Consumers can visit the 2016 health insurance plans and prices tool on HealthCare.gov and use the new total yearly out-of-pocket cost estimator to learn more about their specific costs.

Finally, the report confirms the popularity of silver plans. Among reenrolling consumers with 2014 silver level plans, the majority (91 percent) stayed in silver plans in 2015. Enrollment in silver level plans is much higher than other metal level plans—69 percent of enrollees chose a silver plan in 2014. Silver plans appeal to many consumers because, generally, eligible consumers must enroll in a silver plan in order to apply their cost-sharing reduction (approximately 85 percent of silver enrollees in states using the HealthCare.gov platform received cost-sharing reductions in 2015).

The 10 states with the highest annual savings from switching were: Florida, Texas, North Carolina, New Jersey, Pennsylvania, Wisconsin, Louisiana, Arizona, Indiana and Georgia.

Open Enrollment in the Health Insurance Marketplace starts on November 1, 2015 and runs through January 31, 2016. Sign up by December 15 to have coverage that starts January 1. You can find help by calling SChealthconnector.org offices at 843-882-7062 or by visiting www.SChealthconnector.org

To read today’s report and to see state by state information on consumer choices visit:


Consumers Choice Health Plan to stop offering plans in 2016

22 Oct , 2015,


We were extremely disappointed today to learn that South Carolina residents will no longer have access to Consumers Choice Health Plan on the health insurance marketplace for 2016. Full details from the SC DOI press release below.



Consumers’ Choice Health Insurance Company Agrees to Wind Down Its Operations

COLUMBIA, SC – Consumers’ Choice Health Insurance Company (Consumers’ Choice) has agreed to a voluntary run-off and will not offer health insurance coverage in 2016.
“This was a difficult decision for the insurer and this agency, but this is what is in the best interests of South Carolina consumers and health care providers,” said Ray Farmer, Director of the South Carolina Department of Insurance. “The recent announcement of a risk corridor reimbursement of just 12.6% cast doubt on the collectability of tens of millions of dollars through the federal risk corridor program and led to an unavoidable outcome,” said Jerry Burgess, President and CEO of Consumers’ Choice.

The decision to run off its existing book of business means that Consumers’ Choice will not offer plans for 2016 and any policies that became effective in 2015 will terminate at the end of this year. As a result, approximately 67,000 individuals and small businesses will have to shop for new coverage for 2016 as they will not be able to keep their current coverage. Ultimately, the decision was made to wind down operations because the company’s financial condition could worsen significantly. This decision comes now because it is much easier for consumers to transition
to a new plan effective January 1, 2016 than it would be to move in the middle of a benefit year.
“The South Carolina Department of Insurance will do everything it can to assist South Carolinians through this process,” Farmer said. “In the coming days, weeks and months, Consumers’ Choice will continue to focus all of its efforts on taking care of its members and also working with the South Carolina Department of Insurance as well as the Centers for Medicare & Medicaid Services to help ensure a smooth transition,” added Tim Ervolina, Chairman of the Board of Directors for Consumers’ Choice.

Consumers’ Choice is required to submit a run-off plan to the Department “This should be an orderly runoff of the company’s business. Our expectation is that the company will honor its existing commitments to policyholders and health care providers as a part of winding down its operations. The Department has monitored the financial condition of this insurer very closely since licensure and will continue to do so until this process is complete,” Farmer said.
The Department has compiled an initial list of Frequently Asked Questions for impacted consumers and providers, which are attached to this release and available on the Department’s ACA page.

Consumers’ Choice Health Insurance Company (CCHP) Not Offering Plans in 2016

FAQs & Important Information for Consumers and Providers
1. Why is CCHP closing?
After coordinating with state and federal regulators regarding CCHP’s operations and its long-term sustainability, the decision was made to discontinue offering plans after 2015.

2. How will CCHP closing affect my current insurance coverage?
Current plans will continue uninterrupted through December 31, 2015. Members can continue to use their insurance through that time period and continue to submit claims for all medical expenses that occur through December 31, 2015.

3. Do I need to keep paying CCHP?
Yes. You should continue to pay your insurance premiums through the end of December to have

4. Can I get a replacement policy now?
No, but members will be able to choose a new health insurer for 2016 during the next open
enrollment period, which begins on November 1, 2015 and runs through January 31, 2016.
Consumers should enroll in replacement coverage by December 15, 2015 to have insurance on
January 1, 2016.

5. Where can I get help finding a new policy for 2016?
If you are receiving federal subsidies, you must enroll in a Qualified Health Plan through the Federal Marketplace. You can shop for a new plan by working with an agent, broker, or navigator or by calling the Marketplace at 1-800-318-2596. Plans for 2016 can also be reviewed at
www.healthcare.gov or Additional helpful information is available at the South Carolina Department of Insurance ACA page by clicking here. VIEW PLANS HERE

6. Will my current plan change today?
No, there will be no change in your current plan and CCHP will continue to process claims incurred through December 31, 2015.

7. Can I continue to see my doctors and have my prescriptions filled?
Yes, members can continue to use their insurance as they have all year. The provider network
should remain in place through 2015. When you shop for new coverage for 2016, be sure to check
the network directories for other companies to ensure your doctors and preferred facilities are
members of those networks.

8. What can providers expect?
The provider network should remain in place through 2015 and the company will continue to
process claims.

9. Who should I call if I have questions?
If you have coverage questions, you may contact CCHP at 1-800-580-8736.



What is the Multi-State Plan (MSP) Program? BCBS-SC explains!

15 Oct , 2015,
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What is the Multi-State Plan (MSP) Program? Blue Cross Blue Shield-South Carolina explains!

The Affordable Care Act (ACA) created the MSP, and the U.S. Office of Personnel Management (OPM) administers it. OPM contracts with the Blue Cross and Blue Shield Association (BCBSA) to offer a nationwide network of ACA-compliant qualified health plans. OPM certifies plans, monitors performance, administers external appeals and oversees plan compliance with the ACA.SC MSP plan quote
The ACA created the MSP program to drive competition. MSP options ensure that Americans across the country have access to high-quality health insurance plans with reliable benefits. OPM ensures that these plans have an effective network of providers, a high percentage of spending on health care rather than administrative costs and strong consumer protections.
Other facts about MSP:

MSP coverage became available in the Marketplace in January 2014 through participating Blues plans, including BlueCross BlueShield of South Carolina.
MSP products BlueCross BlueShield of South Carolina offers do NOT have any local network, out-of-area network or benefit differences when compared to all of our other ACA individual metal products sold on and off exchange. All products use the same BlueEssentialsSM network and BlueCard® PPO Basic nationwide network.
OPM is the same agency that administers the health plan for federal government employees, although MSP is completely separate from plans offered to federal employees.

Enrollment in a MSP (Click HERE to See MSP plans)

BlueCross BlueShield of South Carolina offers multi-state plans to individuals in South Carolina through the Federally Facilitated Marketplace (FFM) only. Financial assistance is available to those who qualify. The timing of Open Enrollment for MSP coincides with ACA Open Enrollment each year. We do not offer MSP group coverage.

BlueCross BlueShield of South Carolina offers customers a choice of two MSP health plans: MSP Silver 1 and MSP Gold 1.

MSP plans cover all essential health benefits and other coverage guidelines the ACA and state law require. Enrollment in an MSP is available through www.healthcare.gov.

For More Information

For more information, visit www.opm.gov/healthcare-insurance/multi-state-plan-program/consumer.

Blue Cross Blue Shield South Carolina 2016 health plans

14 Oct , 2015,
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Blue Cross Blue Shield South Carolina 2016 health plan update: BlueEssentials

Earlier this week, the SChealthconnector team got a sneak peak of the NEW Blue Cross Blue Shield South Carolina 2016 health plans, marketed under the BlueEssentials label.

Consumer Choice Health Plan

So far, we have been very impressed with what we have seen! Blue Cross Blue Shield is one of the largest health insurers in the state of South Carolina, and is the only health insurer in South Carolina with an A.M. Best rating of A+ (Superior).

New for 2016: Dental and Vision Coverage on all Plans

All BlueEssentials 2016 plans include dental allowance for adults and children for exams and cleaning:

  • One exam every six months, $27 allowance first visit and $20 on the second visit.
  • One cleaning every six months, $40 allowance for adults over the age of 20, and $31 for a child.

Members are responsible for paying any additional balance for what is not covered. Members will submit a dental reimbursement form to Blue Cross Blue Shield of South Carolina for reimbursement.

Vision Benefits for children and adults, including low copayments on vision examsand discounts on lenses, frames and contacts:

Members Ages 20 and Older

  • One exam per benefit period with a $20 copayment for VSP provider
  • Frames and lenses options covered at a 20% discount
  • Contacts covered at a 20% discount

Members Age 19 or Younger

  • One exam per benefit period with a $25 copayment
  • $50 copayment on eye glasses every year and frames every two years

The vision network includes over 400 providers throughout South Carolina

New for 2016: Wellness Plus

We were extremely excited to find out that all Blue Cross Blue Shield BlueEssentials plans will offer the Wellness Plus benefit for 2016. Wellness Plus covers up to $500 for services not covered under your standard preventative doctor visits. Per BlueCross BlueShield South Carolina, this benefit is designed to help members with services normally considered “preventative” that fall outside of the PPACA prescribed preventative services list.

More competitive rates for 2016

As recently reported by the tireless folks over at ACAsignups.net, the South Carolina Department of Insurance recently released sample 2016 marketplace rates for the SC marketplace and rates for Blue Cross Blue Shield South Carolina 2016 health plans look extremely competitive! According to the data, BlueEssentials Silver plans appear to be the benchmark plan in many South Carolina counties!


Blue Cross South Carolina – Emergency Rx info for members affected by recent floods

8 Oct , 2015,
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Emergency Procedures for Prescription Refills for BCBS SC members

Over the last week, South Carolina has suffered through what many call “the 1000-year flood.” Many have lost homes, personal effects, and in some cases loved ones, to flood waters across the Midlands and our state.

BlueCross BlueShield of SC anticipates that some of our members will need refills for medications they may have lost because of the storm and flooding. BCBS-SC is working with Caremark to implement emergency procedures to help members get replacement medication that was lost or destroyed during the storm. Caremark is an independent company that provides pharmacy benefits management on behalf of BlueCross BlueShield of South Carolina.

Impacted members should call the Customer Service number on the back of their BlueCross ID cards and indicate they have lost a prescription due to the flood emergency. BCBS-SC will grant them a 30-day override on their prescription(s).