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.
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!
If you’re a Native American or an Alaska Native you may have new health coverage benefits and protections in the Marketplace. In South Carolina, the Catawba tribe is a federally recognized tribe, which may entitle members to certain benefits in the health insurance marketplace! SChealthconnector.org is your #1 source for Catawba Native American Obamacare information!
To view marketplace plans CLICK HERE. Upon application, you will be asked to confirm Native American status & cost sharing will be applied. If you would like direct assistance applying, or have other questions regarding Catawba Native American Obamacare information, please call us at 843-882-7062 or email Josh@schealthconnector.org. We are always happy to help!
Some Obamacare benefits are available to members of federally recognized tribes such as the Catawba tribe. Others are available to people of Native American descent or who are otherwise eligible for services from the Indian Health Service, a tribal program, or an urban Indian health program.
Members of federally recognized tribes and ANCSA shareholders can enroll in Marketplace coverage any time of year. There’s no limited enrollment period for these individuals, and they can change plans up to once a month.
Special Marketplace protections and benefits for American Indians and Alaska Natives:
The Health Insurance Marketplace benefits American Indians and Alaska Natives (AI/ANs) by providing opportunities for affordable health coverage.
This coverage can be through a private health plan bought in the Marketplace, Medicaid, or the Children’s Health Insurance Program (CHIP).
Members of a federally recognized tribe and ANCSA Corporation Shareholders
If you buy private Obamacare insurance in the Health Insurance Marketplace and your income is up to around $70,650 for a family of 4 ($88,320 in Alaska), you can enroll in a zero cost sharing plan. This means you won’t have to pay out-of-pocket costs like deductibles, copayments, and coinsurance when you get care. If your income is above $70,650 for a family of 4 ($88,320 in Alaska), you can enroll in a limited cost sharing plan and pay no out-of-pocket costs when you get services from an Indian health care provider or from another provider if you have a referral from an Indian health care provider.
You can enroll any time. You can enroll in a Marketplace health insurance plan any month, not just during the yearly Open Enrollment period.
American Indians, Alaska Natives, and others eligible for services from the Indian Health Service, tribal program, or urban Indian health program
You may qualify for Medicaid and CHIP more easily. You have special cost and eligibility rules for Medicaid and the Children’s Health Insurance Program (CHIP) that make it easier to qualify for these programs.
You don’t pay out-of-pocket costs for Indian health programs. Regardless of income, you won’t have any out-of-pocket costs for items or services provided by the Indian Health Service, tribal programs, or urban Indian programs (known as I/T/Us), including Purchased/Referred Care.
If you don’t have health insurance, you won’t have to pay the fee that most other people without health insurance must pay. To get a health coverage exemption from paying the fee, you’ll need to claim the exemption when you file your federal income tax return or fill out an exemption application and mail it to the Marketplace. Learn how to apply for this exemption.
Indian Health Services and Marketplace insurance
If you enroll in a private Obamacare health insurance plan through the Health Insurance Marketplace:
You can get (or keep getting) services from the Indian Health Service, tribal health programs, or urban Indian health programs.
You can also get services from any providers on the Marketplace plan.
By enrolling in health coverage through the Marketplace, Medicaid, or CHIP, you have better access to services that the Indian Health Service, tribal programs, or urban Indian programs (known as I/T/Us) may not provide.
If you enroll in a Marketplace health plan, Medicaid, or CHIP, you can keep getting services from your I/T/U the same way you do now. When you get services from an I/T/U, the I/T/U can bill your insurance program. This benefits the tribal community, allowing I/T/Us to provide more services to others!
Today, November 6, 2014, marks the first day that insurance companies are allowed by CMS to market plans for 2015!
First out of the gate today is Bluechoice Healthplan of South Carolina, who just sent us plan brochures for the 2015 plan year. For 2015, Bluechoice has renamed its product line – all individual plans will now be sold under the “Blue Options” name. We hope this will help prevent confusion, as we have encountered many situations where providers thought that clients on individual Bluechoice health plans were covered by the Bluechoice Medicaid plan.
Why choose Bluechoice SC 2015 health plans?
BlueChoice HealthPlan offers Blue Option to individuals and families seeking health coverage in South Carolina. BlueChoice HealthPlan has more than 30 years of experience providing security to South Carolinians. Bluechoice’s service, value and quality are evident in all Blue Option plans.
– 23 Plan designs to fit your budget: 4 Gold, 12 Silver, 6 Bronze plans and 1 Catastrophic plan available to SC residents.
– Expanded statewide doctor and hospital network
– Vision and dental coverage included for all
– 24/7 phone access to doctors and nurses
– Nationally recognized health plan for service and member satisfaction
– Life management services including legal, financial and self-help
Click the link below to view Bluechoice South Carolina 2015 Plans:
Breaking News: SC DOI releases 2015 South Carolina ACA marketplace rates!
The SC Department of Insurance on Friday, October 17, 2014 released sample rates for health insurance plans available on the Health Insurance Marketplace for 2015. The sample 2015 South Carolina ACA marketplace rates were for a 40 year old South Carolina resident and rates were given for 5 major metro areas in South Carolina: Charleston, Horry, Greenville, Richland, and York counties. Sample rates were also provided for both smokers and non-smokers, as the Affordable Care Act does allow insurance companies to charge more for tobacco use.
Open enrollment for 2015 SC Health Plans begins November 15, 2014!
Although we do not yet have a complete set of rates for 2015 South Carolina marketplace plans, the sample information provided by the South Carolina DOI provides a number of insights into what we may see for the 2015 Open Enrollment, beginning November 15, 2014. Let’s break it down by insurer:
Blue Cross Blue Shield of South Carolina
For 2015, it looks like BCBS marketplace rates will actually be LOWER in 2015 for certain regions, notably the coastal areas and the midlands. For example, in Charleston county, the average BCBS Silver plan price for 2015 is $294.88 versus an average 2014 price of $318.10 for a silver plan in Charleston county. This is great news, especially in light of the recent network expansion announcement by BCBS-SC. Last week, we broke a story that Roper St. Francis healthcare system will be in network for marketplace plans in 2015. CLICK HERE for details on the BCBS network expansion. In addition, we have been informed that pediatric dental coverage will not be included in BCBS marketplace plans for 2015 – similar to other marketplace carriers. Eliminating this benefit (you can still buy a standalone pediatric dental policy on the marketplace) makes the Blue companies much more competitive for 2015!
Bluechoice of South Carolina
Similar to BCBS, for 2015 it appears that Bluechoice marketplace rates will actually be LOWER in 2015 for certain regions, notable the coastal areas and the midlands. Rates in Greenville, as illustrated by the SCDOI, look to be flat to slightly lower for most plans in 2015. For example, in Richland county, the average Bluechoice Silver plan price for 2015 is $314.60 versus an average 2014 price of $336.65. This is great news, especially in light of the recent network expansion announcement by Bluechoice. Last week, we broke a story that Roper St. Francis healthcare system will be in network for Bluecross marketplace plans in 2015 – we expect the same in network treatment for Bluechoice, as the 2 insurers essentially share the same network. CLICK HERE for details on the Bluechoice network expansion. Similar to BCBS, Bluechoice will also eliminate the pediatric dental benefit for on exchange policies for 2015, according to our sources.
Consumers Choice Health Plan
Consumers Choice Health Plan was the overall winner for market share for the 2014 open enrollment in South Carolina, so we have been anxious to see what 2015 would look like. For 2014, CCHP was the low price leader in the majority (though certainly not all) South Carolina counties. In the few counties where CCHP was not the low price leader in 2014, we expect CCHP to be the low price leader for 2015, as they have made some network changes in rural areas that should significantly reduce their premiums. Most notably, Newberry county is one of the areas we expect to be affected by an overall price decrease for 2015. Overall, it appears CCHP is getting a slight increase in rates for 2015. Also, it appears CCHP will retain top position as the low price leader among silver plans for the 5 metro area samples provided. It is important to note, however, that rates are getting very close in the upstate among CCHP, Bluecross, Bluechoice and Coventry. In Greenville county for 2015, there is only a $2 difference in price between CCHP and Bluechoice! Hooray for competition!
Coventry Health Care of the Carolinas, Inc.
Although not available in all South Carolina counties for 2014, Coventry enrolled a respectable number of South Carolinians due to having access to both MUSC and Roper St. Francis for 2014 marketplace plans using a tiered network model. For 2015, we noticed a few interesting points for Coventry. First, it appears that Coventry is getting a rate increase across the board for 2015, though the amount of increase varies across plans. It appears in most areas, Bronze plans were least affected by increases. It appears Coventry’s Gold plans were hit with an increase of approximately 10% in most areas. Second, it appears Coventry is expanding their Silver plan options from 1 plan in 2014 to 2 plans in 2015. We hope to have more information about this new plan offering by next week, and will update with the latest. Finally, it appears that Coventry will be newly offering plans on the marketplace in York, Lancaster, and Newberry counties for 2015! It is currently rumored that Carolinas Medical Center will be the preferred network provider for the new marketplace product in York & Lancaster.
Time Insurance – Assurant Health
Last, but certainly not least, is Assurant Health, marketed by Time Insurance. Assurant will be a new entrant into the marketplace for 2014 in South Carolina. As the 2015 South Carolina ACA marketplace rates released by the SCDOI indicate, Assurant will be the highest priced option available on the marketplace for 2015. However, we must note, that Assurant will be the ONLY plan available with a broad, quality PPO network on the marketplace. In addition, Assurant will be the only company offering Platinum plans on the marketplace in South Carolina for 2015! Assurant will be a great option for SC residents who demand a wide PPO network (Aetna Signature network), out of network benefits and an open formulary!
If you have questions about anything mentioned above, leave a comment, call or email us!
On November 15th, 2014, South Carolina residents can visit our homepage, click “enroll now” and view 2015 South Carolina ACA marketplace rates, apply for tax credits and enroll quickly!
UPDATE: October 25, 2014 – South Carolina Department has released additional sample rate data for ages 25 and 60!
COMPANIES PARTICIPATING IN TRANSITIONAL RELIEF
In November 2013, a temporary reprieve was announced to permit the renewal of non-grandfathered health insurance plans that would otherwise be modified or terminated as a result of the 2014 market reforms provided for in the Patient Protection and
Affordable Care Act. The South Carolina Department of Insurance worked with carriers to prevent further market disruption and provide guidance to issuers interested in participating in this transitional relief policy.
As a result of this action, 11 carriers with non-grandfathered policies covering 143,000 individuals in South Carolina elected to participate in transitional relief. Below is a
listing of companies (including phone numbers for consumer inquiries) that have elected to participate in the transitional relief plan and, thus, will offer individual and/or small group policyholders the opportunity to renew their non-grandfathered health
plan for an additional year. Pursuant to federal requirements, this offer is only applicable to non-grandfathered health plans that were in effect as of October 1, 2013 and that are renewed between January 1 and October 1, 2014.
Tips for Consumers: Participating carriers are required to provide notice to policyholders of the opportunity to renew their coverage under this transitional policy, so consumers should expect to hear directly from their carrier if they are offering renewal
of non-grandfathered plans.
Consumers are encouraged to contact their carrier with questions regarding whether they may continue their existing coverage. The Department’s Office of Consumer Services may be reached at 1 (800) 768-3467 for
COMPANY NAME, CONTACT INFORMATION MARKET SEGMENT(S)
BlueCross BlueShield of South Carolina Individual & Small Group
For Individuals: For Small Groups:
1 (800) 868-2500 ext. 46401 1 (800) 868-2500 ext. 41010
BlueChoice Health Plan of South Carolina Individual & Small Group
1 (866) 280-0766
Connecticut General Life Insurance Company* Individual
1 (877) 345-6756
Golden Rule Insurance Company* Individual
1 (800) 657-8205
Humana Insurance Company* Individual
1 (877) 222-0650
John Alden Life Insurance Company Small Group
1 (800) 328-4316
Mid-West National Life Insurance Company Individual
1 (800) 527-5504
The MEGA Life and Health Insurance Company Individual
1 (800) 527-5504
Time Insurance Company Small Group
1 (800) 328-4316
UnitedHealthcare Insurance Company Small Group
1 (888) 842-4571
UnitedHealthcare Insurance Company of the River Valley
Today we begin the first in a series of videos designed to help you get started with the enrollment process at www.healthcare.gov. Today’s video will show you the process used to create your account at healthcare.gov. Check it out below:
As your #1 South Carolina Obamacare Agent we are committed to helping South Carolina residents find the best, most affordable coverage for your unique situation. As a licensed health insurance agent/broker for over 10 years, we have the experience needed to help you make the right decision. Many South Carolina residents will qualify for lower costs on their health insurance premiums through healthcare.gov. The first step to finding your health insurance coverage for 2014 is to create an account at healthcare.gov. Not sure which plan to choose? Contact us today, and we can help you determine if you may qualify for a health insurance tax credit to lower your costs!
Why create your account at healthcare.gov?
By creating your account at healthcare.gov, you are just minutes away from determining if you qualify for a premium tax credit to reduce you health insurance costs. Many South Carolina residents who apply through healthcare.gov may also qualify for cost sharing subsidies. These tax credits and cost sharing reductions are only available for health insurance plans purchased through healthcare.gov. We can help you with the process! Get started today by watching our video and create your healthcare.gov account!
Is it safe to create your account at healthcare.gov?
After the SC Department of Revenue breach in 2012, it is understandable that many SC residents are wary of their online privacy. While many people are worried about the security of their information at healthcare.gov, we would like to point out that identity theft happens all over the internet. If you use popular services such as Facebook, Google, or online banking, chances are your information is already readily available on the internet. We recommend everyone who uses the internet on a daily basis be wary of their personal information safeguards, use strong passwords, clear your browser cache regularly and use 2-step authentication where possible. As an online health insurance agent, I use a variety of security methods such as encryption, 2 step authentication, virus protection and strong passwords to ensure HIPPA compliance and my own personal data security.
Great news! We have recently learned that the Coventry health plans offered through the Federal Marketplace in Charleston, Berkeley & Dorchester counties now have the Medical University of South Carolina contracted in the Tier 1 network! We confirmed this earlier in the week with our Coventry sales representative. But don’t take our word for it! Check out the screenshot below of a Tier 1 network hospital search from the Coventry website. The Post & Courier recently reported that Coventry had an exclusive contract with Roper St. Francis, however, made no men.tion of MUSC participating in the Tier 1 network. As your #1 South Carolina Obamacare agent, we work hard to bring you the most up to date information during the 2014 open enrollment season!
If you found this, or any other information on the site helpful, please feel free to choose us as your agent during your healthcare.gov enrollment. When filling out your application online, you can add me as your agent in Section 3, titled “Help Applying for Coverage” – select Agent/Broker and enter the following information: Name: Joshua Dickerson, NPN: 7889453, FFM ID: jtdickerson. As your agent we can coordinate with your insurer of choice to insure that your enrollment application is complete and processed correctly. We are licensed and appointed with all insurers on the federal exchange/marketplace in South Carolina. Need help applying on the Federal Marketplace? We can help! Contact us today to schedule a virtual meeting where we can get you logged into healthcare.gov and assist with your enrollment from the comfort of your own home. Our agency uses join.me to create secure virtual meetings to assist South Carolina residents applying on the federal marketplace. Why wait? The marketplace is NOW WORKING for most applicants!!!!
10/03/2015 – We can now confirm that there will be at least one South Carolina Platinum plan offered in EVERY South Carolina county for 2015 on the Health Insurance Marketplace. According to our sources, this will be a PPO based product offered by Assurant. This means that SC residents will now be able to use tax credits to purchase a Platinum level plan
SC Platinum Plan Quote
through the health insurance marketplce. Our private exchange, which opens on November 15, 2014, will allow customers to apply for tax credits, compare prices and plans, and enroll (in a Platinum plan, if you wish!) in less than 15 minutes!
Stay tuned for more updates. In the meantime, you can find more information about South Carolina Platinum plans in our original article below:
Have you seen the new 2015 South Carolina Platinum Plans? I have heard repeated numerous times in the news and in print, that “Insurance companies are not offering any Platinum plans in South Carolina.”I would like to take a moment to say that THERE ARE, IN FACT SOUTH CAROLINA PLATINUM PLANS OFFERED IN 2014!
Of course, there is a catch – these South Carolina Platinum plans are only offered off of the exchange/marketplace.
What does “off marketplace” mean? Keep reading to find out!
What is a South Carolina Platinum Plan?
Platinum plans, as defined by the Affordable Care Act (ACA, or as some say, “Obamacare”) are health insurance plans that have an actuarial value of 90%. In general, Platinum plans have higher monthly premiums, but lower out of pocket costs. For this reason, South Carolina Platinum plans are more suited to people who expect to go to the doctor often, have regular monthly prescriptions, or expect to have other substantial medical expenditures throughout the year.
Off-Exchange/Marketplace Health Plans
Off exchange plans are plans that are offered outside of the Federal Health Insurance Marketplace. These plans, starting January 1, 2014, must comply with all of the laws that apply to health plans offered on the Federal Exchange/Marketplace at www.healthcare.gov. Just like plans on the marketplace, qualified health plans purchased outside of the federal marketplace must still cover the 10 essential health benefits as defined by the healthcare reform law. The biggest difference to YOU, the consumer? Anyone who purchases an off-exchange plan cannot qualify for Federal subsidies to offset health insurance premiums. Generally, most South Carolina individuals and families making between 100% and 400% of the Federal Poverty level may be eligible for premium assistance through the Federal Exchange. I personally believe, that in certain situations, many South Carolina residents who are eligible for a subsidy, may be better off forgoing the subsidy and buying an off exchange policy. In addition, many off-marketplace plans use more robust provider networks than those found in marketplace plans. Recently, local South Carolina Newspapers such as the Post & Courier and The State Newspaper published articles about the limited networks for many health plans available on the Federal Marketplace. This is why we recommend working with a South Carolina Obamacare agent to be sure that you choose the plan that best suits YOUR unique needs.
Who offers South Carolina Platinum Plans?
Of course, as a full service Health Insurance Agency we offer South Carolina Platinum plans through through Assurant Health. Assurant Health offers 2 South Carolina Platinum Plans: CoreMed Platinum 1 and CoreMed Platinum 2. Each of these plans allows the enrollee to select either the CIGNA PPO Network or the Aetna Signature Administrators Network. For benefit summaries for each of the two South Carolina Platinum Plans, click the links below:
Who is Assurant? Great question. Assurant traces its roots to the founding of the LaCrosse Mutual Aid Association established in LaCrosse, Wisconsin in 1892, formed to provide consumers with disability insurance. Assurant Health now provides quality health care insurance products to customers with an emphasis on individuals who need coverage but are not part of a larger group plan. With a 120-year legacy, the business offers affordable health care products including major medical, supplemental and fixed-benefit plans for individuals, families and small employers. Financial ratings information for Assurant’s various companies can be viewed HERE.
Who should consider a South Carolina Platinum Plan?
Anyone who visits the doctor often, takes many prescriptions, or otherwise has high anticipated medical costs. Our analysis indicates that South Carolina residents under the age of 50 may see the most value in a South Carolina Platinum plan in 2014. In our analysis, many residents with high medical costs were better off paying higher Platinum plan premiums in exchange for much lower out of pocket costs. Please contact us today to help determine if you may be a good candidate for a South Carolina Platinum plan. We can HELP!
Update – 10/28/2013
We really enjoyed this article from the New York Times, especially as it relates to South Carolina Platinum plans :
WITH so much attention being paid to the troubled debut of the Obama administration’s health insurance exchanges, another alternative has largely gone unnoticed: unless you live in Washington, D.C., or Vermont, you can also buy insurance outside the exchanges — by going directly to insurance brokers, agents or company Web sites. Read More Here
Update – 11/12/2013
Platinum plans are 2nd most popular plans on the Kentucky Health Insurance Marketplace!
Young female with pricey tastes: Kentucky Obamacare numbers
If Obamacare data were a horse race, Kentucky would be leading the pack.
Kentucky has released in-depth, demographically detailed information about enrollments in its state-run Obamacare marketplace, setting a high bar for federal authorities to beat when they finally release their own enrollment data from HealthCare.gov later this week for the first time. Read More…
Last weekend a new link/page was added to www.healthcare.gov. This link is titled “See Plans Now” (see image below – you can click to enlarge). This new feature claimed to let users view plans and rates in their area.
Unfortunately, the information provided via this tool is incorrect for nearly all users. Why, you ask? Because the healthcare.gov rate calculator does not estimate rates based on your exact age. Instead, the it simply asks if you are older/younger than age 49.
In the next image, you can see that when you choose to “”See Plans Now” you are simply asked if you are “49 or younger” or “50 or older”. Not exactly a great baseline for calculating health plan rates.
For this exercise, I chose Charleston County, SC as my area of residence, and selected “Age 49 or younger”. Of course, I am 35 years old, and my exchange application is still being delayed for Identity verification (2 weeks and counting). So it seems reasonable that I may want to browse rates on the federal exchange while my Identity Verification is processing. Of course, after completing the required information about myself and my family status, I was given a list of every plan available in Charleston county, SC. Unfortunately, the rates given were much lower than what my ACTUAL rates are, based on my South Carolina Health Exchange Rates quote engine! See the image below for the rates I was given:
As you can see, the healthcare.gov plan finder tool gave me estimated rates of $230.27 for the CoventryOne Silver $10 Copay Roper St Francis Plan.
Actual Results: Real numbers from SChealthconnector.org
So after viewing the rates over at healthcare.gov, I proceeded to run quotes for myself here on the schealthconnector.org South Carolina Health Exchange Rates page. As expected, my ACTUAL premium was much higher than that given by healthcare.gov $268.50 (See image below – click to enlarge). IN the age of Google, Amazon & Ebay, it seems obvious that transparency should be the #1 priority for a consumer website – hopefully our government can do much better- and SOON!