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BCNEPA Supporting Efforts to Ensure Consumer Options in New Marketplace

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By: Anthony Matrisciano
November 26, 2013

Special Care Coverage to be Extended for Six Months

Wilkes-Barre, PA— Blue Cross of Northeastern Pennsylvania (BCNEPA) is working to provide customers with information and options in support of the  Pennsylvania Insurance Department’s (PID) announcement today regarding individuals facing policy cancellations due to the requirements of the Affordable Care Act (ACA).  BCNEPA announced today that it would extend coverage for current Special Care members as part of this effort.

In this confusing time, BCNEPA is committed to providing our members with the information necessary to help them make informed decisions about their health care coverage.  The company has been pleased to work with the PID in a coordinated effort to educate those impacted by policy cancellations.

As reported in recent weeks, health insurance plans for certain individuals were to be withdrawn from the market effective January 1, 2014 because they do not meet ACA standards.  The problems with the rollout of the Federally Facilitated Marketplace (FFM), however, led President Obama to announce that states would be permitted to take steps to ensure continued coverage for individuals affected by product withdrawals.

Pursuant to the PID’s announcement, BCNEPA will offer members currently enrolled in its Special Care product the choice to keep their existing coverage until June 30, 2014.  Special Care is a low-cost, limited-benefit policy designed for income-qualified individuals who do not qualify for Medical Assistance or Medicare but find it difficult to afford private insurance coverage.

Many Special Care members may be eligible for federal financial assistance to help them purchase new plans on the FFM.  To help existing Special Care members until they can transition to new ACA-compliant plans on the FFM and access federal financial assistance for which they may be eligible, BCNEPA is offering these members the option to continue their current policy for up to six months.

Although this extension offers Special Care members additional time to select a new plan, BCNEPA encourages them to review the coverage options available on the FFM as soon as possible.  In most cases, these plans offer better coverage at a lower cost due to the subsidies and tax credits available.      

For example, BCNEPA’s metal plans (Platinum, Gold, Silver, Bronze and Catastrophic) available on the FFM offer richer benefits – such as prescription drug coverage, unlimited doctor visits and hospital care – than members have today under Special Care.

Additionally, individuals with income levels below 200 percent of the Federal Poverty Level (FPL) – that is, below $22,980 – who choose a Silver Plan will likely qualify for both a federal premium tax credit and a cost-share subsidy to help pay for their coverage, meaning their monthly costs may be less than what they pay today with Special Care.  

To avoid a future gap in coverage, members who choose to keep their current Special Care plan through June 30, 2014 will need to enroll in a new ACA-compliant health insurance plan by June 15 for coverage to start on July 1.

BCNEPA will be communicating directly with Special Care and other subscribers affected by this announcement to inform them of their options for maintaining coverage into 2014.

About Blue Cross of Northeastern Pennsylvania

Headquartered in Wilkes-Barre, Blue Cross of Northeastern Pennsylvania is an independent licensee of the Blue Cross and Blue Shield Association. BCNEPA offers a comprehensive portfolio of health insurance products and administrative services to nearly 545,000 individuals in 13 counties in northeastern and north central Pennsylvania. The company’s mission is to provide integrated health care services and products to improve the quality, accessibility and affordability of health care in the populations it serves.