Small Group Updates

Plan Pairing Restrictions

There will not be any plan pairing restrictions as of Quarter 4, 2019. This will continue throughout 2020.

Deductible changes

• BlueSolutions 100/60 $3,000/$6,000
  • Deductible changed to $3,400/$6,800
• BlueSolutions 100/60 $6,550/$6,750
  • Deductible changed to $6,750/$13,500

Out-of-pocket value changes

• BlueSolutions 100/60 $1,500/$3,000
  • Out-of-pocket limits changed from $4,500/$9,000 to $6,750/$13,500
• VantageBlue 100/80 $4,000/$8,000
  • Out-of-pocket limits changed from $6,350/$12,700 to $5,000/$10,000

Copay changes

• Effective upon a client’s 2020 renewal, the routine and non-routine vision office visits will have the same copay.  Previously, the routine vision copay was higher than the non-routine vision copay. The new copay follows the Specialist copay. This change will impact all VantageBlue plans, as well as one BlueSolutions plan.

Routine/Non-routine

• $50/$20 will now be $20/$20
• $50/$30 will now be $30/$30
• $50/$40 will now be $40/$40
• $55/$40 will now be $40/$40
• $55/$50 will now be $50/$50

2020 Small Group Portfolio – Plan Additions

• Network Blue New England 80/NC $1,000/$2,000
• Network Blue New England 100/NC $4,000/$8,000
• Blue Choice New England 100/80 $4,000/$8,000
• VantageBlue 100/80 $8,150/$16,300

VantageBlue

Free Sick Visit

• Currently, our VantageBlue plans provide members with a free, first sick visit.
• This benefit was introduced a few years ago to encourage members to see their PCPs rather than utilize urgent care and emergency room services.
• We haven’t seen this benefit have the impact we’d hoped for; therefore, this benefit will be removed in 2020 upon renewal.

Acupuncture

• Acupuncture coverage was added to the VantageBlue 100/80 $1,000/$2,000 plan
• All platinum VantageBlue plans also will now include acupuncture coverage.

Large Group Updates

Product Family and Plan Removals

Product Family Drop:

• The BlueCHiP with Flex product family is being withdrawn from the 2020 Large Group Portfolio
• If a client is currently enrolled in this product, they can continue to enroll in their existing plan(s).

Plan Drops:

• HMC2C Coin 83 – 100/80, $1,500 deductible with $15/25/50/100 office visits
• HMC2C Coin 94 – 100/80, $2,000 deductible with $15/25/50/200 office visits
• HMC2C Coin 342 – 100/80, $5,000 deductible with $25/40/50/100 office visits
• HMC2C Coin 52 – 80/60, $1,000 deductible with $25/40/50/150 office visits
• VantageBlue 113 – 100/80, $250 deductible with $25/40/50/150 office visits
• VantageBlue 22 – 100/80, $2,000 deductible with $15/25/50/150 office visits
• BlueSolutions Plan 65 – 100/60, $5,000 deductible with $25/40/50/150 office visits after deductible
• BlueSolutions Plan 69 – 80/60, $3,000 deductible with $25/40/50/150 office visits after deductible

BlueSolutions

• For BlueSolutions Plans 81 and 82 – now plans 83 and 84 respectively – the OOP will be changed from $2,750/$5,400 to $2,800/$5,600
• These changes were made in order to comply with the IRS annual minimum values.

VantageBlue

Free Sick Visit

• Currently, our VantageBlue plans provide members with a free, first sick visit.
• This benefit was introduced a few years ago to encourage members to see their PCPs rather than utilize urgent care and emergency room services.
• We haven’t seen this benefit have the impact we’d hoped for; therefore, this benefit will be removed in 2020 upon renewal.

Network Blue New England

• Network Blue New England 23 – 80/NC $1,000/$2,000 with $30/50/100/200 office visit copays – will be added to the Large Group Portfolio.