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Good afternoon, Independence Blue Cross has announced the 2016 portfolio of individual and family health plans. Please review the information below.
Independence is pleased to introduce our 2016 portfolio of individual and family health plans, which are available for sale starting November 1, 2015. We will continue to offer the full range of plans available in 2015, plus a new, lower-cost version of our popular Keystone Proactive plan, Keystone HMO Silver Proactive Value.
This broad spectrum of innovative and affordable health insurance plans includes all metallic levels and coverage types (including dental, vision, and pharmacy) to meet different customer needs and price points.
What's new for 2016
Introducing Keystone HMO Silver Proactive Value
We are excited to announce the addition of a new plan - Keystone HMO Silver Proactive Value. This plan offers the lowest monthly premium of our popular Silver plans. There is a low Tier 1 deductible, but many services, such as visits to PCPs, specialists and the ER, lab costs, and prescription drugs, are not subject to the deductible, so members will pay only their copay. The Keystone HMO Silver Proactive Value plan is compatible with premium subsidy and cost-sharing reduction plans.
All plans comply with the 2016 Actuarial Value Calculator
This year's portfolio aligns with 2016 Centers for Medicare and Medicaid Services guidelines for coverage by metallic level. In addition, member cost-sharing has been updated where necessary to meet these requirements. As a result of these changes, the Keystone HMO Bronze plan now has one of the most affordable premiums in the region, and many existing Keystone HMO Bronze members will see a decrease in premiums for 2016. Members with Personal Choice® PPO Bronze Reserve may also experience a rate decrease in 2016 as a result of cost-sharing adjustments. All existing members will receive a renewal package that details any cost-sharing changes for 2016.
Change of deductible type for PPO Bronze Reserve
For 2016, the deductible for the Personal Choice® PPO Bronze Reserve plan will change from aggregate to embedded for family coverage. This means that a covered family member only needs to satisfy his or her individual deductible before receiving plan benefits. This deductible will be $6,400 for individual coverage and $12,800 for family coverage for in-network services.
Pediatric coverage for contact lenses
We've added Pediatric coverage for contacts under the embedded vision benefit, which means even more choice and affordability for your customers.
Prescription drug benefit changes
- New specialty drug cost-sharing tier. New for 2016 is the addition of a separate cost-sharing tier for specialty drugs included on all of our consumer plans. Members should check their benefit booklets for full details.
- Brand-name contraceptive coverage. Starting January 1, 2016, Independence will only provide 100% coverage for brand-name contraceptive drugs if no generic alternatives or generic equivalents are available. This may result in increased out-of-pocket costs for members that are currently taking brand-name contraceptive drugs with available generic alternatives.
2016 plans and rates
The following downloadable materials were created to facilitate your discussions between you and your customers as you navigate the 2016 Open Enrollment period:
These rates can be even lower for customers who qualify for a subsidy.
Open Enrollment 2016: Dates to know
We're excited about our 2016 product line, and we're looking forward to helping you meet your customers' needs. Here are some key Open Enrollment dates to keep in mind:
- November 1, 2015 - Open Enrollment begins.
- November 30, 2015 - Current Independence members should be encouraged to submit plan changes by this date, so that they receive their ID cards before their coverage begins on January 1, 2016.
This will also ensure that their December invoice displays the correct premium amount.
- December 15, 2015 - Last day to enroll for health coverage to begin on January 1, 2016.
- January 1, 2016 - First day new coverage can begin.
- January 31, 2016 - Open Enrollment for 2016 ends. Customers who apply by January 31 will have an effective coverage date of March 1.
Sales Materials
We have developed a variety of materials to help your customers better understand our plans and how they can help protect and enhance their health. These materials can be valuable tools to help you and your customers discuss which of our plans best fit their needs and budget. These materials and additional resources will soon be available online at the Broker's Consumer Toolkit website.
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