December 2017 | Volume 1 What's Inside: Reporting for Covered Members Calendar Year 2017 | ASO Customer Email Release | 1095-B Forms | Fitness Your Way End of Year Offer | Check out the November edition of 360° for Business | Two Networks, One Fierce Collaboration: Valley Advantage EPO | Wellness Credits Reminder | CareConnect Insurance Plan Offer Increases Access to Providers | E&O (Errors and Omissions) Liability Coverage Reporting for Covered Members Calendar Year 2017 The Patient Protection and Affordable Care Act (PPACA) Reporting Responsibilities of Insurers and Employers Health insurance companies and certain employers are required to provide information to members and the IRS that confirms their members have minimum essential coverage (MEC). The chart below details reporting responsibilities based on the size and insured status of employer groups. EMPLOYER INSURED SELF-INSURED SMALL EMPLOYER (On average, fewer than 50 full-time employees, including full-time equivalents) Capital BlueCross sends 1095-B to members Capital BlueCross sends 1094-B and 1095-B to IRS Small employer sends the 1095-B to members Small employer sends 1094-B and 1095-B to IRS LARGE EMPLOYER (On average, more than 50 full-time employees, including full-time equivalents) Capital BlueCross sends 1095-B to members Capital BlueCross sends 1094-B to IRS and 1095-B Large employer sends 1095-C (only Parts I and II) to employees Large employer sends 1094-C and 1095-C to IRS Large employer sends completed 1095-C to members Large employer sends 1094-C and 1095-C to IRS All 1095-B and 1095-C forms must be postmarked by January 31, 2018. IRS forms are available at IRS.gov ASO Customer Email Release Capital BlueCross will provide a list of subscribers and their respective covered dependents for whom each ASO customer provides MEC. The email will be sent via SecureMail to the Group Administrator no later than January 8, 2018. Applicable large employers are required to provide Form 1095-C to all of their full-time employees, even if the applicable large employers do not provide MEC. The information provided by Capital BlueCross will not include these individuals. New enrollees and/or retroactive enrollees added after the spreadsheet is made available to ASO groups will not be reflected on the spreadsheet. If an updated membership and coverage spreadsheet is needed, please contact the group's Account Executive. Capital BlueCross provides only the information for Part III of Form 1095-C. The employer must complete all other sections pertaining to their tax filing, safe harbor, and to whom they provide coverage. Groups can find all needed documentation at IRS.gov. Any information provided to ASO group customers (or others) regarding the mandated reporting requirements is not legal advice or legal opinion and should not be construed as such. It is intended for general purposes only. ASO customers are encouraged to consult a lawyer and/or tax professional concerning their own situation, legal obligations, and any specific legal questions. 1095-B Forms 1095-B forms will be mailed to the following fully insured members: All fully insured group subscribers Off-exchange Individual subscribers On-exchange catastrophic subscribers PersonalBlue subscribers 1095-B forms are only issued to subscribers. If the subscriber is enrolled through a group, the group does not receive copies of their employee's 1095-B forms. Groups do not receive any listings, reports, or any other documentation specific to the 1095-B forms issued to their employees. Duplicate and replacement 1095-B forms can be found on a member's secure account at capbluecross.com. They can click on the "Tax Forms" button, located under "Manage My Information," or contact Customer Service. Updates or corrections If a member identifies on their 1095-B a need for changes, updates, or corrections, they should do one of the following no later than March 16, 2018: If enrolled through an employer, all coverage updates and/or changes should be directed to the employer who should follow established processes to provide Capital BlueCross with updated information If enrolled in an Individual account product that was not purchased on the Federally Facilitated Marketplace (FFM), an updated enrollment application should be submitted to Capital BlueCross. Blank enrollment applications are available at capbluecross.com If enrolled in a catastrophic product that was purchased on the FFM, submit the required updates via the FFM.  An updated 1095-B form will be issued the day after the enrollment update has been processed by Capital BlueCross.  Updated 1095-B forms will only be issued to those subscribers whose 2017 enrollment information has changed. The following enrollment changes will precipitate the issuance of a corrected 1095-B: Members (individuals on insurance plans through subscribers): first name, last name, or middle initial SSN birthdate coverage termination date Subscribers (individual enrolled through his or her employer): first name, last name, or middle initial SSN birthdate Address: street, city, state, zip code, and/or country Employer Tax ID associated with the subscriber's group/employer If a corrected 1095-B should have been issued and it is not received within 10 days of the enrollment update, the member should call the Customer Service number on the back of their member ID card. Applicable large group employers who are fully insured (50 or more employees) will also be sending their covered members additional tax filing information on a Form 1095-C. Fitness Your Way End of Year Offer: Free Enrollment, Locked-in Low Rate! Have a fitness resolution? We just made it better! For the month of December, Capital BlueCross is waiving the Fitness Your Way enrollment fee for members to lock-in the current $25/month rate to join any of the 9,500 participating gyms. That low rate belongs to members for all of 2018. Beginning January 1, the monthly rate increases, so sign up now!  Have your Capital BlueCross member ID Go to Blue365 and search for Fitness Your Way Use promo code FYW25 at checkout Own your fitness resolutions! Check out the November edition of 360° for Business The November issue of 360° for Business was recently released to our group customers. The new information-packed newsletter replaces BenefitFocus. What's inside this month? Saving Money with Tiered Benefits EPIC Hearing Healthcare New Health Assessment for 2018 How the HERO Scorecard Assesses Your Culture of Health And more!  Two Networks, One Fierce Collaboration: Valley Advantage EPO Capital BlueCross and St. Luke's University Health Network have collaborated to created Valley Advantage EPO (Exclusive Provider Organization). Peace of mind and security go hand-in-hand with Valley Advantage EPO: a health plan that combines the high-quality benefits and services of the Capital BlueCross family of companies partnered with the renowned doctors and hospitals in the St. Luke’s University Health Network. With Valley Advantage EPO: No referrals are necessary. Quickly locate over 1,300 network doctors and specialists with the provider finder. Access to a network that works for you. Valley Advantage doctors and hospitals work closely together to deliver coordinated care that helps reduce unnecessary tests. Get care when you need it. Urgent and emergency care are covered anywhere, anytime. You're covered while you travel. With BlueCard, you’re covered when traveling outside Central Pennsylvania and the Lehigh Valley. Learn more at capbluecross.com. Wellness Credits Reminder! Certain ASO groups in the Mid-Market and Large Group segments are eligible for wellness credits as part of their sales and renewal process. January 1, 2018 eligible groups that have completed their wellness credit requirements are reminded that receipts are due to their Capital BlueCross Account Executive by January 15, 2018. CareConnect Insurance Plan Option Increases Access to Providers The CareConnect Gatekeeper PPO insurance plan is now offering members access to more physicians and hospitals than ever before. The CareConnect plan connects Capital BlueCross' high-quality benefits and services with the renowned doctors and facilities of UPMC Pinnacle's growing network. CareConnect PPO is available to fully insured ASO groups headquartered in Dauphin, Cumberland, or Perry counties. The product may be sold as a full replacement or as a multiple-product offering with the group.   Read More   E&O (Errors and Omissions) Liability Coverage January is a great time to renew your E&O liability coverage! Capital BlueCross has partnered with BCS Insurance Company to bring you a program exclusively designed for our appointed agencies and producers. Learn more about this essential coverage here, and apply below!   E&O Liability Coverages   Capital BlueCross is an independent licensee of the BlueCross BlueShield Association serving 21 counties in Central Pennsylvania and the Lehigh Valley. Communications issued by Capital BlueCross in its capacity as administrator of programs. This is an advertisement. 2500 Elmerton Avenue, Harrisburg PA | capbluecross.com | © 2017 Capital BlueCross All Rights Reserved.  Nondiscrimination and Foreign Language Assistance Notice