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Health Plan Options
June 2018 | Volume 1
What's Inside:
HealthyRewards Redesign in 2019 | New PPO Benefit Encourages Members to Visit Blue Distinction Centers | Connect with Capital Special Alert: Introducing Virtual Care | New Group Termination Request Form | Members Have a Chance to Win a $100 Amazon Gift Card | 360° on Reform | Happening Now at Our Capital Blue Health and Wellness Centers
 
HealthyRewards Redesign in 2019
HealthyRewards is getting a new name and new look! In 2019, the redesigned Healthy Blue Rewards will include a new member portal and features that deliver an enhanced experience. The new program name will apply to all 2019 business effective January 1, so you may see “Healthy Blue Rewards” in RFP responses. We'll share more details soon.
 
New PPO Benefit Encourages Members to Visit Blue Distinction Centers
Help your groups control costs and improve employee health. Capital BlueCross now offers a unique PPO benefit that encourages members to get treatment at Blue Distinction Centers (BDCs). These providers are recognized for their proven history of delivering high-quality care.

Effective July 1, large groups (100+) with custom plans can offer their members a zero or lower-than-normal cost share for care at BDCs that specialize in the following services:
  • Bariatric surgery
  • Knee and hip replacement
  • Spine surgery
  • Transplants (heart, liver, bone marrow, pancreas, and lung)
    • Excludes multiorgan, small bowel, and kidney (there are currently no facilities in our service area with these designations)
Please note: Maternity, cardiac, and cancer care designations are not included in the benefit.
 
Benefit Options
 
Preferred Standard
  • All cost share will be waived (no deductible, 0% coinsurance on BDC/BDC+ facility claims)
  • Normal cost share applies on non-BDC/BDC+ facility claims
 
Other Standard, Option 1
  • Deductible is applied
  • 0% coinsurance on BDC/BDC+ facility claims
  • Normal cost share applies on nonBDC/BDC+ facility claims
 
Other Standard, Option 2
  • Deductible is applied
  • 0% coinsurance on BDC/BDC+ facility claims
  • No coverage for services from nonBDC/BDC+ facilities.
 
Please note: Members will be responsible for their deductible and coinsurance on professional services, which are not covered by the benefit performed at the BDC/BDC+. Please make this point clear when consulting with groups that are interested in the benefit.
 

The regular member cost share will apply to diagnostic care and the professional portion of the claim for the services. Facility services and professional services are billed as two separate claims. Depending on benefit selection, members are responsible for cost share associated with the professional claim and partial cost share for facility services. Professional providers are not tied into the BDC/BDC+ evaluation for these facilities.

The benefit is available for PPO, PPO HRA, and PPO HSA products. The waive deductible option is not available on the PPO HSA product.
The benefit is not available for PPO Choice, PPO Plus, CareConnect, or Valley Advantage EPO.
 
Producers and groups should contact their sales executive to coordinate quote requests for the new benefits options.

If you want to share this information with members, they can visit capbluecross.com to locate BDC/BDC+ providers.
 
Connect with Capital Special Alert: Introducing Virtual Care
As a reminder, Virtual Care is replacing the telehealth app. Members who have used the telehealth service are being redirected to the new app with instructions for registration. The new app can be downloaded and used on June 15. 

See the Special Alert we emailed on May 29. You can also find more details on our Virtual Care flyer.
 
New Group Termination Request Form
An interactive Group Termination Request Form is now available. It replaces the free form letter previously required. Please begin using this updated form immediately.
Group Termination Request Form
 
Members Have a Chance to Win a $100 Amazon Gift Card
Members who register for their secure account at capbluecross.com by June 30 could win a $100 Amazon gift card! (See official rules.)*
 
It’s easy! Ask members to visit capbluecross.com and sign up. Then, whenever they log in, they can:
  • Find doctors and hospitals
  • View their plan documents
  • Check the status of their claims
  • Search health and wellness topics
  • View or request member ID cards
 
If they've already registered, they're already in the running for the $100 Amazon gift card!*
*Terms and conditions apply. See official rules.
 
360° on Reform
A new 360° on Reform was sent to our Sales reps on May 30. See what's happening!
 
Happening Now at Our Capital Blue Health and Wellness Centers
Check out the Capital Blue health and wellness center website for a calendar of events and classes, including descriptions, online registrations, and more!
Saucon Valley
2845 Center Valley Parkway
Center Valley, PA 18034
Hampden Marketplace
4500 Marketplace Way
Enola, PA 17025
 
If you have any questions, please contact your account executive.
Local Heroes Living Fearless - Live Fearless - livefearlesscbc.com
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.
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