Connect with Capital, November 2018, vol. 1

November 2018 | Volume 1

What's Inside:
2019 Schedule of Preventive Care Services | 2019 Underwriting Compliance Guidelines | New for 2019: EAP Offering for Small Groups | Change in BenefitWallet’s PATRIOT Act Screening Process | A Better 360° for Business Experience

2019 Schedule of Preventive Care Services

A 2019 preventive care services reference guide is available. The guide is not intended to be a complete list of covered services. Groups and members should refer to their contract and Certificate of Coverage for specific benefit information. Members can also contact Customer Service using the phone number printed on the back of their member ID card.

2019 Underwriting Compliance Guidelines

The Underwriting Compliance Guidelines for 2019 commercial group business are now available. Updates include:

Clarification that Act 4 dependents are not eligible for dental or vision coverage
Electronic signatures are permitted when legible authentication validation information is also provided for the group application, member application, and waiver form
Groups should consult with their tax professional to determine their eligibility to combine multiple entities for the purpose of applying for healthcare coverage; the group will self-attest to their eligibility rather than have Underwriting perform compliance review of tax documents to assess their eligibility
Paperwork due dates and email addresses for group submissions have been revised for 2019
Participation rules no longer require Small and Mid-Market groups to meet 25 percent residency in the Capital BlueCross service area*
Small Business ASO is available to groups with at least five enrolled contracts
The one-month premium deposit requirement also includes ancillary-only groups that are adding medical coverage as a new product offering

*All HMO subscribers must reside within our service area (30-mile border leniency is applied).

New for 2019: EAP Offering for Small Groups (1-50)

Effective January 1, 2019, fully insured Small groups can offer an employee assistance program (EAP) at no cost to them or their employees.* Employers just have to contact the EAP provider to complete the program’s setup process. After that, eligible employees can call the EAP directly to get the assistance they need. We’ll provide more information about the service later this month.

*This service is only available to employees and their dependents with Capital BlueCross medical coverage. Those with Senior℠ are ineligible; however, any dependents with non-Senior medical coverage can participate.

Change in BenefitWallet’s® PATRIOT Act Screening Process

As a result of the 2001 Federal PATRIOT Act, all HSAs are subject to a screening process to verify the member's eligibility. Benefitwallet handles the screening for our members, protecting the member by ensuring their identity cannot be used for criminal purposes. They reach out to Capital BlueCross when a member fails to respond to the request for documentation.

Currently, members are permitted to open their HSAs before the screening is done. If the member fails the screening, resulting in closing their account, the funds are mailed back to the member.

Effective November 29, 2019, BenefitWallet will not open an HSA for an individual member until after the screening is passed. For the vast majority, the screening is an automated process that goes quickly. For the small percentage of members who need to provide documentation, they must wait until the documentation is received and they pass the screening.

BenefitWallet will be notifying our HSA groups of this upcoming change soon.

BenefitWallet® is an independent company whose products and services are not BlueCross products and services. BenefitWallet is solely responsible for these products and services.

A Better 360° for Business Experience

For a better reading experience, you will now get 360° for Business delivered to your inbox! Direct access will help you stay on top of the information-packed monthly newsletter we send to employer groups. Enjoy!

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