What's Inside: Submit paperwork 30 days before effective date to enhance the group and member experience | Who to contact with web-related questions | Group product resources for 2024 | Introducing Reliance Plus for 2024 | Medicare secondary payer status | Pharmacies and onsite flu clinics | Active minds help bodies thrive | RSV vaccine access in retail pharmacies | Please welcome Vicki Doule
Submit paperwork 30 days before effective date to enhance the group and member experience
High volumes can impact processing times. To offer the most positive experience for our customers, we strongly advise that you have group submissions to us a minimum of 30 days before the desired effective date.
The new group paperwork mailbox should be used for submissions only when the YES tool cannot be used (i.e., ancillary-only adding medical), or permission has been given to use other submission methods.
Non-Large groups requesting any group-level information changes as found in Section 1 of the group application, or who are requesting changes to their benefits, should be emailed to the small group paperwork mailbox. Partial terminations should also be sent to this mailbox.
When a group is cancelling all lines of business, use the YES tool. Partial terminations should be sent to the group term request mailbox.
Always include the group name, group number, and nature of the inquiry in the subject line of any email correspondence. Use 'General inquiry' in the subject if it is not group-specific.
Include the who, what, when, where, and why details in the body of your email.
If you do need to call or send a follow-up inquiry, let us know when and how the original request was submitted.
Limit duplicate requests by refraining from sending the same inquiry to multiple departments at Capital.
Always use the most current form available in the Salesforce Partner Community and ascertain that all required fields contain a value. Outdated form versions and incomplete fields will cause processing delays.
Who to contact with web-related questions
Producers who are having technical issues should contact the support center online by clicking 'submit a ticket,' or call 717.541.7200.
If you need to find additional resources or need help navigating our website, reach out to the respective business area for guidance:
Capital Blue Cross will offer an option for all-in-one dental, vision, and hearing coverage for members with our BlueReliance and Security Medicare Supplement plans in 2024. Members will enjoy these benefits with no deductible for just $35 a month.
Dental
$15 copay for routine dental exams/cleaning.
$15 copay for X-rays.
Comprehensive coverage for fillings and simple extractions.
$500 annual allowance for comprehensive dental.
Vision
$20 copay for routine vision exams.
$125 annual allowance for frames or contact lenses.
Coverage for eyeglass lenses every 12 months.
Plus, discounts off the retail balance.
Hearing
$20 copay for routine hearing exam.
$500 annual allowance for prescription hearing aids.
As an insurer, we are required to collect specific information about employer group size according to the Medicare secondary payer (MSP) counting rules on at least an annual basis in order to comply with federal MSP laws.
Capital Blue Cross will mail letters every year to gather employer group size updates.
The first letter is an MSP status form sent in conjunction with group renewal paperwork.
A non-response letter is sent 30 days later when there has been no response.
A final letter is sent 15 days after the group receives the first non-response letter.
Pharmacies and onsite flu clinics
Some Capital Blue Cross participating pharmacies offer onsite flu (influenza) clinics to our group customers. Fully insured and self-insured groups who have coverage for preventive seasonal vaccines as part of their Capital Blue Cross pharmacy benefits can offer onsite flu clinics to their employees.
Capital will not coordinate the onsite flu clinics for our group customers; instead, a group customer can request an onsite flu clinic.
To request an onsite clinic, employer groups will need to:
Contact a participating pharmacy.
Determine if the group will need or want an online scheduling tool.
Provide the pharmacy with a date and time to hold the clinic.
Identify the expected number of participants or employees (a minimum of 30 employees is required but the pharmacy may negotiate for less).
The following are contacts for in-network pharmacies that offer onsite flu clinics:
Keeping our minds active and challenged is a vital component of healthy aging. The Capital Blue Cross Health Promotion and Wellness team offers a health presentation on Healthy Mind Basics that can be scheduled virtually or at a client's worksite. The 30-minute presentation discusses why engaging in regular mental health activities is important to achieve optimum mental wellness and reviews factors that influence mental health and ways to stimulate the mind to remain active. Participants learn about journaling, as well as daily activities to strengthen the brain’s internal connections.
Capital Blue Cross members can access mental health resources, including the self-guided Managing Your Stress and Building Resilience programs, by logging into their Healthy Blue Rewards account or by downloading the AlwaysOn® Wellness app through the App Store (iOS) or Goggle Play (Android).
If your clients are interested in learning more about these opportunities, please email or call a Senior Health Education Consultant for more information.
RSV vaccine access in retail pharmacies
Capital BlueCross members with pharmacy coverage have access to preventive vaccines at in-network retail pharmacies. Eligible members can get the respiratory syncytial virus (RSV) vaccine from their provider or from any in-network pharmacy that offers the vaccine.
Members should contact the pharmacy to confirm they have the vaccine available. The member will present their ID card at the pharmacy to receive a preventive vaccine. Members can refer to their Benefits Booklet (formerly named Certificate of Coverage) for benefit details.
Members may also get preventive vaccines from their primary care physicians using their medical plans.
Please welcome Vicki Doule
Vicki Doule, a familiar face in the Lehigh Valley both professionally and through her community involvement, has rejoined Capital as our Lehigh Valley Executive Lead.
Please welcome her back to the Capital team.
Your producer relations team
Capital Blue Cross has adopted a team approach to support you, as we collaborate to enhance business relationships, foster your growth through education and incentives, and actively support the communities we serve. The Producer Relations team thanks you for your commitment and hard work. Reach out whenever you need them.
If you have any questions about content in this email, please contact your account executive.
Capital Blue Cross is an independent licensee of the Blue Cross Blue Shield Association serving 21 counties in Central Pennsylvania and the Lehigh Valley. Communications issued by Capital Blue Cross in its capacity as administrator of programs.