July 2009

In This Issue

 

2009 NCMS Plan Customer Survey Results

The NCMS Plan conducted its annual Customer Survey in February. Again this year, the response rate was excellent with 30% of participating practices responding. We appreciate the feedback and are happy to report that participating practices continue to have a positive overall feeling towards the NCMS Plan and the service provided.

Below you will find a few key statistics pulled from the survey results demonstrating our commitment to providing the best service and Plan possible:

  • 96% would recommend the NCMS Plan to others. Up from 95% last year.
  • 97% of respondents felt that customer service provided by MMIC Agency, Inc. was good or excellent. Up from 96% last year.
  • 91% of respondents felt that the NCMS Plan was a good value for the money. Up from 88% last year.
  • 93% of respondents were satisfied with the accessibility and responsiveness of their agent. Up from 91% last year.

We are pleased with the results of the survey, but acknowledge there are areas where we can improve. We will continue to work diligently to bring you the best Plan possible. Our efforts will include providing excellent customer service in all areas of the Plan, as well as offering workshops and informational sessions on topics important to you. In fact, this most recent survey asked questions about employee health and wellness education in your practice. We see a significant opportunity to increase education and gain participation in many of the wellness programs that are being offered.

Thank you, again, for your feedback and support. The next NCMS Plan Customer Survey will be conducted in February 2010. We look forward to hearing from you!

Probationary Periods Waived for Re-Hires After Lay-Off

The NCMS Plan is waiving probationary periods for employees re-hired with your practice within 90 days of being laid off. In this situation, the employee will be eligible for coverage effective the date of re-hire. Please note: this guideline does not apply to employees who voluntarily terminate employment. The NCMS Plan is not changing rules regarding pre-existing condition exclusions. If the employee has had a break in coverage greater than 63 days, the employee will still be subject to pre-existing condition exclusions.

This process should be followed to enroll employees re-hired within 90 days of being laid off:

  1. The employee fully completes a new enrollment form (available at www.ncmsplan.com).
  2. The employer of that employee writes Re-Hire from Lay-Off on the top of the employee enrollment form.
  3. The employer ensures that the enrollment form is correctly completed and submits the paper enrollment form to the NCMS Plan's administrator, Blue Cross and Blue Shield of North Carolina (BCBSNC):
    a. Via fax to BCBSNC Enrollment: (919) 765-3564
    b. Via email (by scanning and attaching the form) to ncms@bcbsnc.com

BCBSNC is currently working to add new functionality in the eBenefitsNow tool that will enable employers to apply this new probationary period waiver to their re-hired employees. Until this new functionality in eBenefitsNow is added, employers must submit paper enrollment forms when enrolling a re-hired employee. Follow process outlined above.

If you have any questions about this, please contact George Fanelli, NCMS Plan Account Service Representative, at (919) 878-7561 or george.fanelli@mmicnc.com.

Ask George

Question: An employee recently gave birth to her first child. How much time after the date of birth does she have to add the child to her health insurance?

Answer: Congratulations to your employee on her first child! The employee now has the option of adding her newborn as a dependent under her policy - but must do so within 30 days of the birthdate to be considered "timely" and for the coverage to be effective from date of birth.

Other timely enrollees are those that apply for coverage and/or add dependents within a 30-day period following these qualifying events:

  • Employee or their dependents become eligible for coverage
  • Employee gets married
  • Employee gains a dependent through adoption or foster care placement
  • Employee or dependent loses coverage under another health plan

Since the NCMS Plan does not process enrollments or changes retroactively beyond 30 days, it's always best to submit any transactions concerning dependent coverage within that "timely" 30-day timeframe.

CHIPRA Update

The Children’s Health Insurance Program Reauthorization Act of 2009 (CHIPRA) was signed into law on February 4, 2009. As of April 1, 2009, employer-sponsored health plans, including the NCMS Plan, must provide special enrollment periods if the employee or dependent is covered under Medicaid or CHIP, and loses that coverage because of loss of eligibility. Employees will have to request coverage under the group health plan no later than 60 days after the date of coverage termination under Medicaid or CHIP. The NCMS Plan is prepared to begin accepting employees designated by employers as eligible for special enrollment.

There is a requirement for employers to provide each employee a written notice about the ability to enroll within this new special enrollment period. The NCMS Plan will review summary plan descriptions, applications, and benefit booklets to prepare to make necessary changes to these documents to meet this requirement. The notice requirement goes into effect the first plan year after model notices are issued by the Department of Health and Human Services (DHHS). DHHS has until February 2010 to develop the model notice.

If you have any questions about this, please contact George Fanelli, NCMS Plan Account Service Representative, at (919) 878-7561 or george.fanelli@mmicnc.com.

New Verification of Coverage Feature

NCMS Plan members who are ordering a replacement ID card from the Web can now print a one-page verification of coverage to share with healthcare providers or pharmacists prior to receiving their ID cards.

Members who log into Member Services on bcbsnc.com can access this new feature from the “Request a New Card” link in the “Your Plan” section.

Why provide this feature?

It helps members quickly provide pertinent benefit information to their providers or pharmacists as they wait for their replacement ID cards or if their ID cards are lost or stolen.

Other key points about the Verification of Coverage page:

If a member has updated their dependent status or address information, those changes will not appear on the verification of coverage page until two business days after the changes are made.

The Verification of Coverage page does not replace the ID card and is not a guarantee of benefits. Members should begin using their actual ID cards as soon as they receive them.

Group Benefits Continuation

Did you know that your employees may be eligible to continue their group coverage if their employment ends or if they are no longer eligible for benefits? The following is the second part of a two-part series (first part, CHOICES, February 2009) providing a snapshot of the continuation provisions mandated at the federal and state level. As the employer, you are responsible for understanding these laws and meeting the obligations outlined. For more complete continuation information, visit the U.S. Department of Labor or the North Carolina Department of Insurance.

Part Two: The North Carolina Continuation Law

Under state continuation guidelines, employees (and their dependents) who terminate employment for any reason, or whose hours are reduced, or who lose eligible employee status may continue their health coverage for up to, at most, 18 months. Employers not covered by COBRA (e.g. less than 20 employees) are subject to this state law.

Employees are not eligible under state law if:

  1. The employee is currently eligible for COBRA coverage.
  2. The employee's coverage is terminated because they failed to pay the appropriate contribution.
  3. The employee or their dependent(s) requesting continuation are eligible for another group health plan.
  4. The employee was covered less than three consecutive months prior to termination.

An eligible employee must notify you of their intention to continue coverage and pay the applicable fees before their period of eligibility ends (60 days after the date of termination or loss of eligibility). The state law benefits run concurrently and not in addition to any applicable federal continuation rights. Dental and vision plans are not subject to state continuation guidelines.

COBRA will normally provide better options to employees and dependents. However, the state law is important if an employee was terminated for gross misconduct and thus not eligible for COBRA benefits or the employer is not covered by COBRA (e.g. less than 20 employees).

Questions about state continuation? Contact George Fanelli, NCMS Plan Account Service Representative, at (919) 878-7561 or george.fanelli@mmicnc.com.

About the North Carolina Medical Society

As the largest physician organization in the state, the North Carolina Medical Society (NCMS) is devoted to representing the interests of physicians and protecting the quality of patient care. The NCMS Plan, sponsored by the NCMS, is the only statewide employee benefits plan designed specifically for North Carolina physicians.

For more information about many other benefits of NCMS membership, visit www.ncmedsoc.org.

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