|In This Issue|
||BlueCard Program Exposes Some NCMS Plan Members to
||ACA Reporting Requirements: Forms 1094 and
||What's a Satisfactory Customer Satisfaction
||Reminder: HSA Administration Change|
||NCMS Plan Introduces New Dietitian Network|
||Jason Horay Named Among Top 100 Health Promotion
BlueCard Program Exposes Some NCMS Plan Members to Anthem Breach
On January 29, 2015, Anthem, Inc. (Anthem) discovered that cyber
attackers executed a sophisticated attack to gain unauthorized access to
Anthem's IT system and obtained personal information relating to consumers
who were or are currently covered by Anthem or other independent Blue
Cross and Blue Shield plans that work with Anthem. Anthem believes that
this suspicious activity may have occurred over the course of several
weeks beginning in early December, 2014. As soon as Anthem discovered the
attack, they immediately began working to close the security vulnerability
and contacted the FBI. Anthem has been fully cooperating with the FBI's
investigation. Anthem has also retained Mandiant, one of the world's
leading cybersecurity firms, to assist them in their investigation and to
strengthen the security of their systems.
Though the NCMS Plan and
Blue Cross and Blue Shield of North Carolina (BCBSNC), the NCMS Plan’s
administrator, were not directly attacked, current and former NCMS Plan
members may be impacted. Some members who received healthcare services
through the BlueCard program in any of the areas that Anthem serves over
the last 10 years may be impacted. The Blue Cross and Blue Shield
Association's BlueCard program is a national program that enables members
of the NCMS Plan and BCBSNC to obtain healthcare services while traveling
or living in another Blue Cross and Blue Shield Plan's service area.
The information accessed may have included names, dates of birth,
Social Security numbers, health care ID numbers, home addresses, email
addresses, employment information, including income data. Anthem has no
reason to believe credit card or banking information was compromised, nor
is there evidence at this time that medical information such as claims,
test results, or diagnostic codes, was targeted or obtained.
Anthem is contacting impacted members directly. NCMS Plan
practices are not responsible for either determining who was impacted nor
communicating with impacted members.
Anthem has arranged to have
AllClear ID protect an impacted member’s identity for two (2) years at no
cost to the member. Anthem will individually notify potentially impacted
current and former members with specific information on how to enroll in
free credit monitoring and identity protection services. Anthem will
provide these services to any member who believes he or she may have been
affected. Members can visit AnthemFacts.com or call Anthem at 877-263-7995 to sign
up for credit monitoring and identity repair services. If a member is
interested in the services, they will begin the process by simply checking
a box that says, “I certify that I am a current or former member (from
2004 on) of an affected Anthem plan or other independent Blue Cross and
Blue Shield plan.”
If an employee or former employee reports
receiving a communication from Anthem, we wanted you to know why and what
ACA Reporting Requirements: Forms 1094 and 1095
A requirement of the ACA is that employers report to the IRS and their
enrolled employees information about health coverage provided. This is due
to the individual coverage mandate and the employer shared responsibility
mandate. The reporting requirement begins with tax year 2015 with the
first forms due in early 2016.
NCMS Plan practices are not
fully-insured employers, rather they are employers sponsoring a
self-funded multiple employer welfare arrangement (MEWA). As such,
participating practices are required to file information with the IRS
regarding coverage provided and to furnish statements to covered
individuals regarding their minimum essential coverage. The NCMS Plan is
not responsible for this reporting on behalf of participating practices.
A MEWA should not be confused with a "Multiemployer Plan", a term
that is frequently used in IRS communications regarding ACA reporting
requirements. A multiemployer plan is an employee benefit plan maintained
under one or more collective bargaining agreements to which more than one
employer contributes. These collective bargaining agreements typically
involve one or more local unions that are part of the same national or
international labor union and more than one employer. The NCMS Plan is not
a multiemployer plan.
The forms that a practice would complete are
1) the 1095, which is sent to both the individual on a policy and the IRS,
and 2) the 1094, a cover sheet sent to the IRS that accompanies the 1095s.
Depending on the size of your practice (more than or less than 50
full-time equivalents), you may need to file the B (less than 50) or the C
(more than 50) form. The C form requires more information including the
cost of coverage to the enrolled employee.
The 1094 and 1095 forms
for tax year 2015 have not yet been published by the IRS. However the instructions for the 2014 B forms and the 2014
C forms may serve as an early guide to what is likely to be expected
for 2015. Most NCMS Plan practices (those with less than 50 full-time
equivalents) will complete 1094-B and 1095-B. Though the 1094/95-Bs are
subject to change when 2015 forms are finalized, the coverage your
practice is offering to employees is employer-sponsored coverage (Part I,
Line 8). Since you are reporting self-insured group coverage you will not
complete Part II (Lines 10-15). As the sponsoring employer, you will enter
your practice's name and information in Part III. In Part IV, you will
enter information for each covered individual.
Larger NCMS Plan
practices subject to the employer shared responsibility mandate will
report information about coverage on Form 1095-C. Practices with
third-party payroll services or human resource information systems should
consult their vendors to see if their systems will facilitate this
reporting on your behalf.
The ACA and its reporting requirements
can be confusing and this is only a brief summary. More information
regarding these reporting requirements can be found on the IRS website, but if you have questions, please
contact your NCMS Plan agent or our office at (800) 662-7917.
What's a Satisfactory Customer Satisfaction Score?
Would you be satisfied if 95% of your patients said they would
recommend your practice to others?
Would you be grateful if the
same percent thought the service your practice provided was good or
Tough questions, right? If you say yes to both, you
discount the 5% who would not recommend your practice or did not think the
service was good or excellent. If you say no, you set a possibly
unattainable expectation that you could satisfy every single patient every
These survey statistics are actual scores from the
NCMS Plan's 2015 Customer Survey, a survey we conduct annually. While we
are pleased with the consistency of our high scores in these measures year
after year, it would not matter if the scores were significantly lower
because we know we can always improve what we do for you. We will continue
to focus on the things that make a difference to you; from the
accessibility of our agents and staff to the progressive health promotion
strategies we can bring to your office.
We appreciate your
feedback each year, but please don't wait until our Customer Survey comes
out to provide us your feedback. If you have suggestions or concerns
throughout the year, send me an e-mail, mailto:email@example.com.
What makes our NCMS Plan unique is that it only exists as an
extension of the physician and medical practice community. We are here to
support you and sustain healthy competition in the employee benefit
marketplace for physicians and medical practices.
Question: George, I know it’s March 1, 2015, but we have an employee
that left employment with our practice in October, 2014 and we forgot to
submit the termination notice. Can you terminate their health insurance
back to October 31, 2014?
Answer: We can process termination
for this employee, however, at this point, processing of this termination
will be effective back only to January 31, 2015. NCMS Plan practices are
subject to a 30-day retroactivity limit. This limitation applies to all
benefit transactions, including enrollments and terminations.
avoid situations where the 30-day retroactivity limit would generate an
effective date other than what was wanted or expected, practices should
submit employee enrollments, changes, or terminations as soon as possible.
Practices should also review each monthly billing statement so that any
potential discrepancy can be uncovered and rectified quickly and without
You can e-mail transactions to firstname.lastname@example.org or fax to (919) 765-3564
for processing. If you have questions about the retroactive processing
limit or a specific situation to review, you can always contact me
directly at at (919) 878-7561 or email@example.com.
Reminder: HSA Administration Change
As described in the September 2014 issue of CHOICES, Blue
Cross and Blue Shield of North Carolina (BCBSNC) selected HealthEquity
(HEQ) as their preferred Health Savings Account (HSA) administrator. HEQ
replaces BenefitWallet (BW) and offers a better employer and member
experience with easier enrollment, easier online management, improved
reporting, and anytime/anywhere access.
The transition to HEQ
began with renewals on or after 11/1/14. The transition impacted NCMS Plan
practices renewing 11/1/14 and then at each monthly renewal thereafter
through 10/1/15. A practice can choose to stay with BW after their
transition date, but will automatically transition to HEQ if they do not
indicate otherwise. This transition only impacts NCMS Plan practices
currently using BW as their HSA administrator through BCBSNC. Be sure to
indicate on your renewal selection form whether you will transition to HEQ
or use another HSA administrator like BW.
Leading up to your
practice's transition date, BCBSNC will send eligibility files to HEQ with
member information and initiate the communication process with employees
about their accounts and services. Members will receive a welcome kit with
a debit card within 10 days of account activation. Practice contacts will
also receive an employer welcome kit from HEQ with more information about
how to fund employee accounts and the benefits of HEQ administration.
Since this process cannot begin until you submit your NCMS Plan renewal
paperwork, early submission is important to provide sufficient time for
new HSA setup.
Upon receipt of member HEQ debit cards, do not
immediately destroy existing BW debit cards. Existing individual member BW
HSAs will not transfer automatically to HEQ, so members may still need to
use their BW debit card to access those funds. Members will need to act
independently to either transfer their existing account balance or simply
continue to spend down their BW account until the balance is exhausted,
but will be responsible for any monthly service fees. Accountholders will
receive information on how to transfer balances if they choose to do so.
BCBSNC will send eligibility files only to HEQ after a practice's
transition date, so BW will no longer receive any newly eligible
information for account set up purposes after that time. Practices that
elect to stay with BW will have to manage the new account setup process on
their own working with BW.
Please let your NCMS Plan agent know if
you have questions, or call our office at (800) 662-7917. We want to
ensure that the transition is a smooth one for you and your employees.
NCMS Plan Introduces New Dietitian Network
The NCMS Plan is committed to helping practices realize the benefits of
an effective health promotion program and equipping employees with
multiple strategies to eat, move, and live mindfully. We are pleased to
announce a new effort to further that goal, the NCMS Plan Registered Dietitian Network.
As a NCMS Plan
member practice, you can help employees cut through the noise about
nutrition and provide effective, onsite dietitian services as part of a
comprehensive health promotion program. The NCMS Plan Registered Dietitian Network supports practices by
matching them with a dietitian in their area that can serve their
employees. The selected dietitians have been vetted and have an
affiliation with the NCMS Plan to provide 1:1 and group nutrition
counseling to help employees assess their diet and set attainable goals.
The NCMS Plan covers nutritional counseling visits, which may include
ongoing counseling to assess and adjust dietary intake in order to reach
health or fitness related goals and is considered a Preventive Screening,
Our goal is to continue encouraging these types of
organizational-level changes to increase employee engagement, reaching
beyond just those who are already health conscious. NCMS Plan practices
benefit by continuing to create a healthy work environment that helps
employees make better choices and lead healthier lives.
additional details and to learn how the Registered Dietitian Network can
best fit into a healthy workplace program, please contact Jason Horay
directly at (919) 878-7560 or Jason.Horay@mmicnc.com.
Jason Horay Named Among Top 100 Health Promotion
NCMS Plan Health Promotion Coordinator, Jason Horay was named as one of
the Top 100 Health Promotion Professionals by the Wellness Council of
America (WELCOA) for promoting well-being among NCMS Plan members.
WELCOA’s Top 100 were selected based on peer voting and a judging
panel that reviewed the applications. To qualify, the health professionals
must coordinate ongoing health programs, implement innovative health
solutions, have a vision for the future of the health industry, and serve
as business and community leaders. WELCOA is the largest national
organization for health professionals and sets the standard for workplace
“I’m grateful to receive this recognition
from WELCOA. The NCMS Plan continues to enhance its products and services
to drive wellness, support behavior change, and ultimately allow members
to lead healthier lives. Enhancing the well-being of the medical practice
professionals we serve requires key leadership support, and I have found
that support widespread across the state. My vision is to move beyond the
traditional risk reduction model and focus on the vitality of our members.
As health promotion professionals, we need to take a more holistic
approach and offer solutions that fit with a person’s unique lifestyle.”
“We are proud of the work Jason does on behalf of our
clients and the NCMS Plan. Jason’s passion for wellness compels employers
to recognize the importance of quality health programs and the positive
impact they can have on employee health. We congratulate Jason on this
well-deserved honor by a highly regarded wellness organization,” said MMIC
Agency’s Vice President of Operations, Gary Bossert.
As a member
of the Top 100, Jason will be featured on welcoa.org.
About the North Carolina Medical Society
Established in 1849, the North Carolina Medical Society (NCMS) is
devoted to representing the interests of physicians and protecting the
quality of patient care as the largest physician organization in the
state. The NCMS Plan, sponsored by the NCMS, is the only statewide
employee benefits plan designed specifically for North Carolina
For more information about many other benefits of NCMS
membership, visit http://www.ncmedsoc.org/.