March 2015

In This Issue
BlueCard Program Exposes Some NCMS Plan Members to Anthem Breach
ACA Reporting Requirements: Forms 1094 and 1095
What's a Satisfactory Customer Satisfaction Score?
Ask George
Reminder: HSA Administration Change
NCMS Plan Introduces New Dietitian Network
Jason Horay Named Among Top 100 Health Promotion Professionals

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 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 it means.


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 excellent?

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 single time.

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,

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.


Ask George

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.

To 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 issue.

You can e-mail transactions to 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


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, covered 100%.

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.

For 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 Named Among Top 100 Health Promotion Professionals

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 wellness programming.

“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.” said Horay.

“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


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 physicians.

For more information about many other benefits of NCMS membership, visit