June 2024 Insurance Information & News

Horizon BCBSNJ Data Breach Affects Some Members

Horizon BCBSNJ was notified by a vendor, Continuum, of a data breach that occurred in October 2023. An unauthorized party accessed certain member information, including names, addresses, health insurance details, and treatment information. Social Security numbers and financial data were not impacted. Horizon is working with Continuum to address the issue and is notifying affected members.

AmeriHealth Platform Transition: Improved Service for Members

New Member ID cards: You’ll get a new ID card with a unique number. Show this card at your first doctor visit after the transition.

Enhanced member website and mobile app: Expect a more personalized experience with features like “Health Journeys” (care summaries) and virtual care teams. The mobile app is available now, and the website upgrades in June 2024.

IBX Annual Medicare Secondary Payer Collection

Employers with 300 or fewer employees need to update their group size information with Independence Blue Cross by December 31st. This helps determine Medicare coverage for employees. A survey with more info is available online (use CID number from mailing).

PA Incentivizes Coverage of OTC Contraceptives

Pennsylvania is encouraging health insurers to cover new over-the-counter birth control pills. Insurers who don’t cover these pills will face extra scrutiny during the approval process. This aims to make contraception more affordable and accessible for women in the state.

Change on the Horizon for Prescription Drugs and EHBs

The US government is proposing a rule that would require all prescription drugs covered by large group health plans to be treated as essential health benefits. This means that there would be no annual or lifetime dollar limits on these drugs, and the cost of the drugs would count towards the out-of-pocket maximum. Employers with these types of plans may need to make changes to their plans in order to comply with the new rule.

Compliance Corner! PCORI FEE REMINDER

  • PCORI Fee Information:
    • All medical plans owe the PCORI fee based on the number of participants.
    • Insured plans: Carrier pays the fee.
    • Self-funded plans (including HRAs): Employer files Form 720 and pays directly.
  • PCORI Fee Rates:
    • Plan year ending Oct 1, 2022 – Sep 30, 2023: $3.00 per participant
    • Plan year ending Oct 1, 2023 – Sep 30, 2024: $3.22 per participant
  • How to Pay:
    • Form 720 and fees are due July 31st of the year following your plan year.
    • Example: If your plan year ended in 2023, the form and fees are due July 31, 2024.
  • Counting Participants in Multiple Plans:
    • HRA + Insured Plan: Counted separately, disregard dependents in HRA.
    • HRA + Self-insured Plan: Counted together, count all participants (including dependents) once.
    • Multiple HRAs + Insured Plan: Similar to HRA + Insured Plan, may be treated as single plan for HRAs (disregard dependents).
    • ICHRA Plans: Employer pays, may disregard dependents.
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