blue cross blue shield tobacco surcharge

Plans have flexibility to determine how to provide the portion of the reward corresponding to the period before an alternative was satisfied (e.g., payment for the retroactive period or pro rata over the remainder of the year), as long as the method is reasonable and the individual receives the full amount of the reward. %PDF-1.4 % Private Health Insurance Plans, How to Choose Between Major Medical Insurance and a High-Deductible Health Plan, Here Are Free or Discounted Healthcare Options If Youre Underinsured, Special Enrollment Periods and Qualifying Life Events, Lost Your Medicaid? Family size: Each person has their own premiums. Frequently Asked Questions | Blue Cross Blue Shield Home Learn Frequently Asked Questions Looking to find answers to your billing, claim forms, and other questions? return 'medicare'; This decision was controversial: Some believe that it's only fair for tobacco users to pay more for their health coverage, given the toll that tobacco use takes on a person's health and the added costs to treat tobacco-related health conditions. Tobacco users can be charged up to 50% more than people who don't use tobacco. Tobacco Surcharges - Legal Rules Employers may consider implementing a smoking cessation program to encourage their employees to stop smoking or using tobacco products. Local, state, and federal government websites often end in .gov. There are issues these companies should examine before doing so. Everything You Need to Know About Your Breastfeeding Health Insurance Benefits, Top Individual Health Insurance Companies, Mapped, Three in Ten Say Life Will Never Return to Normal: Survey, 4 in 10 Enrollees Would Go Uninsured Without Obamacare: Survey. If you have doubts, contact your health insurance company and discuss your e-cigarette habits. Please enable Cookies and reload the page. If you are at an office or shared network, you can ask the network administrator to run a scan across the network looking for misconfigured or infected devices. 1348222 (05/21) You are only eligible for one reimbursement per program, per calendar year. 97 0 obj <> endobj Samara Lorenz, Director, Oversight Group. You wont have to pay any out-of-pocket costs for most smoking cessation programs, which can include counseling, a prescription cessation medication, and replacement therapies. Louise Norris has been a licensed health insurance agent since 2003 after graduating magna cum laude from Colorado State with a BS in psychology. Will Unvaccinated People Have to Pay More for Health Insurance? Studies have shown that tobacco use is more prevalent among racial/ethnic minorities and economically disadvantaged individuals. rights reserved.BlueCross BlueShield of South Carolina is an independent licensee of the Blue Cross The surcharge is an extra charge on health plan premiums for This includes over-the-counter medications with a prescription from the provider. 0000001252 00000 n These members will be responsible for paying a tobacco surcharge equal to 20 percent of their total monthly premium beginning Jan. 1, 2020. They contend that many smokers begin the habit before they are 18. What is a tobacco surcharge? Access a wealth of healthcare resources and tools with MyBlue. Once you are insured, remember that smoking remains the leading preventable cause of death, so you should consider taking advantage of the free cessation programs that can help protect you and the health of those close to you. The Blue Cross Blue Shield Association is an . 0000013746 00000 n 2023 Obamacare Subsidy Chart and Calculator, ACA Eligibility Mistakes and Subsidy Repayment, 7 Healthcare Options If You Lose Your Obamacare Subsidy, Marketplace Insurance vs. You can use the Horizon Blue app, too! The estimate was about $89 per month and covered all the preventative care we wanted. if (document.getElementById('inArticle_hc-radio1').checked == true){ function isChecked(){ Giovannelli J, Lucia K, Corlette S. Insurance premium surcharges for smokers may jeopardize access to coverage. ){HDG'-@2@1X -, c`H. Health insurance premiums vary from one zip code to another. Moreover, the time commitment required for the reasonable alternative standard must be reasonable. Despite the deadly dangers of smoking with lung cancer now the No. "Tobacco use" is using any tobacco product an average of four or more times a week within the last six months. Recent DOL lawsuits demonstrate increased enforcement of HIPAA wellness rules. 0000033336 00000 n The cessation program must be reasonably designed to promote health or prevent disease. With that ruling, you can say the old tobacco policies went up in smoke. James received a Master of Library Science degree from Dominican University. Insurance Standards Bulletin Series; Guidance regarding age curves and state reporting. Read the Affordable Care Act. Arkansas limits it to 20%, and Kentucky limits it to 40%. Independence Blue Cross offers products through its subsidiaries Independence Hospital Indemnity Plan, Keystone Health Plan East and QCC Insurance Company, and with Highmark Blue Shield independent licensees of the Blue Cross and Blue Shield Association. Members Must Notify the State Health Benefit Plan (SHBP)When their Tobacco Status Changes:It is a members responsibility to notify SHBP immediately if their answer to the tobacco surcharge question changes during the year. Discrimination under the ADA includes requiring medical examinations and making disability-related inquiries, including medical history inquiries, unless 1 of 2 exceptions applies: (1) such exam or inquiry is job-related and consistent with business necessity; or (2) the medical exam is voluntary and part of an employee health program available at the worksite. Money Saving Health Insurance Tips for Spouses. In some circumstances, an individual may not satisfy the reasonable alternative standard until the end of the year. As for when the lower premium to those who meet the reasonable alternative standard must be available, the plan must provide the lower premium even for the months during which the individual did not meet the reasonable alternative standard. Of course, it is always wise to engage legal counsel to help craft such programs. } Members Currently Not Paying the Tobacco Surcharge:If a member is not currently paying the tobacco surcharge and does not make an active election during Open Enrollment, the current enrollment will default to the new Plan Year and the member will continue to not pay the tobacco surcharge. To learn more, visit our Employers page. The ACA divides wellness program activities into 2 groups: participatory and health-contingent. 0000002022 00000 n James Lacy, MLS, is a fact-checker and researcher. Health Insurance Alabama | Blue Cross and Blue Shield of Alabama During the Public Health Emergency (PHE), over-the-counter (OTC) COVID-19 FDA-authorized test kits are covered for eligible members and will be reimbursed with no member cost share based on the federal guidance. An official website of the State of Georgia. Nearly half of small employers using tobacco surcharges do not provide tobacco cessation wellness programs. Contact your local BlueCross and Blue Shield representative for details regarding claims or coverage. HealthcareInsider.com is a website domain of Healthcare.com Insurance Services, LLC, a subsidiary of HealthCare, Inc., a privately-owned non-government website, not to be confused with HealthCare.gov. Regular prescription drug benefits will apply to smoking and tobacco cessation drugs not meeting these criteria. Although lawmakers who wrote the ACA felt strongly that a person's health status should not be taken into consideration when setting health insurance premiums, they agreed to allow insurers to charge tobacco users higher premiums. Otherwise, contact your Blue Cross and Blue Shield company for assistance. Because inhaler products lack tobacco, e-cigarette users may wonder whether they must identify themselves as smokers when signing up for health insurance. The PAC amount for HIP Plus members is based on household income in one of five tiers below. } else { The protection of your privacy will be governed by the privacy policy of that site. Blue Cross Blue Shield. This blog post is for informational and educational purposes only. Tobacco Surcharge The tobacco surcharge applied to certain employees' health insurance premiums is $80 per month, or $960 per calendar year. For more information, view our privacy policy. Dont do it. By law, all ACA Obamacare health plans cannot reject tobacco users. Do you still have to pay the surcharge if you quit? Louise Norris has been a licensed health insurance agent since 2003 after graduating magna cum laude from Colorado State with a BS in psychology. outlined on page 2. krisanapong detraphiphat / Moment / Getty Image. 0000011077 00000 n If youre not honest about tobacco, you risk being charged with insurance fraud. function isChecked(){ For example, requiring attendance nightly at a one-hour class would be unreasonable. After Frank Lalli, the former editor of Money and George magazines, was diagnosed with Multiple Myeloma, a potentially deadly blood cancer, he turned his experiences with our health care system into becoming The Health Care Detective and the author of Simon & Schusters Your Best Health Care Now. Older people are charged more than younger people, with a cap of three times the rates that apply to a 21-year-old, and smaller premiums for people under the age of 21. } } Members Currently Paying the Tobacco Surcharge:If a member is currently paying the tobacco surcharge and does not make an active election during Open Enrollment, the current enrollment will default to the new Plan Year and the member will continue to pay the tobacco surcharge. Eligible members can obtain tobacco cessation counseling from their primary care providers, as well as at their local CVS MinuteClinic. } Health insurers took in more than $1.25 trillion to cover policies for function isChecked(){ If your nicotine cravings are hard to manage, you can get a prescription from your doctor for your eligible tobacco cessation drugs, including over-the-counter (OTC) products (see the list below). Preventive care benefits for all adults. 0 Created by: Lisa Schroeder. Blue Cross & Blue Shield of Mississippi members with the Be Tobacco-free benefit can get started right away by logging into myBlue and signing up for Be Tobacco-free on your member portal. Employer health benefits survey. Not sure which Blue company you belong to? State specific rating variations. While the states allow insurance companies to drastically increase premiums for smokers, not many states charge the full 50 percent. To motivate employees, these programs often include a tobacco surcharge. Don't have your card? outlined on page 2. Non-Discrimination Statement and Foreign Language AccessCopyright {{ new Date().getFullYear() }} All If they were eligible for the average premium subsidy, their after-subsidy cost would be $372 per month, as opposed to $84 per month if there was no tobacco surcharge (note that these numbers are simply based on national averages; in reality, they vary considerably depending on the person's age and location). Completing the CAPTCHA proves you are a human and gives you temporary access to the web property. Earn Rewards and Avoid the $80 Monthly Tobacco Surcharge on Your Medical Insurance Team members with the Baptist BlueCross BlueShield (BCBS) insurance plan can earn up to $300 in rewards for working toward a healthier lifestyle and avoid an $80 monthly tobacco surcharge on their medical insurance plan. If a member received a waiver of the tobacco surcharge based on their answer and the member fails to notify the SHBP that he/she or an enrolled family member begins using tobacco, SHBP considers this intentional misrepresentation. We are mailing out notification letters to these members this week. You can also view a listing of Blue Cross and Blue Shield companies who participate inMedicare AdvantageandPrescription Drugchoices. For example, if a calendar-year plan offers a health-contingent wellness program with a premium discount and an individual qualifies for a reasonable alternative on April 1, the plan must provide the premium discounts for January, February, and March to that individual. In addition, he has testified twice before the U.S. Congress as an expert witness. The extra money being saved by participation is impossible to pass up given their financial situation. return 'health'; We rely on the most current and reputable sources, which are cited in the text and listed at the bottom of each article. Therefore, if a tobacco cessation program is offered through a group health plan, the ACA incentive maximum of 50% of the total cost of employee coverage applies to those programs. The 1996 New York Health Care Reform Act (NYHCRA) provided for two levies: A surcharge on defined claims for indigent care and health care initiatives; An assessment fee for Graduate Medical Education (GME), based on New York state residency. Insights, information and powerful stories on how Blue Cross Blue Shield companies are leading the way to better healthcare and health for America. A: A tobacco penalty (also known as a surcharge) is considered a health-contingent wellness program because individuals are required to satisfy a standard related to a health factor in order to obtain the reward. If your company aims to reduce tobacco use among employees, one way it may consider doing this is by charging tobacco users more for their health insurance premiums. Use is more prevalent among racial/ethnic minorities and economically disadvantaged individuals details regarding claims or coverage cessation to. 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