Working with Blue Cross Blue Shield of Texas. Presentation format: Type your question in the GoToMeeting Questions area located in the toolbar on your.

Working with Blue Cross Blue Shield of

Texas

Presentation format:

• Type your question in the GoToMeeting “Questions” area located in the toolbar on your right side of the screen• If time allows, the Moderator will answer the questions verbally at

the end of the presentation• There will not be a live Q&A session• This webinar is being recorded and will be posted 30 minutes after

the presentation at www.TheBrokerageInc.com

Agenda

• Certifications• Submission Deadlines• Understanding Your BCBS Producer Portal• Quoting/Online Submission• Dental Requirements• Estimating Tax Subsidies• Resources

Read your News from the Blues!

Questions

I spoke with a provider yesterday that is in the BCBSTX HMO network, but they are not taking the Advantage HMO network.Therefore when you are online and doing a HMO provider search on BCBS and the provider is indicated to be in the HMO network it may not really be indicating that they will take the HealthCare Reform plans.Therefore if you enroll someone in an HMO network then they will have even more limited network than what is implied on the BCBS website.

ACA Traini

ng

•You ARE required to take the Marketplace Certification if you are working “On Exchange” (helping your clients apply for tax subsidies/cost sharing).•You Are Not required to take the Marketplace Certification if you are working “Off Exchange” (clients are enrolling without tax subsidies/cost sharing).

BCBSTX

Training

• You ARE required to complete the Marketplace Matters training on the BCBS website if you are selling “On or Off Exchange” plans• On Exchange – Complete Option A• Off Exchange – Complete Option B

Completing

• You ARE required to send in training forms to BCBS regardless of which option you are selling.• All certification instructions can be found on our website at www.TheBrokerageInc.com under

Products/Individual Major Medical

• Apps must be submitted no later than 2/15/143/1/2014Effective Dates

• Apps must be submitted between 2/16/14 and 3/15/14

4/1/2014Effective Dates

• Apps must be submitted between 3/16/14 and 3/31/14

5/1/2014Effective Dates

Submission Deadlines

March 31st is the final deadline to submit business until November 15, 2014 for a 1-1-15 effective date (QEP excepted).

Qualifying Events

• He loses minimum essential coverage, including through divorce.• He gains a dependent or becomes a dependent through marriage, birth, adoption or placement for adoption or foster care.• He becomes a citizen, national or lawfully present individual.• He is eligible to enroll but didn’t because of a mistake, misrepresentation or inaction of an officer, employee or agent of the Marketplace.• The plan he enrolled in substantially violated a material provision of its contract with the individual.• He becomes newly eligible for premium tax credits or cost-sharing assistance.• He becomes ineligible for premium tax credits or cost-sharing assistance.• He makes a permanent move and has access to new health plans.• He is a member of an American Indian tribe (American Indians can enroll in a plan or change plans one time each month).• He demonstrates to the Marketplace that he has other extenuating circumstances that qualify him for special enrollment.• When any of these situations happen, he will have 60 days to go to the Marketplace to enroll in a health insurance plan or change plans.

Short Term Major

Medical

Critical Illness

Hospital Indemnity

Accident

Need Answers for After Lock In? Here Are Your Solutions!

Commission

• 6% - Years 1-3• 4% - Years 4 +• Based on full premium, not subsidized premiums

Payment

• BCBS will be releasing commissions for January 1, 2014 effective dates between February 18 – 20th

• Snapshot Bonus Program• On 11/30/13 BCBS take a snapshot of your business for small group and

individual business.• On 5/1/2014 BCBS takes a 2nd snapshot of your business.• The difference between the two snapshots will receive $50 per app up to

$25,000.

Bonus

Agent Assignment Confirmation Form

• Fill out the Agent Assignment on all applications submitted to BCBS to make sure you are recognized as the Agent of Record• Send your forms to

Belynda@TheBrokerageInc.com

Login to www.bcbstx.com

Click on Producer TabEnter your Username and

Password

Now you are at Blue Access for Producers

Understanding Your Producer Portal

Product and Forms

• Product Overviews, Comparison Charts, Dental Information

Marketing and Sales

• Advertising Materials, Compensation Schedules

Training and Administration

• Access the Market Place Matters Training

Other Information

• Legislative Updates• Provider Finder• Commission Statements

Use Your Producer Portal To Access

Online Tools @ BAP

Use your Quote and Enroll button to quote

Off Exchange Applications. You can save and email your

quotes when quoting Off Exchange.

Generate a formal proposal and your

clients can enroll from the email you send.

Individual Tools

Use your Express Link Button when quoting On Exchange Applications. You will need to copy and paste your Express Link into a new internet browser if you are working on the quote. You can also email your Express Link to your client and let them do the work

Individual Tools

Use your Track Application Status button to track applications and find out the status of your clients.

Quoting and Enrollment

On Exchange

When Quoting On The Exchange Be Prepared

• Make sure your clients have all information needed to go to the Marketplace• Names, Birthdates, Household Income, Social Security Numbers• Make sure you have your FFM & NPN numbers to enter in Healthcare.gov.

Consumers Need To Create Their Own Usernames and Passwords

• Agents will be out of compliance if creating for their clients• Make sure your client records their usernames and passwords as they will need

them at a later date.

Eligibility Results

• Make sure your clients either print or save the results letter for future use.

Key Points to Remember

Your Express Link

Put in your client information

If you select yes you will then have the option to either get an estimate or get an

official tax credit amount

If you select yes

This is for an estimate only

Amount of Estimate

If you select yes to get an official tax credit amount

You will need to create an account

You will get this screen to go to the exchange

The Marketplace

First page of the application

You will need to log into your email

account and click the link to confirm

your email

You will now log in

Select what type of coverage you need

Click Next

1st step

Market Place – More Information

• Once identity questions are verified you will be prompted to enter household information and income amount.• After all information is entered the eligibility results will be available

• Open the pdf to view the eligibility results and either save and email or print the letter for your clients. They will need to keep this information for tax purposes.

• Find the Return to Issuers Website button to return to the BCBS website.• After returning to the BCBS website tax subsidies and/or cost sharing

will reduce the premiums and benefits in order for your client to determine which plan to enroll in.

Application Submission

Select your plan

Select a dental option

Page shows plan and premium

First page of the application

Applicant information

Additional Information

Credit card option will take you to a 3rd party vendor

(May charge $9.99 for this service in the future.)

Or you can have the client sent a bill for

the premium

Applicants signatures

There will be a button here that you

will click to submit the application

Checking Status on your Business!

• For Underwriting Status and other New Business forms• Open your web browser and visit www.HSCIL.com • Click on the button labeled "Producer Services".• Click on the button labeled "Register".• Complete the simple form being sure to provide your Tax ID (SSN or EIN) and your BCBS

writing number listed above in this email. Once you have completed the form, click "Continue".

• You will receive a notice stating that you should check your e-mail to validate your account. • Check your email and look for a message. Follow the instructions contained in the email,

clicking the link to validate your account.• After validating your account, you will receive a message stating that "You have successfully

validated your e-mail address and account. Please log in." Click the "log in" link.

Dental Pediatric and Adult

Pediatric dental is required to be offered on all ACA Plans.

Consumers can add a stand alone dental plan from Blue Cross Blue Shield

Dental follows the same open enrollment period as medical

Things to Know about Dental Plans

Estimating Tax Subsidy

Calculating subsidies is very easy!

Use the Kaiser Family Foundation subsidy calculator!

Instant results

Family of 4, $60,000 expected

income in 2014,Subsidies cover 41% of annual

premium

Open the “Notes” when you scroll down this page

Scroll down further for important FAQs

• Providers not accepting plans get name and phone of providers office and send to Belynda@TheBrokerageInc.com

Provider Issues

• EFT• Pay By Mail• Pay in Person• Credit/Debit Card Option• Check By Phone

Premium Payments

• BCBSTX Clients have until 2/28/14 to pay their January and February

Payment Deadlines

• Clients that enrolled directly on the exchange can only make changes by contacting The Marketplace.

HealthCare.gov Enrollment

Things To Know

Important News From The Marketplace

System Maintenance Will Affect Feb. 15 Applications On Feb. 15, the Social Security Administration (SSA) is taking down its website for regularly scheduled systems maintenance activities.

This will affect people applying for coverage on the healthcare.gov site, since eligibility verification with the SSA is part of the application process. Applications for March 1 coverage will need to be submitted before 2 p.m. CT in order to find out if the applicant qualifies at the time of application.

Any applications received after 2 p.m. will be processed beginning on Tuesday, Feb. 18.

Belynda DiciaccioBelynda@TheBrokerageInc.com 469-635-6715

Cristin Hopkin-BishopCristin@TheBrokerageInc.com 469-635-6707

Dana RagsdaleDana@TheBrokerageInc.com 469-635-6746

Melissa Lopez Melissa@TheBrokerageInc.com 210-887-7754

The Brokerage Inc. - ACA Contacts

BCBS Agent Support Line – 855-782-4272

Market Place Call Center – 800-318-2596

Market Place Agent Support – 855-267-1515

Medicaid – Medicaid.gov

CHIP – 877-KIDSNOW

Other Resources

Find valuable tools in our Individual Health section at www.TheBrokerageInc.com

Q & A

• To ask a question, type your question in the GoToMeeting Q&A box• If we cannot answer all questions with certainty, we will include the

answer in our follow up, after additional research has been done• All answers during this segment will be provided as a follow up to you

via email.