We Can Help
Welcome to our new quarterly news brief designed to bring you the latest news about your school’s student health insurance coverage. Look for up-to-date information on current and upcoming industry regulations, along with tips you can share with your students to help them make the most of their plan.
New rulings may impact student health plans Recently released guidance from the federal government on the Affordable Care Act (ACA) and student health plans eliminates the need for these plans to meet the current range of actuarial values referred to as metal levels. Beginning with coverage effective dates on or after July 1, 2016, the actuarial value requirement for student health plans has been revised to require that the plans meet or exceed a 60% actuarial value and that the policy holder is aware of the calculated value and how that value compares to the next closest metal level. This change will provide much needed flexibility in benefit designs and improve turn-around times for alternate benefit quotes during renewal evaluations for our insured schools. Look for updates on this topic in future news briefs.
Generics Plus Formulary changes coming soon! Pharmacy costs continue to rise due to many factors such as drug cost inflation, fewer opportunities for generic drug versions projected to enter the market, and the influx and use of specialty drugs. Beginning this fall, we will implement a change to the prescription benefit that will help address these rising costs. This change will not apply to schools with 2 tier prescription benefit plans.
The generics plus drug list, also known as a formulary, is essentially a leaner version of the standard drug list and includes both non-specialty and specialty drugs for all major therapeutic categories. The list includes mostly generic drugs and fewer preferred brand choices. As a result, members who were on the standard drug list may be impacted by certain drugs changing from a preferred brand status to a non-preferred brand status. These drugs will still be eligible for coverage but may be at a higher member payment share.
A notification is being sent to student members who are affected to encourage them to ask their doctor if a generic or lower cost preferred brand name alternative may be right for them. Students may be able to save on prescription drugs by switching their prescription. Students can view the complete drug list online at bcbsil.com (after registering for and logging in to Blue Access for MembersSM). For specific questions, we encourage students to call the number on the back of their member ID card.
Go mobile with the BCBSIL AppDid you know your students can access their benefit information on the go? All they need to do is download the free BCBSIL App from the App Store® or Google PlayTM. They can:
Emergency room or urgent care? With new ERs and urgent care centers popping up, it’s hard to know where to go for care. Both freestanding emergency rooms and urgent care centers can provide urgent care treatment, but there may be a significant cost difference. It’s important for your students to do their research about nearby facilities ahead of time and to understand when more costly emergency care is needed and when an urgent care center may be the appropriate choice.
We can help you get the word outNeed help informing students about your school’s student health plan, but don’t know where to start? We can help. Whether it’s orientation packets, school newspapers, campus monitors, school websites and campus events, we have marketing communication materials that will meet your needs. Want to learn more? We will be conducting a webinar soon, so be sure to look for your invite or contact your Account Representative for more details.
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