0000001803 00000 n Substance Use Treatment & ResourcesLearn more about substance use disorders and find a treatment provider that meets your needs. } else { You must . Lower-income Americans are more likely than higher-income Americans to use tobacco products. 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. This blog post is for informational and educational purposes only. Pick up your free medication at any in-network retail pharmacy. 117 0 obj <>/Filter/FlateDecode/ID[<4E80C67A0673E84CB3E5C55B5ABC2E2C><218A9316D8DACD40B89F155B0ED9FAC1>]/Index[97 33]/Info 96 0 R/Length 100/Prev 131941/Root 98 0 R/Size 130/Type/XRef/W[1 3 1]>>stream The State Health Plan now offers Tobacco Cessation Counseling benefits for its members with health care coverage through Blue Cross and Blue Shield of North Carolina (Blue Cross NC). function isChecked(){ To live free of worry, free of fear, because you have the strength of Blue Cross Blue Shield companies behind you. 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. Tobacco Surcharges - Legal Rules Employers may consider implementing a smoking cessation program to encourage their employees to stop smoking or using tobacco products. And in California, the District of Columbia, Massachusetts, New Jersey, New York, Rhode Island, and Vermont, insurers are not allowed to charge tobacco users higher premiums. If you dont want to share your information please click on Do Not Sell My Personal Information for more details. 0 The settlement followed months of. Quality Care Thats Right for YouWhether you need a routine check-up or a specialty procedure, you want the best care you can find. The estimate was about $89 per month and covered all the preventative care we wanted. "There's a very clear line we can draw . 0 We have received claims for BlueEssentials members who did not indicate tobacco usage at enrollment, but have been given a diagnosis showing tobacco use and/or nicotine addiction. 0000002631 00000 n Under the Affordable Care Act (ACA), group health plans (and self-insured employers) can charge tobacco users up to 50% more for their health insurance premiums than non-tobacco users, and when they do this it is called a tobacco surcharge. Under the Affordable Care Act (ACA), group health plans (and self-insured employers) can charge tobacco users up to 50% more for their health insurance premiums than non-tobacco users, and when they do this it is called a tobacco surcharge. Heres What to Do Next, Health Insurance After Divorce: Your Options, Turning 26: Health Insurance Guide for Those Aging Off Their Parents Plan, How to Keep Your Doctor When Your Health Insurance Changes, Health Insurance After the Death of a Spouse, Parent or Other Plan Member. Insurance premiums could rise across the board. - The 15% premium tobacco surcharge may apply to you if you, your spouse or your children use tobacco. Content is fact checked after it has been edited and before publication. Currently, seven states plus the nations capital prohibit insurers from charging smokers extra: Three other states allow a surcharge of less than 50% : In the other 40 states, smokers can be charged 50% more for monthly premiums compared to non-smokers. Before sharing sensitive or personal information, make sure youre on an official state website. BCBS recognizes doctors and hospitals for their expertise and exceptional quality in delivering care. } View a copy of the letter here. In some circumstances, an individual may not satisfy the reasonable alternative standard until the end of the year. ){HDG'-@2@1X -, c`H. The cessation program must be reasonably designed to promote health or prevent disease. Some states have taken action to prohibit or modify the tobacco surcharge, reducing its impact within those states. We use cookies on this website to give you the best experience and measure website usage. Tobacco use must rise to a certain level before health insurance companies can penalize you. 1 cancer threat to men and women 34 million Americans still smoke regularly (14% ) and another 6 million use vaping nicotine inhalers. The participant is not expected to achieve a certain wellness goal, such as losing a certain amount of weight or having a certain blood pressure level. Dont do it. Members who were impacted will receive a refund for any tobacco surcharge they paid from Jan. 1, 2020 to May 1, 2020for this member. Cigarette smoking and tobacco use among people of low socioeconomic status. BlueCross BlueShield of South Carolina is an independent licensee of the Blue Cross Blue Shield Association. She is also lead author of the book, Rule the Rules on Workplace Wellness Programs, published by the American Bar Association. If you are paying this surcharge and would like to have it removed, you All Rights Reserved. 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. Thank you, {{form.email}}, for signing up. As noted, roughly 6 million people over 18 are using electronic nicotine-inhaling devices, such as Juuls, e-cigarettes, and vapes. rights reserved.BlueCross BlueShield of South Carolina is an independent licensee of the Blue Cross If you're paying a tobacco surcharge and you've kicked the habit at least six months ago, you can update your information when your health plan renews for the coming year (either through the exchange, directly through your health insurer, or through your employer, depending on how you get your health coverage). Please review the terms of use and privacy policies of the new site you will be visiting. 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. The Blue Cross Blue Shield Association is an association of independent, locally operated Blue Cross and Blue Shield companies. Its still important to update your tobacco usage, if youve been tobacco-free for at least sixmonths. 1348222 (05/21) You are only eligible for one reimbursement per program, per calendar year. DHEC offers a free program called the SouthCarolinaTobaccoQuitline. 0000002154 00000 n Use the link below to download it. 29 32 U.S. Department of Labor. BlueEssentialsSM and Business BlueEssentialsSM plan members may pay a surcharge for recent tobacco use. While this post may have links to lead generation forms, this wont influence our writing. Call the National Information Center at 1-800-411-BLUE (2583) weekdays from 8 a.m. to 8 p.m. Eastern time. How to Best Prepare Yourself for Negotiating Medical Bills. Center for Consumer Information and Insurance Oversight. ANTHEM BLUE CROSS AND BLUE SHIELD (ANTHEM) AND . *You must meet age requirements for prescribed tobacco cessation drugs to receive this benefit. Across all exchange enrollees, 86% qualify for premium subsidies that amount to an average of nearly $492 per month. rights reserved.BlueCross BlueShield of South Carolina is an independent licensee of the Blue Cross 0000005920 00000 n You must complete the Healthways Well Being Assessment and a telephonic well-being coaching program or any online tracking by December 15, 2017. 8:30 a.m. - 5:30 p.m. CT, Fri. 8 a.m. - 6 p.m. CT For Blue Plus members: Call 1-844-421-5661. An official website of the State of Georgia. SET. CITY OF SAN ANTONIO EMPLOYEE BENEFITS GUIDE - INSIDE: HEALTH CARE PREMIUMS, HEALTH PLANS & HELPFUL TOOLS - The City of San Antonio". 0000002110 00000 n What you need to know about the disease and our commitment to ensuring you have access to the right care at the right time. Incentives for nondiscriminatory wellness programs in group health plans. 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. The idea is if an employee contracts COVID-19, it could lead to higher healthcare costs . How Did the Tax Cuts and Jobs Act Affect Individual Health Insurance? If you are experiencing difficulty accessing our website content or require help with site functionality, please use one of the contact methods below. 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 'health'; Active employees (and other applicable individuals) will lose SHBP coverage for 12 months beginning on the date that their false response or failure to notify SHBP is discovered. These legal requirements include ACA, Americans with Disabilities Act (ADA), and other civil rights laws considerations. While we make every effort to keep the Provider Finder "up-to-date," it is always best to confirm any provider information you select from this utility with your local Blue Cross and Blue Shield representatives. Do you still have to pay the surcharge if you quit? return 'health'; James Lacy, MLS, is a fact-checker and researcher. Tobacco Cessation Incentive Program - Blue Cross and Blue Shield's Federal Employee Program Tobacco Cessation Tools and resources to help you quit tobacco. A Preferred Provider Organization (PPO) is an arrangement designed to supply health care services at a discounted cost by providing incentives for members to use designated health providers (who contract with the PPO at a discount), but which also provides coverage for services rendered by health care providers who are not part of the PPO network. Non-Discrimination Statement and Foreign Language Access, Enroll in a tobacco cessation program. The program offers: Visit the SouthCarolinaTobaccoQuitlinewebsite to learn more. Read the Affordable Care Act. 0000013746 00000 n US Department of Health and Human Services. Looking to find answers to your billing, claim forms, and other questions? You can also find your local BCBS company on BCBS.com. Sonia Barkat is the founder of Umbrella Pact and a contributing consultant to The Impact. The surcharge is an extra charge on health plan premiums for } else { Call 1-800-GEORGIA to verify that a website is an official website of the State of Georgia. CMS announced a transitional policy and extensions to the policy that together allow issuers to continue to renew non-grandfathered policies that are not compliant with the ACA until October 1, 2021, so long as the coverage comes into compliance with applicable requirements by January 1, 2022. For more insurance terms and definitions, please see ourGlossary. If you don't make this change, the tobacco surcharge will apply when the plan automatically renews. Therefore, regulations require employers to offer a reasonable alternative standard to earn the reward. By being truthful with your insurance company, you can save yourself all sorts of onerous complications down the road.The potentially grave consequences for misrepresenting your tobacco use should convince you to always be transparent. Tobacco use includes these products: Chewing tobacco Cigarettes Cigars Pipes Hookah Snuff Call WebMD at 1-855-326-5102 to determine your eligibility and schedule your first call. This material must include contact information for obtaining a reasonable alternative standard and a statement that recommendations of an individuals personal physician will be accommodated. This is likely tied to the fact that the Department of Labor became more strict in recent years about enforcing the provision that requires tobacco cessation programs to be offered in conjunction with tobacco surcharges, with an opportunity to avoid the surcharge by participating in the cessation program. If your client has NOT been using tobacco, his or her physician can fill out the Tobacco Appeal Form and email it to Membership.Enrollment@bcbssc.com or fax it to 803-870-9439 by Jan. 1. 2020;39(5):871-875. doi:10.1377/hlthaff.2019.00709. During enrollment, you answered questions about tobacco usage. Cookies collect information about your preferences and your devices and are used to make the site work as you expect it to, to understand how you interact with the site, and to show advertisements that are targeted to your interests. If you smoke or vape or chew tobacco regularly, you can count on being hit with a hefty premium increase of up to 50%, either at work or if youre buying an Affordable Care Act (ACA) Obamacare plan on the Exchange Marketplace. The Tobacco Surcharge amount for the current Plan Year is an additional : $80 : per month added to the health premium. 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. That paper trail could be uncovered and flagged as your insurer is reviewing your treatment before paying your bills. To achieve this, health-contingent tobacco cessation programs must allow a reasonable alternative standard (or a waiver for not meeting the initial requirement of not being a tobacco user) for obtaining the lower premium for any individual for whom, for that period, it is unreasonably difficult due to a medical condition or medically inadvisable to satisfy the initial standard. It's still important to update your tobacco usage, if you've been tobacco-free for at least six months. Not to mention, youll very likely lose your insurance or at least be charged all the back money you owe as a smoker. } Most employers do not use tobacco surcharges. By 2017, the prevalence of tobacco surcharges among small employers' health plans had grown to nearly 18%. Employers ' health plans t make this change, the prevalence of tobacco Surcharges among small employers ' health.. The best care you can also find your local bcbs company on.... 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