BCBSTX Renewal — Blue Balance Funded Option for Grandfathered or Transitional Groups

Employer Email Template

Send this email to employer clients with a Grandfathered / Grandmothered (transitional) plan if the group qualifies for the BCBSTX Blue Balance Funded plan and the renewal includes this option. This template identifies the benefits and downsides of the Blue Balance Funded plan.

Download the email template by clicking the button below.

As an alternative, you can copy the text below, modify the language as necessary, add the attachments, and email to your clients.

Body of Email:

Dear :

It’s that time of year again! Attached is the BCBSTX renewal for 2017. You can see the renewal premiums for your current plan(s) on page .

With rising health insurance premiums, insurance carriers are expanding plan and network options in an effort to improve flexibility, cash flow and potential financial savings for employers. In the fall of 2017 BCBSTX introduced the Blue Balance Funded Plan. This is a partially self-funded plan that allows more latitude in lowering costs and potential money back when claims run well. With a partially self-funded plan, you still have a monthly payment, made up of 3 parts – claims funding, administrative fees, and stop loss premiums. BCBSTX is providing this option only to renewal groups that meet the following criteria:

1. 10 or more enrolled employees

2. Good payment history with BCBSTX

3. Must have 70% or lower loss ratio

Your group meets the criteria and this option is included for your review. Although there are potential rewards for electing a partially self-funded plan, there are some negative factors to consider:

1. You need to ensure that your plan is in compliance with regulatory requirements.

2. You would be required to pay the annual PCORI Fee and prepare a report.

3. You would also be required to complete the 1095 reports to the government confirming which employees had coverage under your plan. These reports are currently being done by BCBSTX since you are now on a fully insured plan. Future regulations can modify requirements—either more or less.

4. If you have a bad claims year, your next renewal would be high with no way to return to your grandfathered or transitional policy.

We have attached the BCBSTX self-funded brochure for your review. I will call to be sure you got this email and to answer any questions.

Thanks so much for working with us and we look forward to discussing this alternative with you.

Documents to Include:

Open and save these documents, then attach them to the email.