Policy Downgrades Suspended due to PPACA Interim Final Rules

The followoing was recently posted by Blue Cross/Blue Shield and explains some of the rules changes and their effects on current BC/BS customers:

“As we shared with you last week, the Departments of Health and Human Services, Labor, and Treasury released interim final rules concerning grandfathered health plans under the Patient Protection and Affordable Care Act of 2010 (PPACA).

Given the new details provided in the rules, we have determined that a decrease in benefits (e.g., increasing deductible) will result in the loss of grandfathered status and that this change may result in a future premium increase that offsets any savings from the downgrade. As a result, Blue Cross and Blue Shield of Illinois (BCBSIL) is temporarily suspending the processing of all downgrade benefit changes for individual member policies that are not currently marketed plans (i.e., closed plans). Any applications from members in closed plans for downgrades in benefits that were not processed prior to June 14 will be returned to members, explaining in additional detail this temporary change in processing policy downgrades.

Members in plans that are currently marketed (i.e., open plans) can continue to downgrade their benefits; however, those whose original effective dates were prior to March 23, 2010, will lose their grandfathered status and will be moved to a PPACA compliant version of their product Jan. 1, 2011, with an appropriate rate.”

Please note this is a temporary change for 90 days while we are reviewing the regulations and determining what changes may be allowed in the future.

Thanks,

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