Kilpatrick

Carrier News

BCBS Enhances Blue Balance Funded Program for Small Groups (10-50) and Begins Outreach

Earlier this month, BCBS began a communication outreach program to introduce their recently updated Blue Balance Funded program to existing small group customers (and their brokers). The campaign targets qualifying inforce groups with Sep through Dec anniversary dates. BCBS will provide these groups with a Blue Balance Funded quote in addition to their standard renewal offer. The outreach campaign began with an email to brokers on May 16. They will send emails to applicable groups on May 23 and May 30.

Blue Balance Funded is a portfolio of self-funded plans offered at fixed monthly composite rates. The program is similar to Cigna’s Level Funding, All Savers Alternative Funding, and Humana’s Level Funded. The plans are comprehensive and mirror plans offered in BCBS’s fully insured, middle market portfolio. Unlike fully insured small group plans, Blue Balance Funded plans are not restricted to metallic plan levels or the Essential Health Benefits coverage requirements. The plans cover all state mandated benefits covered by fully insured small group plans. The portfolio provides a more diverse mix of plan options for small employers. The quote packages show illustrative four-tier rates to help clients set employee contributions. BCBS will use two-tier composite rates (Employee / Family) for billing purposes.

We can quote preliminary rates subject to underwriting on new business prospects.

Groups must meet BCBS’s eligibility requirements. They include but are not limited to:

  1. 10-50 enrolled employees and defined as a small employer (ATNE less than 51)
  2. Must have prior group coverage for at least 12 consecutive months
  3. 75% participation among eligible employees not waiving with other coverage
  4. 50% minimum contribution
  5. Be free from bankruptcy proceedings for 12 months

Technical Program Specifics

Case Size 25-50 enrolled
Underwriting Method HB2015 and Rx claims
Individual Stop Loss Deductible $25,000
Aggregate Claim Corridor 110%
Stop Loss Contract 12/24
Timing of Surplus Payment 4 months after plan year
Portion of Surplus Distributed 50%
Surplus Distribution Method Admin credit at renewal. Check at termination.

More Information

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