Across all exchange enrollees, 86% qualify for premium subsidies that amount to an average of nearly $492 per month. Blue Shield Association. This might be through providing follow-up information or advice designed to improve the health of tobacco using employees. You can also find your local BCBS company on BCBS.com. You have the choice of two . We rely on the most current and reputable sources, which are cited in the text and listed at the bottom of each article. and Blue Shield Association. Can My Employer Reimburse My Individual Health Insurance Premiums? The next time you sign up for health insurance, youll be asked whether you smoke and how often. Effectuated enrollment snapshot. currently enrolled in the Blue Cross Blue Shield medical insurance plan. The EX Program qualifies as a reasonable alternative standard. More employers are considering a premium surcharge on employees participating in the company's health plan who are not vaccinated. 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. That depends on your plan. SET. If you are experiencing difficulty accessing our website content or require help with site functionality, please use one of the contact methods below. return 'medicare'; This article will explain the federal rules that apply to tobacco surcharges, and how some states have modified those rules. 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. The Blue Cross Blue Shield Association is an association of independent, locally operated Blue Cross and Blue Shield companies. Taxpayers are on the hook for $178 billion in federal funds allocated to hospitals and health care providers. 0000010895 00000 n Read the Affordable Care Act. Tobacco Cessation Coaching Want to Quit Smoking? Prescribing FDA-approved tobacco cessation medications to nonpregnant adults of any age. The PAC amount for HIP Plus members is based on household income in one of five tiers below. function isChecked(){ You can find out by typing yourhome or work ZIP code in our Plan Finder. Barbara J. Zabawa is the founder and president of the Center for Health and Wellness Law, LLC, a law firm dedicated to improving legal access and compliance for the health and wellness industries. The EX Program qualifies as a reasonable alternative standard and has helped over 940,000 tobacco users build the skills and confidence for a successful quit. BCBS recognizes doctors and hospitals for their expertise and exceptional quality in delivering care. hbbd```b``"I r,&&X""Y%(0 &mV3dl=bH)@g&@"@;$30N` @ Completing the CAPTCHA proves you are a human and gives you temporary access to the web property. What is a tobacco surcharge? Although lawmakers who wrote the ACA felt strongly that a person's health status should not be taken into consideration when setting health insurance premiums, they agreed to allow insurers to charge tobacco users higher premiums. xref The blog post likened the health insurance surcharge for unvaccinated employees to those for tobacco users. 29 32 } Quality Care Thats Right for YouWhether you need a routine check-up or a specialty procedure, you want the best care you can find. Recent DOL lawsuits demonstrate increased enforcement of HIPAA wellness rules. } But ACA allows individual and small group health insurers to adjust premiums based on just four factorsgeographic location, age, family size, and tobacco use. Language: english. Private Health Insurance Plans, How to Choose Between Major Medical Insurance and a High-Deductible Health Plan, Here Are Free or Discounted Healthcare Options If Youre Underinsured, Special Enrollment Periods and Qualifying Life Events, Lost Your Medicaid? Some regular smokers facing a steep premium increase may be tempted to avoid telling the truth. Don't have your card? But it dropped to just 4% as of 2018. Can Medical Bills Go on Your Credit Report? Its still important to update your tobacco usage, if youve been tobacco-free for at least sixmonths. ACA Tax Question: Who Can You Claim as a Dependent? Should smokers pay more for health insurance? Contact your local BlueCross and Blue Shield representative for details regarding claims or coverage. When you visit the site, Dotdash Meredith and its partners may store or retrieve information on your browser, mostly in the form of cookies. Cigarette smoking and tobacco use among people of low socioeconomic status. James Lacy, MLS, is a fact-checker and researcher. Once you are insured, remember that smoking remains the leading preventable cause of death, so you should consider taking advantage of the free cessation programs that can help protect you and the health of those close to you. If you are eligible for the Federal Employee Program (your member ID starts with the letter R immediately followed by numbers), your overseas claim form and instructions can be found here. Independence Blue Cross offers products through its subsidiaries Independence Hospital Indemnity Plan, Keystone Health Plan East and QCC Insurance Company, and with Highmark Blue Shield independent licensees of the Blue Cross and Blue Shield Association. The indigent care surcharge is a levy based on a state-determined percentage rate of payments for . Three other states allow a surcharge of less than 50% : Arkansas - 20% Colorado - 15% Kentucky - 40% In the other 40 states, smokers can be charged 50% more for monthly premiums compared to non-smokers. Be sure to have your account number, paperwork and any important information such as dates ordoctor references handy when you call. - Thurs. 0000010668 00000 n return 'health'; Use our frequently asked questions to find answers. Your medical coverage is provided by Blue Cross and Blue Shield of Louisiana (BCBSLA). The estimate was about $89 per month and covered all the preventative care we wanted. The total premium difference must not exceed 50% of the total cost of employee-only coverage under the plan (or, if an employees family can participate in the cessation program, the premium difference must not exceed 50% of the total cost of coverage in which an employee and any dependents are enrolled). If the reasonable alternative standard is a digital tobacco cessation program, the plan must make the program available, and may not require the individual to pay for the cost of the program. Contact Us | Blue Cross Blue Shield Contact Us BCBS Customer Service Call the toll-free number on the back of your member ID card for BCBS customer service. Our editorial staff is comprised of industry professionals and experts on the ACA, private health insurance markets, and government policy. Substance Use Treatment & ResourcesLearn more about substance use disorders and find a treatment provider that meets your needs. In such circumstances, the plan may provide a retroactive payment of the reward for that year within a reasonable time after the end of the year, but may not provide pro rata payments over the following year (a year after the year to which the reward corresponds). The cost of coverage includes the total amount of employer and employee contributions toward the benefit package under which the employee is (or the employee and any dependents are) receiving coverage. Under the deal, the tobacco industry agreed to pay the state and Blue Cross and Blue Shield of Minnesota more than $6.5 billion, among other provisions. Non-Discrimination Statement and Foreign Language AccessCopyright {{ new Date().getFullYear() }} All Looking to find answers to your billing, claim forms, and other questions? That paper trail could be uncovered and flagged as your insurer is reviewing your treatment before paying your bills. Of course, it is always wise to engage legal counsel to help craft such programs. 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. 0000002188 00000 n Although health insurance companies are allowed to charge smokers up to 50% more for premiums in most states, some smoker-friendly carriers do not. 0000033336 00000 n Members Currently Paying the Tobacco Surcharge:If a member is currently paying the tobacco surcharge and does not make an active election during Open Enrollment, the current enrollment will default to the new Plan Year and the member will continue to pay the tobacco surcharge. outlined on page 2. This update is effective as of January 1, 2020. The facts on the FDA's new tobacco rule. All tobacco users may have their tobacco surcharge removed by completing the wellness requirements outlined in the applicable Tobacco Surcharge Removal Policy below. For example, requiring attendance nightly at a one-hour class would be unreasonable. 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. But a subsequent rule issued by the Centers for Medicare and Medicaid Services defines tobacco use as the use of any tobacco product within the past six months with a frequency of at least four times per week. . 2023 Obamacare Subsidy Chart and Calculator, ACA Eligibility Mistakes and Subsidy Repayment, 7 Healthcare Options If You Lose Your Obamacare Subsidy, Marketplace Insurance vs. Individuals must request the reasonable alternative standard (and they must be notified of the opportunity to make such a request, as noted later). 0000014916 00000 n hb```f`` Ab@CCHQ `q `a`|XLAi:Luv0ry[{!*V7 }@ni& @"` She also serves at The George Washington Universitys Milken School of Public Health as an adjunct professor. First step: set a goal to quit with the Online Health Coach by selecting a quit date within the benefit year and completing all seven quit plan questions. Employers who financially penalize tobacco users miss an opportunity to help them, which is why the ACA reasonable alternative and reasonable design requirements are so crucial in a successful tobacco cessation program. Learn more about our content. The settlement followed months of. If you are eligible, you must complete steps 1-3 to have the opportunity to earn up to $300 in rewards and to avoid an $80/month tobacco surcharge if you test negative on the tobacco/nicotine test. You must complete the Healthways Well Being Assessment and a telephonic well-being coaching program or any online tracking by December 15, 2017. Tobacco users can be charged up to 50% more than people who don't use tobacco. Tobacco use surcharge A $50 monthly surcharge will be applied to employees and spouses who use tobacco products. BlueCross BlueShield of South Carolina is an independent licensee of the Blue Cross Blue Shield Association. Each one of our Blue Cross and Blue Shield independent licensees (our member companies) collect and provide information for our PPO finder via different timetables and methods. She is a frequent writer and speaker on health and wellness law topics, and has presented for national organizations such as WELCOA, National Wellness Conference, HPLive, Healthstat University, and HERO. Since any tobacco product is counted, this includes e-cigarettes and vaping, as well as traditional cigarettes, cigars, chewing tobacco, and pipe smoking. There are several available. Use the link below to download it. Tobacco Surcharge The tobacco surcharge applied to certain employees' health insurance premiums is $80 per month, or $960 per calendar year. The Center for Consumer Information & Insurance Oversight. Member Discounts Take advantage of member-only discounts on health-related products and services. Tobacco Surcharge If you use tobacco products, there will be an extra charge on your PAC. 0000006451 00000 n You can have the surcharge removed. While this post may have links to lead generation forms, this wont influence our writing. Although the majority of states do allow insurers to impose tobacco surcharges of up to 50%, many insurers choose to use smaller surcharges or skip them altogether. 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. Kliff, S. Big tobacco and anti-cancer activists agree: Health provision goes too far. The plan must disclose in all plan materials the terms of a tobacco cessation program and the availability of a reasonable alternative standard to qualify for the lower premium (and, if applicable, the possibility of a waiver). According to a recent survey by the Kaiser Family Foundation, 9% of employers that offer health coverage impose a surcharge for tobacco use (this is across employers of all sizes).