BlueCare Dental provides members with access to the nation’s largest dental care network of access points, with more than 152,000 nationwide.* With so many access points, BlueCare Dental members have great flexibility to see a dentist and use their BlueCare Dental benefits when and where it is convenient for them.

BlueCare Dental providers are credentialed, and the network has the largest number of dental access points in many states, including Illinois. Across the state, members will find 5,711 access points.** In fact, contracting dentists are located in all 50 states. Also, the average provider discount in Illinois is 32.6 percent (based on the average in-force fees).

With Blue Access® for Members (BAM) at www.bcbsil.com, it’s easy for members to select a dentist because they can search for a provider online any time. BAM’s Provider Finder® tool is updated weekly with new network information.

Tags: BCBSIL Dental Network, Blue Cross Blue Shield Dental Network

Members of the Senate have just voted 56-43 to pass H.R. 4872, the Patient Protection and Affordable Care Act “fixer bill,” and the House is getting ready to re-vote on the bill.

Sen. Johnny Isakson, R-Ga., did not vote. All other Republicans voted against the bill. The Democrats who voted against the bill are Sens. Blanche Lincoln, D-Ark., Mark Pryor, D-Ark., and Ben Nelson, D-Neb.

Democrats have been using the budget reconciliation process rules to get H.R. 4872, the Reconciliation Act of 2010, through the Senate with just 51 votes, rather than the 60 votes that normally would be required.

Alan Frumin, the Senate parliamentarian, ruled early today that two college student aid provisions in H.R. 4872 are ineligible for consideration under budget reconciliation process rules.

Democrats are holding the re-vote on H.R. 4872 in the House to avoid the need to try to pass the bill in the House using ordinary Senate rules.

The student aid provisions would protect students from future cuts in grants if Congress does not provide enough money to pay for the grants. The provisions violate budget reconciliation process eligibility rules because they do not produce savings, according to Jim Manley, a spokesman for Senate Majority Leader Harry Reid, D-Nev.

The provisions are “minor,” but because they are likely to be subject to procedural challenges on the floor, and ultimately struck from the bill, they are being removed from the bill, Manley says.

The bill is going back to the House for a new vote because the House and Senate must approve the same version of the bill before President Obama can sign the bill into law.

House Majority Leader Steny Hoyer, D-Md., said today that the House would set to work on the H.R. 4872 re-vote as soon as the Senate wrapped up its work on the bill.

President Obama already has signed the PPACA bill, H.R. 3590, into law.

That bill will lead to many major changes, such as the creation of a health insurance exchange system, nonprofit health insurance cooperatives and a voluntary long term care benefits program, regardless of what happens to H.R. 4872.

If H.R. 4872 takes effect as written, without being amended, it would make a number of changes in PPACA.

H.R. 4872 would, very example, increase the penalty for affected individuals who fail to own qualified health coverage to $2,000, from $750; ease the effects of a proposed 40% “Cadillac plan excise tax” on issuers of expensive health insurance plans; and impose a new tax on income from annuities and other investment vehicles.

State regulators already are suing to block implementation of PPACA and H.R. 4872, and federal and state agencies likely will spend years implementing bill provisions.

Federal agencies are still developing regulations to implement the Health Insurance Portability and Accountability Act of 1996, a much less ambitious act.

The list of federal agencies responsible for implementing PPACA includes the Internal Revenue Service, the U.S. Department of Labor’s Employee Benefits Security Administration, and the U.S. Department of Health and Human Services.

Internal Revenue Service Commissioner Douglas Shulman talked about PPACA implementation during a House Ways and Means Committee oversight subcommittee hearing.

The IRS will not be auditing taxpayers to determine whether they have insurance, Shulman said.

Instead, HHS officials will work with insurers to verify whether taxpayers have the minimum required coverage, Shulman said.

Insurers will give the IRS standard forms “so they can, in turn, deliver about $500 billion in tax relief to help middle class families and small businesses pay for health insurance,” Shulman said.

Tags: H.R. 4872, HR 4872

nsurance and employer groups are talking about the lack of cost control provisions in H.R. 3590, the Patient Protection and Affordable Care Act bill, which passed by a 219-212 vote at 10:48 p.m. Sunday in the House.

H.R. 3590 is the same bill that the Senate passed early on Christmas Eve a few months back, and it now is awaiting the signature of President Obama.

House members also voted 220-211 at 11:36 p.m. to pass H.R. 4872, the Reconciliation Act of 2010. The Senate still must approve that bill, but it would revise and extend many provisions of H.R. 3590. Senate leaders have told House leaders that they have the votes to pass H.R. 4872 using a special budget reconciliation process.

Under normal Senate rules, bills need 60 votes to pass. Budget reconciliation measures need just 51 votes.

Some Republican lawmakers said during floor debate that they or colleagues would try to block implementation of H.R. 3590 — and of H.R. 4872, if H.R. 4872 becomes law — by turning to the courts for relief.

H.R. 3590 and H.R. 4872 passed with no Republican support; 34 Democrats voted against H.R. 3590, and 33 voted against H.R. 4872.

Democrats were jubilant about winning the H.R. 3590 battle and getting H.R. 4872 to the Senate.

“This is what change looks like,” Obama said during an appearance shortly after the vote on H.R. 3590 took place.

“I know this wasn’t an easy vote for a lot of people,” Obama said. “But it was the right vote.”

House Majority Leader Steny Hoyer, D-Md., smiled at the reporters at a press conference on Capitol Hill. “For all of you who pursued all of us: We had the votes,” Hoyer said.

Insurance say they still have concerns the current versions of the bills.

“The access expansions are a significant step forward” Karen Ignagni, president of America’s Health Insurance Plans, Washington, says in a statement about the health bills. “But this legislation will exacerbate the health care costs crisis facing many working families and small businesses.”

The bill “does little to stem the skyrocketing cost of health care and will be financed on the backs of small business during one of the most delicate financial periods in American history,” says Robert Rusbuldt, president of the Independent Insurance Agents and Brokers of America, Alexandria, Va..

WHAT’S IN H.R. 3590?

H.R. 3590 — the PPACA bill that the Senate passed late on Christmas Eve — is on track to become law whether or not the Senate approves H.R. 4872.

The final version of H.R. 3590 would:

- Enact the Community Living Assistance Services and Supports Act long long term care benefits program.

- Require insurers selling in the individual market, in the small group market and through the exchange system to sell coverage on a guaranteed issue and guaranteed renewable basis. Plans could base rating variations only on age, family use, tobacco use and location, and the rates for the oldest insureds could be only 3 times higher than the rates for the youngest insureds. Rates for tobacco users could be only 50% higher than the rates for non-tobacco users.

- Create a new health insurance exchange system that individuals and employers with up to 100 employees could use to buy subsidized health coverage, and 4 “tiers” of coverage, ranging from catastrophic plans to platinum plans.

- Create a new system of nonprofit health insurance co-ops.

- Permit states to form multi-state health insurance compacts, to create multi-state markets for health insurance.

- Create a health insurance tax credit for employers with 25 or fewer employees and average annual wages of less than $50,000.

- Impose penalties on employers with more than 50 employees that fail to provide health coverage and on inidividuals with incomes over a minimum income threshold who fail to have health coverage.

- Require employers with more than 200 employees to enroll employees in health plans automatically.

- Impose a $750 per-employee penalty on employers with more than 50 employees that fail to provide health coverage.

- Impose minimum medical loss ratios that are similar to those in H.R. 3590: 85% for group plans with more than 100 participants; 80% for small group plans; and 85% for Medicare Advantage plans.

- Impose a 40% “Cadillac plan” excise tax on insurers that sell relatively expensive health plans. Insurers now would pay the tax when they sold plans that cost more than $8,500 for individuals and $23,000 for families.

- Tighten health savings account and flexible savings account reimbursement rules. Individuals could not use account funds to pay for over-the-counter medications unless the medications were prescribed by doctors.

- Cap annual FSA contributions at $2,500, but increase the limit annually by a cost of living adjustment, starting Jan. 1, 2011.

- Apply the existing Medicare payroll tax to investment income starting in 2013, and increase the tax by 0.9 percentage points, to 2.35%, for wages over $200,000 per year for individuals and over $250,000 per year for couples.

- Adopt a national standard for eligibility verification and claims status by Jan. 1, 2013; a standard for electronic fund transfers by Jan. 1, 2014); and a variety of other standards by Jan. 1, 2016.

- Give states 5-year grants to develop medical malpractice reform programs.

WHAT’S IN H.R. 4872?

Originally, the Reconciliation Act was going to include health insurance rate regulation provisions. The version passed Sunday by the House excludes that version, because the Senate parliamentarian ruled that H.R. 4872 backers could not handle the provision using the budget reconciliation process.

H.R. 4872 echoes the language of H.R. 3590 in many places and changes it in others.

Provisions that are still in H.R. 4872 would:

- Create a $1 billion Health Insurance Reform Implementation Fund.

- Exempt the first 30 employees of any employer from the no-coverage penalty.

- Increase the per-employee penalty imposed on employers that fail to provide health coverage to $2,000 per employee, from $750.

- Require individuals making more than $200,000 per year and couples making more than $250,000 per to pay a new 3.8% tax on interest, dividends, capital gains and other investment income. (This new tax is higher than the 2.9% tax on investment income recently proposed by President Obama.)

- Increase the Cadillac plan tax limits to $10,200 for individuals and $27,500 for families, and to $11,850 and $30,950 for for retirees and high-risk professionals. Calculations of health benefits value now will exclude dental plans and stand-alone vision plans.- Push the effective date of the $2,500 cap on annual FSA contributions back to Jan. 1, 2013.

- Increase the no-coverage penalty for individuals with relatively high incomes and decrease the penalty for low-income individuals.

Tags: Health Care Bill H.R. 3590, Health Care Legislation, House Health Care Bill, House of Representives Passes Health Care Bill

Despite the uncertainty surrounding health care reform, most U.S. employers say they are making investments that will improve the long-term health and productivity of their workforce, according to a new survey.

Researchers at Hewitt Associates Inc., Lincolnshire, Ill. (NYSE: HEW), polled about 600 large U.S. employers with a total of about 10 million employees.

About two-thirds of the respondents said they invest in long-term solutions to improve the health and productivity of their workers; only 32% said are primarily focused on controlling annual health care costs. Just 3% reported moving away from directly sponsoring health care.

When asked about their future approach to health care, 80% said they plan to focus on improving health and productivity in the next 3 to 5 years.

Almost 95% of the companies said managing costs is a top business issue, up from 91% in 2009.

Tags: 2010 Hewitt Insurance Survey, Hewitt Associate Health Insurance Survey, Hewitt Survey

The open enrollment period to add dependents to an existing Blue Cross® and Blue Shield® of Illinois (BCBSIL) individual policy is coming to an end on March 31, 2010. During this period there are no medical questions and the policy is guaranteed issue. The 12 month pre-existing condition waiting period is still applicable.

In order to qualify for the open enrollment period, the existing policy must have been in force prior to June 1, 2009. The open enrollment applies to all dependents under age 26 (and eligible military veterans under age 30), including children and/or spouses.

Tags: BCBS Individual Policy Open Enrollment for Dependents Deadline, BCBSIL Open Enrollment, Blue Cross and Blue Shield of Illinois Add Dependent to Age 26 Deadline, Blue Cross Blue Shield of Illinois dependent additon

President Obama Tuesday night signed into law legislation that provides a stopgap, 31-day extension of federal subsidies of COBRA health care premiums.

The measure was approved earlier Tuesday by the Senate on a 78-19 vote, while the House cleared it last week.

Under H.R. 4691, the 65%, 15-month premium subsidy for laid-off workers is extended to those involuntarily terminated from March 1 through March 31.

Without the extension, employees laid off after Feb. 28 would have been ineligible for the subsidy.

The measure also will allow employees to receive the subsidy if they first lost group coverage due to a reduction in hours and then were terminated after enactment of the legislation, if certain conditions are met.

Meanwhile, the Senate Wednesday will continue consideration of legislation, H.R. 4213, that would extend the premium subsidy to employees laid off through Dec. 31, 2010.

Tags: 2010 COBRA Benefits, 2010 COBRA Benefits Extension, 2010 COBRA Subsidy Deadline, 65% COBRA Subsidy Extension, COBRA Extentension, COBRA Health Care Premium Subsidy Deadline, COBRA Subsidy Extension

COBRA health insurance premium subsidies would be extended and expanded under a new jobs bill being put together by Senate Majority Leader Harry Reid, D-Nev.

In its current version, the draft bill would extend the COBRA premium subsidy to involuntarily terminated employees another 10 months, so employees laid off through year-end would be eligible for the 65% subsidy for up to 15 months.

Without an extension, employees laid off after March 1 would not be eligible for the subsidy.

“There are people who are losing their jobs and they need the ability to buy insurance,” Sen. Reid said on the Senate floor Wednesday.

Separately, the Senate on Thursday may begin to consider H.R. 1586, which among other things, would extend the subsidy through March 28. That measure is considered a stopgap while federal lawmakers consider a longer extension.

“There is virtually no doubt that a longer extension will follow,” said Frank McArdle, a consultant with Hewitt Associates Inc. in Washington.

Sen. Reid’s draft bill also would allow employees who first lost group health insurance coverage due to a reduction in hours and then were involuntarily terminated to receive the COBRA premium subsidy, assuming certain conditions were met.

Other provisions in the draft bill would give employers more time to fund their pension plan obligations, something business groups have sought for more than a year. Without such relief, employers will face huge increases in contributions to their plans, which have been battered by low interest rates and the plunge in the equities markets.

It isn’t known when Sen. Reid will formally introduce the jobs bill. Previously, the Senate majority leader stripped the COBRA subsidy and other provisions from a prior jobs bill in favor of a more narrowly focused measure, which the Senate passed Wednesday. At the time, Sen. Reid said some of the provisions, like the COBRA subsidy, would be reinserted in a series of bills he would introduce at a later date.

Tags: COBRA subsidy, COBRA Subsidy 2010, COBRA Subsidy Expansion, COBRA Subsidy Extension

Governor Pat Quinn signed a bill into law that goes into effect June 1, 2010 that will benefit thousands of orthotic and prosthetic users in Illinois covered by private health insurance plans.

The law ensures that coverage for orthotic and prosthetic devices is the same as nearly all medical or surgical benefits.

“Those covered by orthotic and prosthetic insurance policies will get stronger and better coverage that is in line with other medical and surgical insurance benefits,” said Gov. Quinn.

“This new law should provide a greater degree of financial protection and security to those who depend upon these important devices and to their families.”

In addition, the new law will give more orthotic and prosthetic users access to new, technologically-advanced and well-fitting devices.

There are over 69,000 people in Illinois living with limb loss and a comparable number of people living with disabling diseases such as Spina Bifida, Cerebral Palsy and Muscular Dystrophy.

Governor Quinn signed into law HB 2652, which was sponsored by Senator Antonio Munoz (D-Chicago) and Representative Kevin Joyce (D-Worth). The law goes into effect June 1, 2010.

The new law pertains to health insurance plans that contain coverage for orthotics or prosthetics (excluding foot orthotics). It amends the Illinois Insurance Code by adding a section requiring those insurance plans to provide coverage that’s on par with “substantially all medical and surgical benefits” covered in that plan.

The law pertains to health insurance plans covering orthotics or prosthetics that are issued, renewed or delivered six months after June 1, 2010.

Helping to inspire passage of this new law is the family of 14-year-old Allie Johnson, who was born without a right arm. Her insurance company would only cover one prosthetic for her lifetime.

Her mother, Laurie — who for nearly 15 years has worked with Families and Amputees in Motion and is now its president—has spent that last two-and-a-half years working with legislators and other advocates to pass the insurance parity bill.

“This new law is going to help thousands of Illinois citizens. It will improve their lives financially but, just as important, enable many of them to go back to work and contribute to society in general,” said Laurie Johnson.

Other groups and constituents that rallied in support of the Orthotic and Prosthetic Insurance Coverage Parity law include: Illinois Society of Orthotists and Prosthetists; United Healthcare; Tammie Higginbotham; and Douglas Knight, a member of Spina Bifida Association and the National Federation of Independent Business.

Among those joining Governor Quinn at the bill signing ceremony were: Representative Joyce; Senator Munoz; Representative Jim Durkin (R-Countryside), co-sponsor of the bill; Rep Monique Davis (D-Chicago) co-sponsor of the bill; Laurie and Allie Johnson; and Jim Kaiser, a Member of Families and Amputees in Motion.

Tags: H.B. 2652, Illinois Orthotic and Prosthetic Parity Act