December 28, 2012

HHA-12-9
DC-12-9
ASC-12-9
MS-12-11

BC-12-14
SA-12-9
HP-12-9

To:

All Blue Cross and Blue Shield of Kansas Contracting Providers

From:

Connie Winkley – Education/Communication Coordinator
Institutional Provider Relations
Blue Cross and Blue Shield of Kansas, Inc.
An Independent Licensee of the Blue Cross and Blue Shield Association

Subject:

2013 State of Kansas (SOK) member benefits
2013 Federal Employee Program (FEP) member benefits

The State of Kansas (SOK) group health plan renews with BCBSKS on January 1, 2013. The 2013 SOK member benefit information is available on the BCBSKS Website. Click on the link below to view the BCBSKS webpage, which includes forms, contact information and FAQs for SOK plan members.

The 2013 plan options for SOK members continue to be Plans A, B and C and information on each plan can be found by clicking on the link below.

2013 SOK Member Benefits

For SOK members Healthcare Reform preventive services are covered at 100% MAP (Maximum Allowable Payment) under Plans A, B and C. Some of the SOK plan highlights for 2013 are as follows:

Plans A and B:
There are no changes to Plans A and B other than the additional women's preventive services that were mandated for anniversary dates on or after 08/01/2012. The State has elected to include coverage for vasectomies at 100% of the BCBSKS allowed amount. Contraceptive medical devices are billable to BCBSKS and pharmacy prescriptions are billable to Caremark.

The Preferred Lab Benefit for Plans A and B will continue to be administered by Quest and Stormont Vail Labs. Laboratory procedures done by a preferred lab will be covered at 100% MAP. Lab services performed by any other contracting lab are covered subject to deductible and coinsurance. Healthcare Reform preventive labs (are covered at 100% MAP with any contracting lab.

Plan C:
Plan C continues to be a Qualified High Deductible Health Plan, yet it has some significant changes. For plan year 2013 members covered under Plan C will have a $2500/5000 deductible, then services pay at 100% MAP for the remainder of the year. The deductible is a combination of medical and drug claims with the drug being administered by Caremark.

Plan C does not have the Preferred Lab Benefit that is available on Plans A and B. Members enrolled in Plan C will have a Health Savings Account (HSA) with a debit card to assist in paying the deductible.

Please review the 2013 SOK Member Benefit information on the BCBSKS Website for all changes to the 2013 SOK member benefits.

Below are links to the plan summaries for each of the 3 plans, as well as a link to the 2013 SOK Benefits Summary with information on all 3 plans.

Plan A Summary of Benefits and Coverage

Plan B Summary of Benefits and Coverage

Plan C Summary of Benefits and Coverage

2013 Benefits Summary

 

The Federal Employee Program (FEP) group health plan renews with BCBSKS on January 1, 2013. The 2013 FEP Benefit information can be located by clicking on www.fepblue.org.

FEP continues to offer two plan options: Standard Option and Basic Option

Standard Option members receive services by choosing a Preferred provider from a network of hospitals, physicians, dentists, pharmacies and other healthcare providers. When the member uses a Preferred provider, the provider files the claim, payment is made to the provider and the member is only responsible for any difference between the allowance and the payment. This is also true for Participating providers. Members can choose to use Non-participating providers, but the out-of-pocket expenses may be higher than if the member uses Preferred or Participating providers.

2013 changes to the Standard Option include:

Basic Option members must receive care performed by Preferred providers, except in certain situations, such as emergency care. Most care under Basic Option is subject to a copayment amount. Preferred providers file your claims and payment will be made to the provider.

2013 changes to the Basic Option include:

2013 changes that are included in both the Standard and Basic Options include:

Please visit www.fepblue.org for detailed information on the 2013 FEP member benefit plans and changes.

View or download the FEP 2013 Benefit Plan Brochures online by clicking on the link below.

2013 Federal Employee Program (FEP) Benefit Plan Brochures

If you have questions regarding the 2013 SOK or FEP member benefits, please contact your BCBSKS Institutional Provider Representative.

 

 

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