July 10, 2014




All Blue Cross Contracting Providers


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


BCBSKS policy on providers paying premiums for Marketplace health plans

The Department of Health and Human Services (HHS) issued guidance on November 4, 2013 regarding third-party (including hospitals and other health care providers) payments of premiums and/or other insured cost-sharing obligations for qualified health plans in Marketplaces. Within that guidance, HHS noted it has significant concerns with this practice because it could skew the insurance risk pool and create an unlevel field in the Marketplaces. HHS discouraged the practice and encouraged issuers to reject such third party payments. HHS further indicated it intends to monitor this practice and take appropriate action, if necessary. 

In conjunction with this guidance, it is Blue Cross and Blue Shield of Kansas' (BCBSKS) policy to accept only premium payments from our members, groups, or private, not-for-profit foundations.  Funds from such foundations should be designated only for patients selected for their financial status, not for their health status, and BCBSKS expects that any such premium and cost sharing payments cover the entire policy year.

If you have questions regarding this newsletter, please contact your Institutional Provider Representative.  Denny Hartman can be reached at 1-316-269-1602; Cindy Garrison at 1-785-291-8862 and Janne Denton at 1-785-291-8813.