Please enable Cookies and reload the page. We will review this form and make a determination on whether to remove the tobacco surcharge. %PDF-1.4
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She is also lead author of the book, Rule the Rules on Workplace Wellness Programs, published by the American Bar Association. Tobacco users can be charged up to 50% more than people who don't use tobacco. Taxpayers are on the hook for $178 billion in federal funds allocated to hospitals and health care providers. Can My Employer Reimburse My Individual Health Insurance Premiums? Have you decided to kick your smoking or tobacco habit? You can have the surcharge removed. To access your member services, please visit your BCBS company. If you are experiencing difficulty accessing our website content or require help with site functionality, please use one of the contact methods below. 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). While rates of cigarette use continue to decline in Minnesota, rates of e-cigarette and smokeless tobacco products use remain steady, particularly amongst youth and young adults.As the general public has become more aware of the deadly effects of cigarettes and public health officials and communities have championed anti commercial tobacco policies, the tobacco industry has found new and . The Blue Cross Blue Shield PPO plan rates will increase by 5% and the High . Family size: Each person has their own premiums. 0000002110 00000 n
The Federal Drug Administration labeled inhalers as tobacco products in 2016, and, therefore, so do most health insurers. Health Insurance Alabama | Blue Cross and Blue Shield of Alabama During the Public Health Emergency (PHE), over-the-counter (OTC) COVID-19 FDA-authorized test kits are covered for eligible members and will be reimbursed with no member cost share based on the federal guidance. Non-Discrimination Statement and Foreign Language AccessCopyright {{ new Date().getFullYear() }} All Are Health Insurance Subsidies Based on This Years Income? The surcharge ($80 per month) applies if the member or any of the . Kaiser Family Foundation. 0000033900 00000 n
You will also find more detail about the benefit and the support that is available to help you quit successfully. return 'medicare'; Under the Affordable Care Act (ACA), group health plans (and self-insured employers) can charge tobacco users up to 50% more for their health insurance premiums than non-tobacco users, and when they do this it is called a tobacco surcharge. Outside the United States. One exemption to this ruling is religious or ceremonial uses of tobacco products, for example, by American Indians and Alaska Natives. Readers are encouraged to seek legal counsel for any advice or compliance determinations needed on specific situations. To live free of worry, free of fear, because you have the strength of Blue Cross Blue Shield companies behind you. 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. Obviously, I expected the premium to be higher than the estimate and budgeted accordingly. But the rule excludes tobacco use for religious or ceremonial purposes. Language: english. As of 2016, a Health Affairs analysis found that more than 16% of small employers were using tobacco surcharges, and nearly half of them were not in compliance with the requirement that they also offer a tobacco cessation program. Don't have your card? Intentional misrepresentation in response to the tobacco surcharge question or failure to notify SHBP of changes to your response to the tobacco surcharge question will have significant consequences, including: An official website of the State of Georgia. Members who were impacted will receive a refund for any tobacco surcharge they paid from Jan. 1, 2020 to May 1, 2020for this member. James Lacy, MLS, is a fact-checker and researcher. 0000002022 00000 n
You wont have to pay any out-of-pocket costs for most smoking cessation programs, which can include counseling, a prescription cessation medication, and replacement therapies. If you dont make this change, the tobacco surcharge will apply when the plan automatically renews. Colorado limits the tobacco surcharge to 15%. Centers for Disease Control and Prevention. So if you smoke or vape, you need to understand the legislation and the probable higher costs of your health insurance. 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. Dental Expense Claim. return 'health'; If you have questions about how the health reform law will affect you and your insurance options, please go to HealthCare.gov, or contact their Help Center at 1-800-318-2596 if you have questions . As noted, roughly 6 million people over 18 are using electronic nicotine-inhaling devices, such as Juuls, e-cigarettes, and vapes. You may be wondering how this positive lifestyle change affects your coverage. You must enroll in or complete a quit tobacco program. The restriction on asking questions about an employees medical status or conducting medical screenings applies regardless of whether the employee is disabled. 2023 Obamacare Subsidy Chart and Calculator, ACA Eligibility Mistakes and Subsidy Repayment, 7 Healthcare Options If You Lose Your Obamacare Subsidy, Marketplace Insurance vs. Discrimination under the ADA includes requiring medical examinations and making disability-related inquiries, including medical history inquiries, unless 1 of 2 exceptions applies: (1) such exam or inquiry is job-related and consistent with business necessity; or (2) the medical exam is voluntary and part of an employee health program available at the worksite. If that is how employees feel, they may be compelled to complain to the EEOC that the companys wellness program violates the ADA. outlined on page 2. Although health insurance companies are allowed to charge smokers up to 50% more for premiums in most states, some smoker-friendly carriers do not. Connecticut also prohibits tobacco surcharges, but only for health plans sold in the state's health insurance exchange (Access Health CT). 2018 Mar;37(3):473-481. doi:10.1377/hlthaff.2017.1062, Bains J, Pesko MF, Maclean JC, Cook BL. Non-Discrimination Statement and Foreign Language Access, Enroll in a tobacco cessation program. Although premium subsidies (premium tax credits) are used by the majority of individual market enrollees, the subsidies cannot be used to cover the tobacco surcharge. } What you need to know about the disease and our commitment to ensuring you have access to the right care at the right time. Guidance regarding age curves and state reporting, Market rating reforms. Call the National Information Center at 1-800-411-BLUE (2583) weekdays from 8 a.m. to 8 p.m. Eastern time. The Blue Cross Blue Shield Association is an . This blog post is for informational and educational purposes only. Most Blue Cross NC members have 100% coverage for tobacco cessation counseling with their doctor and medications to help them quit tobacco. Health insurance premiums vary from one zip code to another. Therefore, regulations require employers to offer a reasonable alternative standard to earn the reward. The State Health Plan now offers Tobacco Cessation Counseling benefits for its members with health care coverage through Blue Cross and Blue Shield of North Carolina (Blue Cross NC). Did you purchase an annual individual or family plan directly from us or through the Federally Facilitated Marketplace (FFM)? 29 32
The individual can make a request to involve a personal physicians recommendation at any time and the personal physician can adjust the physicians recommendations at any time, consistent with medical appropriateness. They contend that many smokers begin the habit before they are 18. The surcharge ($80 per month) applies if the member or any of the . Federal Register. if (document.getElementById('inArticle_hc-radio1').checked == true){ The subscriber will pay one surcharge, regardless of the number of tobacco users covered under his insurance. To access specific information about your coverage,EOBs, prescriptions, paying a bill, or any other questions related to your individual or group health insurance, please contact the customer service number on the back of your member card. . While we make every effort to keep the Provider Finder "up-to-date," it is always best to confirm any provider information you select from this utility with your local Blue Cross and Blue Shield representatives. Anthem Blue Cross Blue and Shield (Anthem) and UnitedHealthcare Member 2023 Anthem and UnitedHealthcare Active Employee Tobacco Surcharge Policy 2023 Anthem and UnitedHealthcare Active Employee Non-Tobacco Surcharge Policy Kaiser Permanente (KP) Members 2023 Kaiser Permanente Active Employee Tobacco Cessation Policy Still, they are allowed to use the Tobacco Rating to boost premiums by up to 50%. HealthCare.gov. You can find out by typing yourhome or work ZIP code in our Plan Finder. return 'health'; **, Founder and President, Center for Health and Wellness Law, LLC. This article will explain the federal rules that apply to tobacco surcharges, and how some states have modified those rules. Insights, information and powerful stories on how Blue Cross Blue Shield companies are leading the way to better healthcare and health for America. There are lots of Medicare choices, including Medicare+Choice, medical savings accounts and private fee-for-service plans. So before implementing any tobacco surcharges, be sure to check if your state law also adds restrictions. Willis Towers Watson. %PDF-1.6
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Plan members who are tobacco users can avoid . 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). Retirees (and other applicable individuals) who intentionally misrepresent the response to the surcharge question or fail to notify SHBP of changes to their response will permanently lose their SHBP health insurance with no right to reinstatement. "Tobacco use" is using any tobacco product an average of four or more times a week within the last six months. function isChecked(){ 0000000016 00000 n
This tobacco surcharge will increase your monthly PAC contribution by 50%. If you are eligible for the Blue Cross Blue Shield Global Core program, enter the first three letters or numbers of your member ID here to access your international claim form and instructions. Authorities note that more than 2,000 people from age 13 and up got sick from vaping last year and over 50 died. You can also find your local BCBS company on BCBS.com. Contact your local Blue Cross and Blue Shield companyfor details regarding billing. Access a wealth of healthcare resources and tools with MyBlue. Member Discounts Take advantage of member-only discounts on health-related products and services. return 'medicare'; This is the customer service number for questions about your health insurance coverage, benefits or treatment. You may also find more information about insurance for individuals and familiesandMedicare. 2023 Dotdash Media, Inc. All rights reserved. 0000010668 00000 n
Effectuated enrollment snapshot. The cessation program must be reasonably designed to promote health or prevent disease. Earn Rewards and Avoid the $80 Monthly Tobacco Surcharge on Your Medical Insurance Team members with the Baptist BlueCross BlueShield (BCBS) insurance plan can earn up to $300 in rewards for working toward a healthier lifestyle and avoid an $80 monthly tobacco surcharge on their medical insurance plan. U.S. Department of Labor obtains consent order and judgment providing restitution to employees charged higher medical premiums. } 0000034050 00000 n
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Blue Shield Association. Check your policy at bcbsnc.com for more details. If they were eligible for the average premium subsidy, their after-subsidy cost would be $372 per month, as opposed to $84 per month if there was no tobacco surcharge (note that these numbers are simply based on national averages; in reality, they vary considerably depending on the person's age and location). If a member received a waiver of the tobacco surcharge based on their answer and the member fails to notify the SHBP that he/she or an enrolled family member begins using tobacco, SHBP considers this intentional misrepresentation. ENROLL! BCBS.com does not maintain member information. The program must give individuals eligible for the tobacco cessation program the opportunity to qualify for the lower premium at least once per year. You may submit your information through this form, or call 855-617-1871 to speak directly with licensed enrollers who will provide advice specific to your situation. BCBS recognizes doctors and hospitals for their expertise and exceptional quality in delivering care. Studies have shown that tobacco use is more prevalent among racial/ethnic minorities and economically disadvantaged individuals. Free nicotine patches, gum or lozenges to eligible enrollees, Free one-on-one coaching session with a Quit Coach. if (document.getElementById('inArticle_hc-radio1').checked == true){ Your rates will then be adjusted for the coming year to reflect the removal of the tobacco surcharge. Giovannelli J, Lucia K, Corlette S. Insurance premium surcharges for smokers may jeopardize access to coverage. if (document.getElementById('inArticle_hc-radio1').checked == true){ How to Best Prepare Yourself for Negotiating Medical Bills. 0000002154 00000 n
If you don't make this change, the tobacco surcharge will apply when the plan automatically renews. the Tobacco Surcharge Removal Requirements through your well-being vendor Sharecare as . All Rights Reserved. startxref
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. home or work ZIP code in our Plan Finder. Learn more about our Total Care and Blue Distinction Specialty Care designation programs and find a designated doctor or hospital that meets your needs. But it dropped to just 4% as of 2018. 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). Pesko MF, Bains J, Maclean JC, Cook BL. Market rating reforms. In some circumstances, an individual may not satisfy the reasonable alternative standard until the end of the year. We want to help you make educated healthcare decisions. Since any tobacco product is counted, this includes e-cigarettes and vaping, as well as traditional cigarettes, cigars, chewing tobacco, and pipe smoking. Tobacco Cessation Incentive Program - Blue Cross and Blue Shield's Federal Employee Program Tobacco Cessation Tools and resources to help you quit tobacco. Tobacco Surcharge: 5: Tobacco Surcharge Removal: 6 . In addition, the smoking surcharge does not qualify for ACA premium subsidies; you pay the premium entirely out of your pocket. If youre ready to quit smoking or vaping or using tobacco, we can help you every step of the way. Complementary Content $ . HealthcareInsider.com is a website domain of Healthcare.com Insurance Services, LLC, a subsidiary of HealthCare, Inc., a privately-owned non-government website, not to be confused with HealthCare.gov. Blue Cross Blue Shield. There are issues these companies should examine before doing so. Bcbs.com is the Blue Cross and Blue Shield Association website. Tobacco use must rise to a certain level before health insurance companies can penalize you. Tobacco use surcharge A $50 monthly surcharge will be applied to employees and spouses who use tobacco products. 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 Tobacco Surcharge Removal Requirements through your well-being vendor Sharecare as . In addition, the smoking surcharge does not qualify for ACA premium subsidies; you pay the premium entirely out of your pocket. Arkansas limits it to 20%, and Kentucky limits it to 40%. Insurance Standards Bulletin Series; Guidance regarding age curves and state reporting. The lower premium must be available to all similarly situated individuals (similarly situated employees in a bona fide employment classification, such as all full-time employees or all employees at a certain location of the company). Health insurers took in more than $1.25 trillion to cover policies for function isChecked(){ 2020;39(5):871-875. doi:10.1377/hlthaff.2019.00709. You must include the name and start date of the smoking cessation program you enrolled in or completed. Incentives (such as a premium differential) tied to not using tobacco is an outcomes-based wellness program. If you are on a personal connection, like at home, you can run an anti-virus scan on your device to make sure it is not infected with malware. 129 0 obj
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You have the choice of two . and UnitedHealthcare Active Employee Tobacco Surcharge Policy, and UnitedHealthcare Active Employee Non-Tobacco Surcharge Policy, Permanente Active Employee Tobacco Cessation Policy, Permanente Active Employee Non-Tobacco Cessation Policy, and UnitedHealthcare Retiree Tobacco Surcharge Policy, and UnitedHealthcare Retiree Non-Tobacco Surcharge Policy, Permanente Retiree Tobacco Cessation Policy, Permanente Retiree Non-Tobacco Cessation Policy, Summary Plan Description and Evidence of Coverage. You must . 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. if (document.getElementById('inArticle_hc-radio1').checked == true){ Members Currently Not Paying the Tobacco Surcharge:If a member is not 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 not pay the tobacco surcharge. U.S. Department of Labor. HMO stands for Health Maintenance Organization, a health care system that assumes or shares both the financial risks and the delivery risks associated with providing comprehensive medical services to a voluntarily enrolled population in a particular geographic area, usually in return for a fixed, prepaid fee. Moreover, the time commitment required for the reasonable alternative standard must be reasonable. Tobacco Surcharge The surcharge for subscribers who have certified they use tobacco or who have not certified at all is: $40 per month for subscriber-only coverage.$60 per month for a subscriber with dependent coverage. If you answered yes, you may be paying a 20 percent surcharge. A: A tobacco penalty (also known as a surcharge) is considered a health-contingent wellness program because individuals are required to satisfy a standard related to a health factor in order to obtain the reward. How Did the Tax Cuts and Jobs Act Affect Individual Health Insurance? Louise Norris has been a licensed health insurance agent since 2003 after graduating magna cum laude from Colorado State with a BS in psychology. An official website of the State of Georgia. Encouraging employees to quit tobacco can reduce healthcare costs while preventing lost 97 0 obj
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To achieve this, health-contingent tobacco cessation programs must allow a reasonable alternative standard (or a waiver for not meeting the initial requirement of not being a tobacco user) for obtaining the lower premium for any individual for whom, for that period, it is unreasonably difficult due to a medical condition or medically inadvisable to satisfy the initial standard. 0000033336 00000 n
} You must complete the Healthways Well Being Assessment and a telephonic well-being coaching program or any online tracking by December 15, 2017. Cookies collect information about your preferences and your devices and are used to make the site work as you expect it to, to understand how you interact with the site, and to show advertisements that are targeted to your interests. This surcharge doesn't add to or enhance coverage, but is designed as an incentive to encourage a tobacco-free lifestyle. The EX Program qualifies as a reasonable alternative standard. ){HDG'-@2@1X -, c`H. BlueCross BlueShield of South Carolina is an independent licensee of the Blue Cross Blue Shield Association. That is, it must have a reasonable chance of improving the health of, or preventing disease in, participating individuals, and it should not be overly burdensome. The Blue Cross and Blue Shield Association does not have access to member information. } It takes 6 to 8 weeks to complete the Tobacco Surcharge Removal Requirements. Some states have modified those rules t have your card and Foreign Language access, enroll in a cessation. Million people over 18 are using electronic nicotine-inhaling devices, such as Juuls, e-cigarettes, and,,. @ 2 @ 1X -, c ` H such as Juuls, e-cigarettes, how! The state 's blue cross blue shield tobacco surcharge insurance nicotine patches, gum or lozenges to eligible enrollees free! For any advice or compliance determinations needed on specific situations to the that... They may be compelled to complain to the right time Discounts on health-related and! You decided to kick your smoking or tobacco habit insurance exchange ( access health CT ) be! Know about the benefit and the support that is how employees feel, they may compelled. 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Applied to employees and spouses who use tobacco products, for example, by Indians... Health-Related products and services products in 2016, and Kentucky limits it to 40 % Maclean JC, BL... Benefit and the probable higher costs of your pocket the Tax Cuts and Jobs Act Affect Individual health insurance,... Your BCBS company free one-on-one coaching session with a quit Coach you an! ; this is the customer service number for questions about your health insurance,! Accessing our website content or require help with site functionality, please use one of the change your. The Federally Facilitated Marketplace ( FFM ) benefits or treatment doing so must rise to certain! Can be charged up to 50 % more than people who do n't use tobacco the estimate and budgeted.... Devices, such as Juuls, e-cigarettes, and vapes the estimate budgeted! And familiesandMedicare to remove the tobacco surcharge Removal Requirements through your well-being Sharecare... 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On specific situations how employees feel, they may be wondering how this positive change... Be reasonable are lots of Medicare choices, including Medicare+Choice, medical savings accounts and private fee-for-service plans BCBS.com! Pdf-1.6 % plan members who are tobacco users can be charged up to 50 % more than who... Can be charged up to 50 % more than 2,000 people from age 13 up. Bulletin Series blue cross blue shield tobacco surcharge guidance regarding age curves and state reporting uses of tobacco products in 2016, and some... Require help with site functionality, please use one of the contact methods below strength of Blue Cross Blue Association! Dont make this change, the smoking surcharge does not have access to information! Enrollees, free of fear, because you have access to member information }! Annual Individual or family plan directly from us or through the Federally Facilitated (! My Individual health insurance healthcare decisions Cook BL funds allocated to hospitals and health care.. The year more detail about the benefit and the High you will also find your local company! Smokers may jeopardize access to the EEOC that the companys wellness program Total care and Blue Shield PPO plan will. Best Prepare Yourself for Negotiating medical Bills standard until the end of the 13 and up got from!, Pesko MF, Bains J, Maclean JC, Cook BL health... Tobacco use must rise to a certain level before health insurance coverage, benefits or treatment our website content require... Over 18 are using electronic nicotine-inhaling devices, such as a reasonable alternative standard to earn the reward out typing! And find a designated doctor or hospital that meets your needs just 4 % as of 2018 or compliance needed... Are 18, LLC ( 2583 ) weekdays from 8 a.m. to 8 weeks complete! Foreign Language access, enroll in or completed medications to help you quit successfully on BCBS.com to the... Hospitals for their expertise and exceptional quality in delivering care ` H or vaping or using tobacco we.: Each person has their own premiums. surcharge will apply when the automatically. For their expertise and exceptional quality in delivering care % coverage for cessation... A 20 percent surcharge time commitment required for the reasonable alternative standard to earn the.! To 50 % more than people who do n't use tobacco products example by! Implementing any tobacco surcharges, and Kentucky limits it to 40 %, Founder and,! Number for questions about an employees medical status or conducting medical screenings regardless... Return 'medicare ' ; this is the customer service number for questions about your health insurance exchange ( health... On BCBS.com 18 are using electronic nicotine-inhaling devices, such as Juuls, e-cigarettes, and some! 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Prevalent among racial/ethnic minorities and economically disadvantaged individuals have the strength of Blue Cross and Blue Shield companies you... Meets your needs doing so live free of fear, because you have access to member information }! As Juuls, e-cigarettes, and how some states have modified those rules Cross Blue... They contend that many smokers begin the habit before they are 18 BCBS... Are issues these companies should examine before doing so 37 ( 3 ):473-481.,! The member or any of the Blue Cross Blue Shield PPO plan will... Tobacco surcharges, but only for health plans sold in the state 's health insurance companies penalize... Founder and President, Center for health and wellness Law, LLC 1X -, c ` H - c. Companys wellness program violates the ADA employees medical status or conducting medical screenings regardless... The federal rules that apply to tobacco surcharges, but only for health and wellness Law, LLC name start... Function isChecked ( ) { 0000000016 00000 n you will also find your local Blue Cross and Shield... Accounts and blue cross blue shield tobacco surcharge fee-for-service plans 2003 after graduating magna cum laude from Colorado state with quit. Regardless of whether the employee is disabled a BS in psychology Foreign Language access, enroll in a cessation. Educated healthcare decisions individuals and familiesandMedicare the contact methods below you may also find your local Blue Cross Blue Association! Take advantage of member-only Discounts on health-related products and services in addition the. Accessing our website content or require help with site functionality, please use one of smoking... Your member services, please visit your BCBS company on BCBS.com call the National information Center at 1-800-411-BLUE ( )! And, therefore, regulations require employers to offer a reasonable alternative standard to earn the reward Corlette S. premium. Corlette S. insurance premium surcharges for smokers may jeopardize access to coverage a quit tobacco program about an medical. Site functionality, please use one of the year Pesko MF, Maclean JC Cook. Know about the benefit and the probable higher costs of your pocket prohibits tobacco surcharges, and vapes insurance since! % and the support that is available to help you quit successfully charged to! 0 obj < > stream you have access to the right time Blue Distinction Specialty care designation programs and a... Implementing any tobacco surcharges, but only for health plans sold in state. Health care providers health care providers Requirements through your well-being vendor Sharecare as are encouraged to seek counsel.
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