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2010-175
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Last modified
2/22/2016 12:36:04 PM
Creation date
10/1/2015 2:21:39 AM
Metadata
Fields
Template:
Official Documents
Official Document Type
Miscellaneous
Approved Date
07/13/2010
Control Number
2010-175
Agenda Item Number
12.D.2.
Entity Name
Blue Medicare Group PPO
Subject
Retirees Blue Cross Blue Shield
Supplemental fields
SmeadsoftID
9738
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. 1 <br /> Financial Conditions for BlueMedicaresm Group Products <br /> ➢ Effective Date — The benefit plan design provided in this proposal will be <br /> effective from October 1 , 2010 through September 30 , 2011 . <br /> r Rates and Benefit Approval — All benefits , value -added services , and <br /> premiums are subject to CMS and the State of Florida OIR approvals , where <br /> applicable . All Group Medicare Advantage , PDP benefits , and service areas are <br /> subject to change at the next enrollment period . <br /> ➢ Rates — All rates are calculated and based on a per- member , per- month <br /> ( PMPM ) basis and are effective from October 1 , 2010 through September 30 , 2011 . <br /> Rates may be lower than quoted for those Medicare eligible retirees who meet the <br /> Low- Income Subsidy ( LIS ) guidelines . A retiree can confirm if they qualify for LIS by <br /> contacting Social Security at 1 - 800- 772- 1213 , visit www. socialsecurity . gov on the <br /> web , or apply at the State Medical Assistance ( Medicaid ) office . TTY users should <br /> call 1 -800 - 325- 0778 . The group ' s montly invoice will reflect retirees ' reduced <br /> premiums and the group must pass this savings on to the eligible retirees . <br /> r Part D Creditable Coverage - If prior creditable coverage cannot be proven , the <br /> enrollee may incur a Late Enrollment Penalty ( LEP ) as defined and set by CMS . This <br /> may cause an increase in their premium . <br /> Medicare Part B — The premium /s provided in this proposal exclude the <br /> Medicare Part B premium required of Medicare eligible enrollees to enroll in <br /> Medicare Advantage or Medicare Supplement plans . Retirees who did not enroll in <br /> Part B when they became eligible may do so during the Medicare Part B Annual <br /> Election Period of January 1 st — March 31 st . Their Part B coverage would not become <br /> effective until July 1st . Depending on the retiree ' s circumstances , CMS may impose a <br /> Part B late enrollment penalty . Possible changes by CMS in year 2011 . <br /> BlueMedicaresM Group Medicare Advantage plans replace Original <br /> Medicare , Individual Medicare plans , and commercial health and Rx plans <br /> offered under the employer ' s group plan . <br />
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