Under the revised benefits provision, BCBS Standard Option enrollees will be responsible for 30 percent of the plan's payment allowance for the surgery to be performed, plus the difference between the plan's allowance and the amount billed by the surgeon. In addition, Blue Cross and Blue Shield will, for the first time, provide prior approval for all non-emergency, out-of-network surgeries of $5,000 or more, enabling enrollees to know in advance how much BCBS will pay for the surgery. BCBS also will provide additional information and assistance to make the patient's costs more transparent. Enrollees must initiate this prior-approval process. * * * With the change in benefits in Blue Cross and Blue Shield, OPM has instructed federal agencies to accept belated Open Season enrollments through the end of January 2009.Here are OPM's FAQs on the belated enrollment process and BCBSA FEP's letter to Standard Option subscribers explaining the change.
Tuesday, December 16, 2008
Blue Cross FEP resolves out-of-network surgery benefit issue with OPM
OPM announced today that Blue Cross Blue Shield FEP has modified its 2009 Standard Option out of network surgical benefit that was the subject of a December 3, 2008, Federal Workforce subcommittee hearing. According to OPM,