Emergency financial assistance is available to small businesses
For employers with less than 500 employees: If COVID-19 is causing financial difficulties for your business, financial relief loans are currently being offered to assist you in maintaining employees and keeping your business operating.
In some cases, you may need to provide your current payroll expenses. Use our eBilling tool to access your payment history.
Erie County COVID Impact Loan Program
The Regional Development Corporation, part of the Erie County Industrial Development Agency, is offering disaster relief assistance for qualified small businesses (under 50 employees).
The cost of the test and treatment is fully covered for our members
We understand that our members may be concerned about their access to care during this time. Be assured, we will cover the full cost of COVID-19 diagnostic tests as prescribed by doctors. We will also cover the full cost of COVID-19 treatment regardless of where the care is provided in the United States. We are not requiring prior authorizations for testing, and all costs for participating doctors, telemedicine, urgent care, and emergency room visits for diagnostic testing related to COVID-19 have been waived.
Managing Premium Invoices and Payments
BlueCross BlueShield offers a quick and easy way to manage your health plan and pay your premiums. By logging into your employer account, you can manage invoices, schedule convenient automatic payments, and track payment history.
Set Up An Online Account
Complete the HIPAA Employer Authorization Form. The completion of this form is required to access the online portal. Once HIPAA Authorization form is received, you can log in to your account to handle tasks such as, pay an invoice, complete an enrollment or termination request.
myStrength by Livongo®
During this stressful time, myStrength by our partner Livongo is here for you. Learn ways to manage extreme stress, get tips for parenting during challenging times, and find support to help you take care of your emotional health. Available through the end of June.
Frequently Asked Questions (FAQs)
BlueCross BlueShield of Western New York is closely monitoring the COVID-19 (Coronavirus) situation. The health and well-being of our members is our top priority, and we remain committed to ensuring our employers and members have access to the care and information they need.
Will my employees have to pay to get the vaccine?
- The first quantity of doses for the vaccine have been paid for in advance by the federal government
- BlueCross BlueShield fully-insured commercial, and Medicare members will not have to pay a cost-share for the COVID-19 vaccines that are authorized through an emergency use authorization (EUA) and recommended by the Advisory Committee on Immunization Practices (ACIP)
- Please note: If a member receives the vaccine at their PCP office, other services performed at the same appointment will be covered in accordance with your health plan benefits
Will there be any plan costs for the vaccine?
- Yes, while the federal government will cover the cost of the vaccine, providers can charge an administrative fee. (CMS has indicated the following allowances – https://www.cms.gov/medicare/covid-19/medicare-covid-19-vaccine-shot-payment)
- We expect similar allowances for commercial and ASO business
- Express Scripts has also implemented a $20 administration fee per COVID vaccination dose
As a self-funded plan, can I apply a member cost share for the administrative fees?
- Federal guidance indicates that any non-grandfathered commercial or ASO employer group must cover the vaccination administration cost at $0 in-network and out-of-network under preventive benefits
- BlueCross BlueShield is strongly encouraging all self-funded grandfathered plans to cover the cost-share for their members. For alternative arrangements, groups should contact their Account Executive
Is the vaccine safe?
- The Food and Drug Administration (FDA) and the Advisory Committee on Immunization Practices (ACIP) carefully review all safety data from clinical trials before authorizing or recommending a vaccine for emergency use only when the expected benefits outweigh potential risks
- FDA and CDC will continue to monitor the safety of COVID-19 vaccines, to make sure even very rare side effects are identified
- For more information on the safety of the vaccine, visit cdc.gov
When can my employees get vaccinated?
- We are supporting the federal, state and county distribution plans for the vaccine
- The CDC has said the goal is for everyone to be able to easily get a COVID-19 vaccine as soon as large quantities are available; however, not everyone will be able to get vaccinated right away
- The first people to receive the vaccine will be nursing home residents and staff and high-risk hospital workers followed by:
- Long term care residents
- EMS workers
- Essential workers
- General population
- Staff at every NYS hospital will have access to the vaccine by a hospital that has the storage capacity
- While specific distribution plans are still in development, we encourage members to prepare for a COVID-19 vaccine by consulting with their primary care provider
How many doses are needed for the vaccine?
- Nearly all COVID-19 vaccines being studied in the United States require two shots
- The first shot starts building protection, but a second dose is required a few weeks later to get the most protection the vaccine can offer
Cost Shares and Claim Processing
Premiums and Invoicing
Enrollment and Eligibility
Will there be enrollment and eligibility flexibility during this state of emergency?
- Yes, BlueCross BlueShield will extend the 30-day enrollment guideline until further notice.
- Eligibility transactions can be updated in a timely and automated manner via BlueConnect, our online enrollment tool.
Does the enrollment flexibility allow for special enrollments during this state of emergency?
Special enrollment is associated with a qualifying event, as outlined in our Group Benefit Administrator Manual
Examples of qualifying events would include newborns, loss of spousal coverage, etc.
These qualifying events allow for changes in coverage in eligibility
Employees who waived coverage during the open enrollment period without a qualifying event cannot be added to the plan
We can connect these employees with our consumer market account executives to explore alternative coverage options
Members can call us directly at 1-800-888-5407
Will you accept emails for eligibility transactions?
- No, we cannot accept emails to request eligibility transactions
- We encourage you to use our BlueConnect tool or complete an application.
- Applications can be downloaded from our website, and employee signature is not required.
- Until further notice, we will not be requiring back up paperwork for items like domestic partner enrollment, adoption or disabled dependents
- We will conduct an audit of transactions to obtain this information once the state of emergency is lifted
Plan and Coverage Options
Can I add a less expensive plan option?
Small groups can hold a one-time special open enrollment provided it’s available to all employees.
NOTE: If employees make a plan change mid-year, accumulators (such as deductibles and out of pocket maximums) would reset with their new plan
Accumulators would also reset at their regular open enrollment period as well
Should you wish to hold such a special open enrollment please contact your Account Executive and/or broker
Large groups are subject to underwriting guidelines and review, and as such should contact their Account Executive and/or broker with questions
What other options are available for coverage for members no longer on my group plan?
Can I maintain group coverage if my business has closed permanently?
- No. Employees will receive a termination notice listing enrollment options which include state-subsidized plans (e.g. Medicaid, Essential Health Plan) or direct pay plans
- We will support your employees, by connecting them with our consumer market account benefit consultants to explore alternative coverage options
- Members can call us directly at 1-800-888-5407
- Employees are not eligible for COBRA coverage if the business has closed permanently
Employee Coverage Considerations
If my business has reduced hours or is temporarily shut down, resulting in temporary layoffs, can I keep my employees on my health plan?
- It’s the employer’s responsibility to determine employee coverage status
- If an employer continues to offer health plan coverage and the account is in good standing, employees will continue to have coverage under the period for which premium has been paid
- It is the responsibility of the employer to notify us of a termination of coverage
If I choose to subsidize COBRA coverage for my employees, whether at the current cost share arrangement or an alternative arrangement, how will that be handled?
- We will continue to cover these individuals so long as full payment of the associated COBRA premium is received
Can I amend my new hire policies to allow for coverage immediately upon employees returning to work or on day 1 for new employees?
Employers can amend new hire policies at their discretion
Self-Funded Plans Regarding Stop Loss
What impact will a reduction in employee hours due to COVID-19 restrictions on business operations have on a stop loss policy?
If you modify your plan’s eligibility rules to extend coverage in connection with the COVID-19 pandemic, stop-loss policy claims incurred during the extended coverage period will apply provided that the following conditions are met:
- The extended coverage is offered only to those individuals who were covered under the plan and whose hours of employment were impacted by the pandemic
- You provide us promptly with a clear written description on your Company letterhead of your extended plan eligibility terms
- The extended coverage period does not extend beyond [x date], [x months after the person would have lost coverage under the plan without the eligibility extension], [the date that the public health emergency caused by the pandemic ends], etc. Any additional conditions could be added (e.g. employee having to pay a share)
An Important Message from our Chief Medical Officer, Thomas Schenk, M.D.
In the News
April 28, 2020 | Source: WIVB
April 27, 2020 | Source: WIVB
April 24, 2020 | Source: The Buffalo News
April 22, 2020 | Source: Spectrum News
April 22, 2020 | Source: WIVB
April 4, 2020 | Source: The Buffalo News
Prescription Drug Coverage: What You Need to Know
Use your 90-day mail order benefit
Refill or renew current prescriptions at retail pharmacies when 25% remains
We encourage all employers to login to their secure accounts to access information about billing, enrollment, termination and forms.
Keep Your Employees Informed
The health and well-being of our members is our top priority. Stay up to date with information regarding COVID-19.