Highmark Blue Cross Blue Shield Updates

View Update 

You’re Invited: Highmark Q2 All-Agency Webinar

Highmark welcomes you to join in an learn more about their approach to their ‘Living Health Solutions’ Model. This session will benefit Producers with clients or prospects, and plans to focus on the following key interests:

• Fertility & Family Planning
• Diabetes Management

We hope you can attend – Registration link found below.

Highmark Plan Advisor Modernization for Small Group Sales

Highmark has invested in system enhancements to modernize their Plan Advisor Tool. This should improve small group renewal and small group new business activities handled through their proprietary system. Launch dates for the new system are shown below for the Highmark segments where we serve as a General Agency Distribution Channel:

Pennsylvania (all regions) – Launch on Monday, April 28^th, 2025
West Virginia – Launch on Monday, April 14^th, 2025

If you are an NFP BNGA Producer Partner that relies on the support of our NFP BNGA team for renewal actions and New Business Quotes/Implementation through the system:

• This change will not impact you directly – our team will continue to transact in the system on your behalf.
• Please continue to direct any renewal decisions or new business submissions to our team via nfpbnga@nfp.com or our secure upload link for processing.
• Although no training will be required and the above does not directly impact your process, please know that changes are underway and your patience through the process will be greatly appreciated.

If you are an NFP BNGA Producer Partner that utilizes the Plan Advisor system directly, for hands-on small group renewal or small group new business activity:

• See the highlighted portion below regarding renewal and/or new business submissions from now through the launch date.
• As a safety net, we ask that you cc: nfpbnga@nfp.com in any items submitted directly to the Highmark team.
• We will contact your team to arrange demonstration and training on the new tool. If you have questions in the interim, please reach out to Kara Bernhart or Cheranne Jurena.
• Your participation in any upcoming learning will be key to future success, and your patience throughout the process is greatly appreciated.

Highmark has also taken this opportunity to adjust their sales collateral to match fields in the updated platform. Please see the updated Small Group Submission Checklist with refreshed materials in the Small Group Sales Resource Center. 

View Update 

Consolidated Appropriations Act Section 204 Reporting Mandate: Prescription Drug Spending

• Section 204 of the Consolidated Appropriations Act, 2021 (CAA) requires health insurance issuers and self-insured group health plans to submit information regarding prescription drug spending, health care spending, and enrollment each year to the Centers for Medicare and Medicaid Services (CMS) on an annual basis. This information must be submitted in specific file formats to CMS for the 2024 calendar year by June 1, 2025.
• Highmark is willing to report on behalf of fully insured and ASO clients, but will need to request supportive information (to complete this reporting) directly from our mutual clients via email over the following week. (Brokers may hear from Highmark Client Managers to assist with contacting some clients if valid client emails are not within Highmark records.)
• Fully insured and ASO clients that would like Highmark to submit data to CMS on their behalf must submit all required information via the Prescription Drug Data Collection (RxDC) Survey no later than April 14th. Otherwise, the client will have to submit independently to CMS.
• Highmark’s approach is outlined below – Please encourage your clients to complete Highmark’s direct request for information.
• Our NFP BNGA team will reach out to you if there are groups that Highmark is seeking your assistance to contact.

View Update 

Highmark Southeastern PA Announces: Earn More with Highmark’s New Business Incentive!

• Highmark announces their new incentive program for New to Highmark clients written with effective dates 2/1/2025 through 1/31/2026
• Below payout amounts are specific to New to Highmark sales within their Southeastern PA Region (Bucks, Montgomery, Philadelphia, Chester, and Delaware Counties)
• Details included on payout timeline indicate when the general agency distribution channel will receive payment. NFP BNGA will distribute full compensation received to our Partner Producers via the corresponding commission cycle.

For questions on general eligibility, reach out to your NFP BNGA team via nfpbnga@nfp.com.

With questions related to any sold client specific incentive, please reach out to nfpbncommissions@nfp.com with the client’s name, market segment size, and effective date.

View Highmark Update 

Highmark Select PA Regions, DE and WV: Earn More with Highmark’s New Business Incentive!

• Highmark announces their new incentive program for New to Highmark clients written with effective dates 2/1/2025 through 1/31/2026.
• Below payout amounts are specific to New to Highmark sales within the West Virginia, Delaware, and the following Pennsylvania Regions:
  • Western PA
  • Central PA
  • Northeastern PA
  • Please note: Delaware appointment is not available through our distribution channel.
• Details included on payout timeline indicate when the general agency distribution channel will receive payment. NFP BNGA will distribute full compensation received to our Partner Producers via the corresponding commission cycle.

For questions on general eligibility, reach out to your NFP BNGA team via nfpbnga@nfp.com.

With questions related to any sold client specific incentive, please reach out to nfpbncommissions@nfp.com with the client’s name, market segment size, and effective date.

View Highmark Update 

Highmark: Sharon Regional Health System Update

Please see the Highmark Announcement relevant to Membership within the Northeastern Pennsylvania region. As any additional news is released surrounding this topic, we will continue to share.

View Highmark Update 

Highmark Weight Loss Medication – Client Email-Letter Template

In answer to requests for suggested verbiage to communicate changes to Highmark’s GLP-1 Receptor Antagonist changes, templates have been created. Sample verbiage and instruction to complete can be found in Highmark’s Producer Blast below.

For reminder on changes announced earlier in the year regarding this change – visit here and summary below on this geography.

• This GLP-1 Receptor Agonist for weight loss exclusion already existed for Pennsylvania ACA Small Group & Individual (and Small Group Grand-mothered in Northeastern PA)
• Weight loss medications, including GLP-1s FDA approved for weight loss, is automatically excluded from coverage beginning with December 1, 2024 plan renewal dates and upon renewals occurring thereafter for the following newly impacted PA segments:
  • PA Fully Insured Large Group (unless specifically meeting grandfathered status requirements)
  • PA Fully Insured Small Group Grand-mothered in Western PA and Central PA

• Coverage of GLP-1’s FDA approved for diabetes will not be impacted, although some Authorizations or Medical Management may apply.
• ASO clients will continue to have choice of coverage.

View Highmark Update 

Highmark Small Group Sales Resource Center (Digital Room)

Highmark welcomes you to phase 1 of the new Small Group Sales Resource Center (digital room)! The below link has been shared, by Highmark Client Service, for customers and brokers alike. Content can be accessed without a login and regardless of appointment status.

Small Group Sales Resource Center 

Important notes about the resource center:

• The resource center will replace the marketing landing pages. The region-specific marketing landing pages will not be updated for 2025.
• The resource center can be accessed via cell phone, but the layout isn’t ideal.
• Phase 1 includes the necessities to sell, renew, and service customers.
  • Updates and additions will take place over the next few days.
• 2025 documents are uploaded at this point. TBD if 2024 documents will be uploaded for retractive reference.
• Phase 2 will include information on Highmark’s Living Health programs and a host of other forms, flyers, brochures, etc. It’s slated for go live by November 15.

Visit the site to take a look, and we recommend that you favorite or bookmark the page for easy access. Please reach out to your NFP BNGA Team with any questions.

Medicare Creditable Coverage Requirements

• Re-sharing the Highmark guidance surrounding the Medicare Part D Creditable Coverage Requirements.
• Due to changes in 2025 Medicare Rx plans, we may see more occurrences of plans deemed ‘non-creditable’.
• As clients report to their membership annually, and often include the determination as a part of other touch points with their members, it is important to know where resources can be found to identify this key determination.
• Highmark has included resources via links in the email below (specific to Highmark Region) and will plan to include this determination status in future released plan portfolios.

If you have questions specific to a client, Highmark Client Management can assist us in determinations. Please feel free to direct any inquiries to your NFP BNGA team via nfpbnga@nfp.com.

Announcing Vice President of Eastern Pennsylvania Sales and Client Management

• Highmark is bringing their Free Market Health Pharmacy downstream as a small market solution.
• Copies of Client Communications are provided via links below, as well as a deeper dive into the advantages the program offers.
• This program will become available to ACA and non-ACA small group clients for an August 1^st, 2024 effective date.
• ASO Clients have the option to adopt the Free Market Health Solution or to continue with their existing specialty arrangement. This decision must be submitted by 8/31/2024 for a January 2025 effective date of change.

View Highmark Update 

May 2024 Updates:

• Highmark regularly assesses their Prescription Formulary to ensure it provides safe & cost-effective treatments options for its members.
• As of July 1, 2024, there are a number of medications removed from Highmark Formularies & some remaining, that now have Step Therapy requirements.
• An appeal/exception process is available for members of plans with Closed Formularies, that seek consideration to stay on their medication. Providers can complete a non-formulary drug form on the members behalf if they believe there is medical reason for continuance of the removed drug.
• Any Highmark members known to be taking a medication impacted by the formulary deletions or utilization management changes, and their Prescribing Providers, will be informed of these changes in writing by Highmark.

View Highmark Update 

• Highmark Southeastern PA Region is offering enhanced Medical Discounts to New to Blue Mid-Market clients that carry existing United Concordia Dental Coverage.
• Offer is valid for clients enrolling in the New Highmark Medical Coverage for 8/1/2024 through 1/1/2026 effective dates.
• For questions regarding the offering or assistance in quoting Medical for the Highmark Southeastern PA regions, please reach out to your NFP BNGA Team via nfpbnga@nfp.com.

View Highmark Update 

New Highmark Billing Late Pay & Termination Process

Highmark has informed us of some changes on how they notify us and employers when a group is either delinquent or set to be terminated due to non-payment of premium.

Employer Notification:

• 15 days behind on premium – Highmark will send a (digital) reminder that payment is due
• 30 days behind on premium – receive a hard copy warning letter in the mail
• 60 days behind on premium – receive a hard copy termination letter in the mail stating the group will be termed on date X unless paid

Broker Notification:

• NFP BNGA will no longer receive copies of letters that were mailed to employers.
• We will receive a list from Highmark of groups who are delinquent once the 30-day warning letters have been mailed.
• Highmark will follow up with us regularly with a list of groups that have paid OR continue to be delinquent.
• Highmark will advise us on final termination date if applicable. This status will be shared with your teams from the NFP BNGA Team.
• For any of the above steps, your NFP BNGA Team will share notification(s) via email with our impacted Producer Partners.

Any groups that terminate and need to reinstate must pay all outstanding premiums as well as current premiums owed.

Spring 2024 Producer Training Series Webinar Recordings & Slide Decks Now Available

For those that may have missed any live sessions of Highmark’s 2024 Producer Training Series, please see the recordings and accompanying slide decks available.

These highly informative sessions offer helpful details surrounding the following topics:

• MyHighmark App and Website (all regions, all sizes, all funding arrangements)
• Mental Well-Being powered by Spring Health (all regions, all sizes, all funding arrangements)
• Specialty Drug Management – Free Market Health (all regions, all sizes, all funding arrangements)
• Highmark Performance Networks (all Pennsylvania regions)
• Large Group Quoting Requirement – applicable to 51-99 and 100+ (all regions)*
• Christiana Virtual Primary Care (specific to Delaware only)
• Dental Updates – separate sessions available for each Highmark Region

*For quoting assistance, please reach out to your NFP BNGA Team. If you are an organization that is hands-on for your own large market quoting submissions, please note that Highmark will be looking to see the General Agency (Benefits Network Inc / NFP) listed as ‘Agency’ on the Quote Request Form, with ‘Name of Producer’ reflecting your agent’s name. Please be sure to include nfpbnga@nfp.com on your submission.

Important Update Regarding Multi-factor Authentication (MFA) for Producer Portal Access

• • Earlier this month Highmark enhanced the security of their Producer portal with prompts for new password & the addition of Multi-Factor Authentication.
  • For those with established portal access, please see below on what to expect throughout upcoming log-in attempts
  • If you are an organization that has shared log-in details through the past, independent access should be established for members of your team that plan to utilize the Highmark system.
  • As your General Agency for Highmark Group Commercial coverage, we can help in this process – Please reach out to your NFP BNGA Team for assistance.

View Highmark Update 

April 2024 Updates:

Highmark PA Update – 2024 MSP/MLR Survey Collection – Action Required

• Communications from Highmark had been distributed earlier this month regarding a survey requirement for groups size. This is directly related to Medicare Secondary Payer (MSP) determinations and Medical Loss Ratio (MLR) calculations.
• As there are multiple regulations that overlap in timing, it may be differentiate this request from the CAA RxDC Survey requests clients are similarly be presented with
• Please see below from Highmark to indicate when/what communication was circulated to clients, along with some further explanations of purpose.
• Helpful Resources included
  • link to the client letter copy
  • link to Highmark’s MSP/MLR survey instructions that includes path to online survey

View Highmark Update 

Highmark Update – CAA Rx Data Reporting Mandate – Action Required by Clients

• Please see the reminder from Highmark regarding upcoming deadline for Consolidated Appropriations Act (CAA) RxDC Reporting.
• Clients that have not completed Highmark online survey(s), in its entirety, by the required deadline will be responsible for their own filing. It has been clarified by Highmark Account Management that the official deadline is 11:59pm on April 30, 2024.

Your NFP BNGA Team is working with Highmark to obtain status reporting, for a snapshot of what clients may not have taken sufficient action. We will share those results with your teams.

View Highmark Update 

Spring 2024 Producer Training Series Webinars

Highmark announces a number of informative webinar opportunities within their Spring 2024 Producer Training Series – your participation is highly encouraged!

• Trainings will take place throughout April 2024. If you are interested but unable to attend live, registration will typically yield a recorded follow-up.
• Please note that trainings are categorized below to specify any Region, Group Size, or Funding specific eligibility criteria. States/Regions where Highmark branded products and services are offered are as follows:
  • Highmark Pennsylvania (NFP BNGA serves as a General Agency Distribution Channel for all PA regions)
    • Western PA
    • Central PA
    • Northeastern PA
    • Southeastern PA
  • Highmark West Virginia (NFP BNGA serves as a General Agency Distribution Channel for the WV Region)
  • Highmark New York (outside of the NFP BNGA General Agency Channel – a referral to partnering GA organization can be provided)
  • Highmark Delaware (outside of the NFP BNGA General Agency Channel – a referral to partnering GA organization can be provided)

If you have questions related to Highmark products or opportunities or wish to receive more information on a Highmark related topic not reflected below, please contact Kara Bernhart of your NFP BNGA Team.

The Highmark Region applicable for your Producer Appointment is specific to the situs location of your client. If you are unsure what Regions you are contracted within, or have interest in expanding your Producer Appointments, please reach out to Cheranne Jurena.

View Highmark Update 

March 2024 Updates:

CAA Rx Data Reporting Mandate – Action Required by Clients

• Section 204 of the Consolidated Appropriations Act, 2021 (CAA) requires health insurance issuers and self-insured group health plans to submit information regarding prescription drug spending, health care spending, and enrollment each year to the Centers for Medicare and Medicaid Services (CMS) on an annual basis. This information must be submitted in specific file formats to CMS for the 2023 calendar year by June 1, 2024.
• Similar to last year, Highmark is again offering to complete the Employer Plan Sponsor portion of this CAA RxDC Reporting requirement.
• Slight changes to the Highmark process this round are the following:
  • Fully insured and ASO clients that would like Highmark to submit data to CMS on their behalf must submit all required information via the Prescription Drug Data Collection (RxDC) Survey below by no later than May 1, 2024. Otherwise, clients will have to submit independently to the federal governing agencies.
  • Highmark is requesting information to complete this reporting directly from our mutual clients via email this week (sample below). Highmark Client Managers may seek broker action to assist with contacting some clients where delivery issues arise – we will inform you of any requests pertaining to your clients.
• To support the completion of the survey, a detailed worksheet and process overview document are being provided by Highmark below. It is strongly recommended to complete the worksheet prior to completing the survey to expedite the submission process.
• Support of this initiative is important to encourage client completion. It is much smoother if clients take advantage of the carrier offer to complete CAA RxDC reporting requirement on their behalf, rather than going through the process independently.
  • A sample Outlook template (example of verbiage some Producers are using in client communication to support Highmark outreach) is available and can be easily modified to suit your messaging preferences. *Please email nfpbnga@nfp.com if you would like to request this Outlook template.
  • If clients choose to ignore this request or not comply by the specified deadline, please note that the carrier & NPF BNGA cannot intercede on their or your behalf.
• We have requested additional details from the carrier to help determine where their CAA RxDC links were specifically routed per client and will work towards helping to track progress of this initiative. More resources will be provided as they are obtained.

View Highmark Update 

Prescription Drug Data Collection (RxDC) Overview 

Prescription Drug Data Collection (RxDC) Survey Worksheet 

How Highmark is Helping Participating Providers After Change Healthcare Cyber Event

Reminder: Highmark’s Well360 Virtual Health Accessibility in 2024

Highmark relies on Producer Partners to help educate members on what benefits are at their fingertips and how to access them best. As Highmark makes a final push to redirect members to the new My Highmark App, the availability of these resources on that platform can help to keep Virtual Health accessibility front of mind to members. The standalone Well360 Virtual Health app and website can no longer be used to schedule virtual visits – it will only be accessible via the My Highmark App.

View Highmark Update 

2024 Highmark Brochures and Forms

2024 Blue Plans – Network Listing and Maps  

2024 Enrollment Form  

2024 Member Change Form  

2024 Preventive Schedule – WPA  

BCBS My Highmark Member Activation – Find In-Network Providers 

Blue365 Flyer, BCBS  

BlueCard International Travel Flyer  

Copay Armor Member Flyer, BCBS  

Mental Well-Being Post-Enrollment Flyer, MyHighmark, BCBS 

Onduo Diabetes Management Post Enrollment Flyer, BCBS 

Sword Virtual Physical Care Member OE Brochure, BCBS 

Well360 Virtual Health Enhanced Flyer, BCBS 

February 2024 Updates:

Highmark Producer Portal’s New Password Requirements for Enhanced Security

As an advanced warning, you may be prompted to create new password when entering the Highmark Product Portal. Password parameters are now stricter and will need to adhere to the guidelines shown below. If you have questions or difficulties, contact the respective technology teams with the contact details provided.

View Highmark Update 

UPDATE: $0 in HSA Fees for New and Existing Clients that Add HSA w Eff. Dates Prior to 6/30/2025

Highmark is currently offering options for $0 HSA administration to self-insured clients. They are extending the promotion further to include effective dates through 6/30/2025. If stepping into a Producer relationship with a current Highmark ASO client, or looking to shop an ASO client with Highmark in the near future, this offer can be beneficial.

View Highmark Update 

Changes & Upgrades to Highmark’s Employer Portal

Highmark is seeking Producer assistance to spread the word regarding Highmark Employer Portal changes.

• The former client portal experience is being replaced by the new experience enhancement.
• An email template is provided for ease of communication to your Highmark clients & to introduce the advantageous features of the upgrade.
• This change similarly affects Producers that utilize the portal, through Highmark Producer Portal Single Sign on, for the ‘Log-in As Employer’ capabilities.
• If you are not currently utilizing this functionality but have interest in doing so, please reach out to your NFP BNGA Support Team.

View Highmark Update 

UPDATE: GLP-1 Receptor Agonist Metformin Autostep Removal

• Changes are occurring for prescription drug management of GLP-1 (Gluacagon-Like Peptide-1 Receptor Agonist) that now require prior authorization.
• This change occurred 1/1/2024 for new starts, but is now applicable to existing users effective 4/1/2024.
• Impacted members are being issued notification from Highmark
  • Members with a diagnosis of diabetes were grandfathered through 9/30/2024 and will not receive a letter at this time.
  • Current mailing (early February) includes applicable members whose employer group renewals May through July 2024.
  • Further impacted members will receive notification on a quarterly basis.
• Examples of Member & Provider Letter verbiage are included below.
• The communication rollout plan outlined is applicable to fully insured groups.

Please reach out to your Highmark Service Manager or NFP BNGA Team for any specifics on an ASO client.

View Highmark Update 

January 2024 Updates:

December 2023 Updates:

October 2023 Updates:

September 2023 Updates:

Highmark released updated Grandmothered Small Group Policy Renewal Options for 2023-2024

View Grandmothered-Portfolio Brochure 2023 WPA – 2024 Update 

Highmark released an update regarding CAA Gag Clause Prohibition Attestation.

• For this particular Consolidated Appropriations Act, 2021 (CAA) Gag Clause Prohibition provision, there are filing requirements to multiple enforcement agencies due December 31, 2023.
• Highmark is taking steps on behalf of its fully insured clients.
• Highmark clients with ASO coverage will be responsible for their own preparation & filings.

July 2023 Updates:

June 2023 Updates:

Highmark distributed the July 2023 Plan for Health Newsletter:

• July 2023 Plan for Health Newsletter
• Highmark_July Recipe Flyer
• Highmark- July Wellness Poster v2
• Highmark_July Digital Display 1080×810

May 2023 Updates:

April 2023 Updates:

March 2023 Updates:

Highmark distributes CAA RxDC Reporting Survey:

• Tri-state agency mandate requires reporting of prescription data for 2022 calendar year
• Highmark’s deadline is Friday, April 21, 2023
• Downline producers with Small Group Highmark business will be contacted by NFP BNGA for next steps

Highmark extends cost-share waiver plans through May 31, 2023

• Public Health Emergency ends May 11, 2023

Highmark announces new 2023 New to Highmark Incentive:

• Applies to Small & Large Group in PA
• Effective dates February 1, 2023 – January 1, 2024
• Amounts as follows:
  • New to Highmark Group Medical:
    • Fully Insured – $100 per contract
    • ASO w Rx – $50 per contract
  • Medical Underwriting Incentive:
    • Completed with FormFire – $7.00 per application
    • Completed Paper Application – $1.00 per application
    • Sold Medically Underwritten – $3.00 per application
  • Bundled Incentives:
    • High Performing Networks* – $3.00 per contract
    • Stop Loss with HMIG – $2.00 per contract
    • Spending Accounts – $2.00 per contract
    • Dental (UCD or BED) – $1.50 per contract
  • Well360 Clinical Incentives:
    • Well360 Clarity – $5.00 per contract
    • Well360 Connect – $4.00 per contract
    • Well360 Focus – $2.50 per contract
    • Well360 Lifestyle – $2.00 per contract
    • Well360 Concierge – $1.00 per contract
    • SmartShopper – $0.50 per contract
• Incentive details:
  • This Incentive applies to Small Group (2-50) and Large Group (51+) clients in Pennsylvania.
  • Applies to effective dates February 1, 2023 – January 1, 2024.
  • All agencies qualify for the New to Highmark Incentive.
  • New to Highmark Incentive is a one-time payout, paid on sold contracts 60 days after the effective date.
  • Medical Underwriting incentive is only paid when Highmark Medical Applications are completed. If more than one producer submits medical applications for the same client, incentive is paid to the first producer to provide a complete submission.
  • Incentive is capped at $500,000 per agency, not to exceed $100,000 per client.
  • Incentive is contingent upon received and applied payment from the client.
  • Highmark reserves the right to recoup the incentive if the group cancels before their next renewal date, or if the business does not remain in place for one full year.

Highmark releases March 2023 Plan for Health Newsletter:

• March 2023 Plan for Health Newsletter
• Focus on Mental Health – crisis lines included with self-care & coping skills
• March Wellness Poster
• March Recipe Flyer

February 2023 Updates:

Corrected Highmark WPA Brochures – Digital Files:

• Highmark WPA Small Group ACA Brochure
• Highmark WPA Small Group ACA Brochure – For Printing

Updated WPA Small Group Sold Checklists:

• SMALL GROUP SOLD GROUP CHECKLIST – CPA
• SMALL GROUP SOLD GROUP CHECKLIST – NEPA
• SMALL GROUP SOLD GROUP CHECKLIST – WPA
• SMALL GROUP SOLD GROUP CHECKLIST – WV

Highmark Spring 2023 Broker Webinar Training Series:

• February 28 @ 10 AM: High Performing Networks
  • Slide deck
  • Recording
• March 1 @
  • 9 AM: Mental Health Parity
    • Slide deck
    • Recording
  • 10 AM: Pharmacy Updates
    • Slide deck
    • Recording
  • 2 PM: Large Group New Business Quote Requirements
    • Slide deck
    • Recording
• March 2 @ 10 AM: Analytics Navigator
  • Slide deck
  • Recording
• March 8 @ 2 PM: PA Blue Edge Dental Updates
  • Slide deck
  • Recording
• March 9 @
  • 10:30 AM: My Highmark Mobile App & Website
    • Slide deck
    • Recording
  • 3:30 PM: NY Blue Edge Dental Updates
    • Slide deck
    • Recording
• March 13 @ 1:30 PM: WV Blue Edge Dental Updates
  • Slide deck
  • Recording
• March 14 @
  • 10 AM: Social Determinants of Health (SDoH)
    • Slide deck
    • Recording
  • 2 PM: Large Group New Business Implementation – Onboarding Portal
    • Slide deck
    • Recording
  • 3 PM: DE Blue Edge Dental Updates
    • Slide deck
    • Recording
• March 15 @ 2 PM: Medical Underwriting & FormFire
  • Slide deck
  • Recording
  • FormFire User Guide
• March 22 @
  • 10 AM: Well360 Motion powered by SWORD
    • Slide deck
    • Recording
  • 3 PM: NY Product Review & Clinical Management Solutions
    • Slide deck
    • Recording
• March 23 @ 10:30 AM: Medically Tailored Meals (Food 2.0)
  • Slide deck
  • Recording

January 2023 Updates:

December 2022 Updates:

• Highmark released the latest issue of The Advisor, available here.
• Highmark released the January 2023 Plan for Health Newsletter.

November 2022 Updates:

• November 2022 “Plan for Health” Newsletter
• December 2022 “Plan for Health” Newsletter
• Pharmacy network update:
  • Kroger intends to terminate their agreement for network participation with Express Scripts effective 1/1/2023
    • Not many Krogers in our area but applies to business in DE, NY, PA & WV
  • Highmark is proceeding as if the contract is terminated but will update if that changes
  • Change will impact members within Highmark’s Commercial, ACA, & CHIP business
    • Members will receive a mailing

• Highmark 2023 Experianfor Small Groups:

  • No-cost identity protection services to all eligible plan members
  • Employers who opted in to identity protection services in 2022 will be automatically renewed through Experian for 2023
  • Employers opting in for the first time in 2023 should do so through the portal at highmarkbcbs.com
    • Open enrollment period is now – December 31
    • Groups should enroll & notify their employees to enroll by December 31

October 2022 Updates:

• Small Group Q1 2023 new business rates are now available on the Producer Portal for PA.
  • Q1 2023 Small Group ACA Benefit Changes brochure available here..
• Please access 2023 SGBAs / Enrollment/Waiver Forms / Electronic Enrollment Spreadsheet (new business only) for specific regions below:
  • WPA Small Group Business Application
  • CPA Small Group Business Application
  • NEPA Small Group Business Application
  • WPA Enrollment/Waiver Forms
  • CPA Enrollment/Waiver Forms
  • NEPA Enrollment/Waiver Forms
  • Electronic Enrollment Spreadsheet
• Summer 2022 Producer Training Series Recap:
  • Fully Insured Clinical Management:
    • Slide Deck
    • Recording
  • Producer Portal – Enrollment & eBill Demo:
    • Recording
    • FAQ
  • ASO Clinical Management Solutions – Part 1:
    • Slide Deck
    • Recording
  • ASO Clinical Management Solutions – Part 2:
    • Slide Deck
    • Recording
  • Beneficity:
    • Slide Deck
    • Recording
  • Individual ACA & Medicare – 2023 Product Overview:
    • Slide Deck
    • Recording

September 2022 Updates:

August 2022 Updates:

Investment account changes:

• 3 different investment options – Managed, Self-Directed, & Brokerage
• Effective 8/1/2022 – all HSA members who do not have an investment account are being directed to new investment solution
• Effective 9/21/2022 – HSA members who do have a current investment account will have funds liquidated & moved to their HSA cash balance account
• Effective 10/3/2022 – liquidation of all member investment funds will be completed
• FAQ for Blue Cross Blue Shield (PA)

Back by popular demand: Producer Training Series – Summer 2022 Edition

• 30-60 minute training sessions to provide up-to-date information
• Fully Insured Clinical Management – Monday, August 29, 2022 @ 11:00 AM
  Description: Join our clinical management team to learn about the Well360 Core clinical solutions available to all fully insured members including Proactive Specialty Case Management, the Integrated Care Team, and our Type 2 Diabetes Management. Information will apply to fully insured all market segments for clients in PA, DE, WV, and NY.
  Registration Link: Click for Fully Insured Clinical Management
• Producer Portal – Enrollment & eBill Demo – Monday, August 29, 2022 @ 1:00 PM
  Description: The enGen team will be providing a demo of the enrollment and billing functions accessed through the producer portal. This information will apply to fully insured clients in all market segments in PA, DE, WV, and NY.
  Registration Link: Click for Producer Portal – Enrollment & eBill Demo
• ASO Clinical Management Solutions – Part I – Tuesday, August 30, 2022 @ 9:00 AM
  Description: Join our clinical management team to learn about Well360 Core for ASO, Well360 Lifestyle and Well360 Focus. New for 2023 – these programs will be available to ASO clients with 250+ contracts. Learn how these clinical solutions enhance engagement opportunities for members with emerging risk and prevalent conditions. Information will apply to ASO clients in PA, DE, WV, and NY.
  Registration Link: Click for ASO Clinical Management Solutions – Part I
• ASO Clinical Management Solutions – Part II – Tuesday, August 30, 2022 @ 10:00 AM
  Description: An opportunity to continue the Clinical Management conversation with a deep dive into Well360 Connect and Well360 Clarity. These programs integrate member advocates with our multidisciplinary clinical team and even member engagement guides to deliver proactive member engagement and guided care navigation that drive optimal health outcomes and near-term cost savings. Information will apply to ASO clients in PA, DE, WV, and NY.
  Registration Link: Click for ASO Clinical Management Solutions – Part II
• Beneficity – Thursday, September 1, 2022 @ 11:30 AM
  Description: Join our client advising team to learn about Beneficity. Beneficity will be available to large national and strategic clients beginning January 1, 2023, and available for clients with Well360 Concierge, Well360 Connect and Well360 Clarity. Beneficity is a single place to access benefits, personalized tools and even links to programs and offerings provided by the employer. It is an easy place to go for total health. The app makes it easy to stay on top of benefits and coverage right from a phone.  Check claims, view ID card or find a provider, connect to a virtual visit or a health coach. It allows members to easily access many employer-sponsored benefits for physical health, financial health, and wellness.
  Registration Link: Click for Beneficity
• Individual ACA & Medicare – 2023 Product Overview – Tuesday, September 6, 2022 @ 12:00 PM
  Description: Join our federal markets team to learn about 2023 products and enhancements for Individual ACA and Medicare members. Information will apply to federal market members in the PA, DE, WV, and NY markets.
  Registration Link: Click for Individual ACA & Medicare – 2023 Product Overview
• Specialty Pharmacy Transition – Wednesday, September 7, 2022 @ 10:00 AM
  Description: Join our pharmacy team to learn about the specialty pharmacy transition to Accredo coming January 2023. Information will apply to ASO clients, individual and SG ACA, as well as SG grandmothered clients in PA, DE, and NY.
  Registration Link: Click for Specialty Pharmacy Transition
• Renewal Timelines & Expectations – Tuesday, September 7, 2022 @ 12:00 PM
  Description: Join members of our client management team to learn about renewal timelines and expectations to help prepare you for the upcoming business session! This webinar will be geared toward 51+ business in PA.
  Registration Link: Click for Renewal Timelines & Expectations

July 2022 Updates:

Highmark to provide guidance & support to customers in light of Roe v Wade legislature – updates to come.

• FAQ link here.

UnitedConcordia & Blue Edge Producer Incentive Program:

• Applies to UCD Direct & BED business
• Please note: Although UCD branded business is written outside of our GA channel, this incentive is also valid towards any Highmark Blue Edge Dental sales that are within our portfolio.
• 2022 Small Business Reward Program
• 2022 Large Business Reward Program

June 2022 Updates:

Click the links below to access Highmark WPA commonly used forms:

• Highmark Enrollment Form – New Participant or Waiver
• Highmark Change Form — Existing Member Changes or Terms

Click here to access a Highmark Portal Training Guide.

Behavioral Health with AHN & Highmark Webinar Recording available here.

Spring 2022 Updates Webinar Info

• Recording: Spring 2022 Webinar
• Slide Deck: Spring 2022 Updates

Marketing Materials

• Performance Blue – WPA
• MEG – WPA
• Well360 Diabetes – Member Flyer – WPA
• Kidney Care Management – WPA
• Behavioral Health – Client Brochure – WPA

Free Market Health – February 2022 Webinar

• Free Market Health Webinar Recording
• Free Market Health Slide Deck

Highmark to Expand Pharmacy Program CoPay Armor, Effective July 1, 2022 – for select eligible self-funded clients

Highmark to adhere to Transparency Mandates in 2022 – more info here.

May 2022 Updates:

View region-specific marketing landing pages or microsites:

• Central Pennsylvania
• Northeastern Pennsylvania
• Western Pennsylvania
• West Virginia

April 2022 Updates:

View Highmark Producer Refresher Recordings:

CLINICAL UPDATES WEBINAR RECORDINGAND SLIDE DECK

High Performance Networks Webinar Recording and Slide Deck (All Markets)

Well360 Core & Sharecare Webinar Recording and Slide Deck (All Markets)

Pharmacy Updates Webinar Recording and Slide Deck (All Markets)

Spending Accounts Webinar Recording and Slide Deck (Mid/Large Market)

Free Market Health Webinar Recording and Slide Deck (Large Market)

Well360 Enhancements Webinar Recording and Slide Deck (Large Market)

HM Life Stop Loss Webinar Recording and Slide Deck (Self-Funded)