Highmark Blue Cross Blue Shield Latest Updates

Highmark Update: The American Rescue Plan Act of 2021 + COBRA (Review Highmark Info Sheets, Client and Eligible Member Letter Samples)

2021 Small Group Resources


Highmark Annual Group Client MSP/MLR Employee Count Collection Online Surveys – due from clients 5.24.2021

Bonus DetailsNew Highmark Incentive Program (2/1/2021 through 1/1/2022 Effective Dates) for Small Group (2-50) and Large Group (51+) sales, cross-sells (and prospects when applicable).  Review the variety of ways you can qualify for payouts related to the underwriting process and sales of Highmark branded business.

NFP-BNGA 51+ Highmark Updates Webinar – Webinar Recording (4.21) and Resources here

Partnership SpotlightHighmark & WellSpan Population Health Innovation

ChristianaCare and Highmark Health Collaboration Announcement

BCBS Class Action Suit

  • Read NFP Guidance issued regarding the Blue Cross Blue Shield Class Action Settlement.
  • Highmark’s Producer Portal similarly provides a link to the settlement website, toll-free inquiry number (866) 681-1142 and email address info@BCBSsettlement.com

Highmark to Offer New Specialty Pharmacy ProgramSempre Health, Effective July 1, 2021

Highmark Press Release:  Highmark Medical and Pharmacy Benefits Integration Lowers Costs, Improves Health Outcomes

Highmark Extends Coverage of COVID-19 treatment and Telemedicine – Press Release

Visit Highmark’s FAQs page

Notice of Risk Corridor Medical Loss Rebate to Small Group clients and Individual Market members

Important Update regarding OOA/OON Radiology and Cardiac Imaging

Highmark Value Added Benefit Announcement – College Tuition Benefit
This college savings program is now available to Medical (Mid/Large fully-insured & ASO in PA, DE & WV) and BlueEdge Dental (Small/Mid/Large clients in PA & DE).

Highmark and HealthNow New York receive Affiliation Approval

Living Health Dynamic Platform update: Verily collaboration announced

No Action Required: Clients being notified of PLHIGA

Highmark HPN: Performance (Flex) Blue Webinar – session focused on the Southern Alleghenies Region (Recorded Webinar)

Highmark Member Brainshark: The Highmark Plan App

Highmark Member FAQs related to COVID-19 Vaccine & COVID-19 Vaccine Flyer

Highmark Resource Reminder regarding end-of-year relief packages and programs to assist small businesses:

  • Paycheck Protection Program (PPP)
  • Economic Injury Disaster Loans (EIDL)
  • Tax Credits
  • Grants
  • Loan Programs

Highmark to Offer New Pharmacy ProgramCopay Armor, Effective January 1, 2021 (Large Group Market)

Highmark HSA Custodian Update (PNC Bank to WealthCare Saver): No Action Needed

Highmark Living Heather Dynamic Platform – a Google Cloud Collaboration

Highmark Update: Extension Allows Members to Continue Receiving Needed Care Without Cost-Sharing Costs through 3/31/2021 for Commercial and ACA Business

For Producers with Clients in the 100+ Market Segment that access Analytics Navigator – Join Highmark for Producer Webinar regarding Reporting Enhancements (Register for one of multiple date options here)

Bonus Info – Additional components added to the New to Highmark Producer Incentive (10/1/2020 through 1/1/2021 Effective Dates)

  • 51+ enrolled in any product line (with additional bundling payouts)
  • 2-50 Together Blue

Highmark Introduces Performance Blue, Performance Flex Blue, and Blue HPN – Highmark Performance Networks  for the 51+ Market (Producer Recorded Webinar)

Highmark 2021 Renewals have been released & New Business Rating is available.  To coincide, please see the following 2021 Resources:

Additional Highmark 2021 Resources available by Region (WPA, CPA, NEPA or WV) on the Highmark Producer Portal (Be sure to choose the appropriate Region via the Change Agency/Region feature on your Welcome Page or contact your NFP-BNGA Team with Questions)

Highmark has determined that all of its 2020 and 2021 Small Group prescription drug plans qualify as “creditable coverage.” View the Highmark Creditable Coverage Determinations & Their Creditable Coverage Notice verbiage by selecting the applicable region:

Are your Clients’ Employees utilizing Highmark’s no-cost identity protection services? Learn more about the Experian Identity Protection Services value added benefit – Available to groups of all sizes.

View the Recorded Small Group Together Blue Highmark Producer Webinar

Highmark Extends Rate Hold for Blue Edge Dental Groups Under 100

Small Group Balanced Funding (Level Funded products) now available for Quoting.

  • View the Highmark Producer Update  with Balanced Funding Resources here.
  • Contact your NFP-BNGA Team with questions.

The American Cancer Society in WPA will host a virtual symposium, November 17, 2020, 9-10AM.  Highmark invites you & your clients to join in and watch their panel of AHN leaders discuss “COVID thru the Cancer Experience” at this informative event.  Please share the registration link with your clientsACS Cancer Forum

View changes to the current Highmark 51+ New to Blue Producer Incentive

Highmark Updates:

Highmark Fitness Your Way by Tivity Health – September Promotional Flyer (initiation fees waived in month of September)

Highmark Western PA Small Group Communication – News From the Small Group Highmark WPA Sales Team (August 2020) Topics to include…

Highmark Update: Direct Access to Spending Accounts

Highmark’s Offering Blue Edge Dental Premium Credits

Highmark Announces Blue Edge Dental Rate Holds

Highmark Revisions to Small Group Forms & Western PA Small Group Checklist made for July 1 forward.  Items are also available on the Highmark Producer Portal or would be provided via the support of your NFP-BNGA Team during implementation of a New to Blue group.

Highmark partners with Fitness Your Way® to offer gym discount programs for Highmark members eager to get back into their health and wellness routine.  Monthly & Enrollment/Initiation Fees applied, but the Initial fee can be waived in the month of July when using Highmark coupon code (JUMPINJULY )  Read more about Fitness Your Way & How Members Enroll

Interested in learning more about Highmark’s Level-Funded Offerings (available 7/1/2020 for groups size 51-500)? Review the following or reach out to Cheranne Jurena

Highmark & HealthNow New York Announce Affiliation Agreement

Highmark raises awareness to small group relief availability – The Pennsylvania 30 Day Fund is a non-profit recently launched to provide forgivable loans of $3,000 to Pennsylvania small businesses struggling as a result of the COVID-19 pandemic. Learn more here

Highmark Extends Coverage of COVID-19 treatment and telemedicine

Highmark News: COVID-19 Update May 22, 2020  Edition

Learn more about Highmark’s Balanced Funding Products (level-funded benefits for groups 51+) available for July 1st effective dates onward.  Watch the Recorded Webinar, view the Presentation Slides or contact your BNGA Team for more information.

Highmark Update – Site of Care Drug Management Program

Updated Highmark Client Change Forms are available for Small Group Clients seeking to update company details (Ownership, Waiting Periods, Eligibility, etc.) within Highmark’s system (instruction included)

Highmark COVID-19 Medicare Retiree Solutions Info

Highmark Announces Improvements to Base Experience Periods (related to non-ACA clients with renewals in 2th Quarter & onward)

Highmark Western PA 2020-2021 Small Group Producer Presentation for refreshers on Grandmothering rules, Pharmacy formulary updates, Underwriting changes & Value adds.

Highmark: Enhancing and Integrating Health Care Transparency Tools for Members

Highmark Weekly COVID-19 Update – April 3, 2020 Edition

Highmark Waived Deductibles, Coinsurance and Copays for In-Network, Inpatient Hospital Care for COVID-19 Treatment

Highmark Frequently Asked Questions for Clients & Producers – re-iterating access points to COVID-19 Medical care & providing resources to financial relief programs

Highmark Annual Group Client MSP/MLR Employee Count Collection Online Survey – the deadline for this mandatory Medicare Secondary Payor survey has been adjusted to 4/30/2020.

Continuity of Coverage and Employer Options’ for Fully Insured & ASO Customers in Response to COVID-19

Important Information Regarding COVID-19 for Fully Insured Customers (3/11/2020)

COVID-19 Relief Program for ASO Customers (3/6/2020)

Highmark Blue Shield & WellSpan Health Announce Plans for new Collaboration to Improve Care & Lower Costs (3/6/2020)

Highmark 51+ New to Blue Incentive_February 1, 2020 through January 31, 2021

Highmark 51+ Extra Incentive for CommunityBlue/Flex New Business or PPO Conversion  extended through January 1, 2021

Highmark to Offer New Pharmacy Formulary Effective February 1, 2020 – Core Formulary (replacing Progressive Formulary in WPA)

Highmark Announces ‘Small Group ACA New Business Incentive Program’ in Western PA (1/1 through 3/1/2020 Eff. Dates)

Highmark Teams Up with Civica Rx and BCBSA to Lower Outpatient Generic Drug Costs (1/29/2020)

Allegheny Health Network Fast Facts

2020 Western PA Small Group Producer Update