09/13/2006 Benefit changes are announced for 2007

Asuris Northwest Health will make the following changes to all health plans beginning January 1, 2007:

Benefit Changes

Prostate-Cancer Screening.  The Washington Legislature passed a mandate requiring prostate cancer screening coverage in all health plans covering hospital or medical expenses. As a result of the passage of Substitute Senate Bill 6188, we have added coverage for prostate-cancer screening to our group, Individual and conversion plans effective January 1, 2007. Medicare-related products are not affected by this mandate.

The new benefit provides cancer screening in the form of prostate-specific antigen tests, or PSAs, and digital rectal exams if recommended by a physician, a physician assistant or an advanced registered nurse practitioner. Many of our standard health plans covered prostate cancer screening under their preventive care benefit. However, starting in 2007 all group plans will cover these services under a separate benefit with no annual dollar maximum.

This mandated benefit change will apply to group health plans effective January 1, 2007, as groups enroll or renew. We will add it to all Individual and conversion plans across the board effective January 1, 2007.

Chemical Dependency.  As required by Washington State law, the chemical dependency benefit limit must increase each year in increments of $500. This means that the chemical dependency benefit maximum in group medical plans will become $13,500 as groups enroll or renew throughout 2007.

As always, ASO groups are encouraged to take state-mandated benefit changes, but they are not required to do so.

Application Changes

Group Master Applications have also been updated due to Substitute Health Bill 6234 (insurance fraud), which requires carriers to add a statement to applications verifying that all information provided on the application is true, correct and complete. 

We also took the opportunity to add language to the Accountable Officer’s Certification Section of our Group Master Application for 51 or More Eligible Employees, outlining the responsibilities of both the group and Regence BlueShield if any benefit summaries, comparison sheets, contracts or member brochures are sent to the group in an electronic medium for addition to the group’s intranet.

If you have questions about these changes to all health plans, talk with your Asuris Sales contact.

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