Policy Updates for 2022 — No Surprises Act
At the end of 2020, the No Surprises Act was passed into law as part of the Continuing Appropriations Act (CAA) and went into effect for plan or policy years beginning on or after January 1, 2022. This important legislation establishes federal standards that will help to protect BAC members from balance billing for certain services, such as emergency care or treatment by out-of-network providers at in-network facilities.
When you see a doctor or other health care provider that is in the plan’s network you may owe certain out-of-pocket costs, such as a copay, coinsurance, and/or a deductible. You may have other costs or need to pay the entire bill if you see a provider or visit a health care facility that is not in the plan’s network, otherwise referred to as an “out-of-network provider.” Out-of-network providers may be permitted to bill you for the difference between what the plan agreed to pay, and the full amount charged for a service. This is called balance billing. This amount is likely more than in-network costs for the same service.
“Surprise billing” is an unexpected balance bill. This happens when you cannot control who is involved in your care, such as when you have an emergency or when you schedule a visit at an in-network facility, but are unexpectedly treated by an out-of-network provider.
The No Surprise Act applies to individual, small group, and large group fully insured markets and self-insured group plans, such as the BAC International Health Fund (IHF). For the IHF, member cost-sharing for these specified out-of-network items and services will be capped at in-network levels and will require providers to work with the IHF’s insurers, United Healthcare and Geisinger, to negotiate remaining bills. If they are unable to reach agreement, an Independent Dispute Resolution (IDR) process, or arbitration, will occur to determine the reimbursement amount. IHF participants that believe they have been incorrectly balance billed should contact the IHF Fund Office at 1-888-880-8222.
New Rally® Rewards for 2022
The IHF is excited for the third year of the United Healthcare Rally® Rewards program. Rally is an app that can help you make simple changes to your daily routine, set health goals, and help you to stay on target to meet those goals. Members that participate receive rewards for taking healthy actions. The first of those actions is completing a quick Health Survey. Rally® will then make personalized recommendations just for you. You will be able to sync your tracking device, join a challenge, and all while earning virtual coins that can be exchanged for rewards.
Other health actions that earn you coins include completing an annual physical, completing a preventive screening, enrolling in the SavRx mail-order service, visiting the BAC Cares on-site clinics in Indiana or Missouri, completing a virtual visit, or participating in the Real Appeal program. Once members have earned enough coins, they can be exchanged for prizes including a BAC jacket, Bose Soundlink Bluetooth speaker, or can be donated towards a donation to the BAC Disaster Relief Fund.
This program is exclusively for members of IHF participating locals. Members can enroll online at www.myuhc.com or by downloading the “Rally by Rally Health” App and entering code BAC123. If you have any questions about the BAC Cares Rally® Rewards program, contact the IHF Fund Office at 1-888-880-8222.