PRESORT STD MAIL

US Postage Paid

Albuquerque, NM

Permit No.1439Business Communications

PO Box 27630

Albuquerque, NM 87125-7630

Blue Update July/Third Quarter 2009A Division of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association.

Experience. Wellness. Everywhere.SM

In This Issue

Route to:

________________ _______________________ _______________________ _______________________ _______________________ _______________________ _______

Membership ContactsAnnette Griego Alliance . . . . . . . . . . .962-7128

Sabrina Gordon Groups A-G . . . . . . .962-7177

Cheryl Nava Groups H-P . . . . . . . . .962-7135

Barbara Rankin Groups Q-Z . . . . . . .962-7129

Fax Numbers

Membership . . . . . . . . . . . . . . . . . . . . .837-8950

Sales . . . . . . . . . . . . . . . . . . . . . . . . . . . 837-8600

Proposals/New Groups . . . . . . . . . . . 837-8757

Donna Blackhat . . . . . . . . . . . . . . . . . . . .962-7140

Jermaine Brown – Supervisor . . . . . . . .962-7149

Toll-Free . . . . . . . . . . . . . . . . . . . . . .866-288-6773

For billing inquiries, call 800-414-7147.

Past issues of Blue Updateare available on bcbsnm.com.

BlueUpdate A quarterly publication for our customer groups

July/Third Quarter 2009

CMS Mandate Requires New Reporting Information Health plans are now required by Mandate S111 from the

Centers for Medicare & Medicaid Services (CMS) to report

certain member and employer information that had been

optional. As a Responsible Reporting Entity (RRE) under

CMS Mandate S111, BCBSNM has implemented the meas-

ures needed to comply with the additional data reporting

requirement on our groups’ behalf. At this time, we are col-

lecting the following information from all group accounts:

• Social Security Number (SSN) – for any Medicare-

eligible members and any members over the age of

45, regardless of Medicare eligibility

• Health Insurance Claim (HIC) Number – for

Medicare-eligible members, regardless of age

• Subscriber Employment Status – to properly report

active employment status, as well as determine

Medicare primary or secondary payment status

accurately

• Employer Identification Number (EIN) – to identify

the subscriber’s employer by their official taxpayer

identification number

BCBSNM is working to obtain missing SSNs. In July, we

will send a letter to all existing subscribers with members in

the target group whose SSNs are missing. The target group

includes:

• Subscribers

• Spouses or domestic partners

• Members age 45 or older

• Medicare-eligible subscribers

Going forward, we will send letters to new members in the

target group for their SSNs during the enrollment process.

Also, we will send a letter to members asking for their SSN

six months before their 45th birthday, as well as an annual

letter in April to all members who still have not provided

their SSNs.

Members can reply via mail, call the Customer Service toll-

free number on the back of their member ID cards, or send a

secure e-mail via Blue Access® for Members. In addition to

the mailings, our Customer Advocates will request this

information when a member whose SSN is missing calls

with an inquiry.

BCBSNM is also reviewing if updated employment status

information is needed for subscribers. With the new regula-

tion, the only allowable employment status categories are

Active, COBRA, or Retired. If your company uses other

status categories, account representatives may contact you to

obtain clarification. In the future, we will also need to

receive timely updates when a subscriber’s employment

status changes. Failure to provide timely updates may

impact members’ claim payments.

Automated Eligibility Processing (AEP) accounts will be

contacted with a target date for adding the Medicare

Subscriber Employment Status to their file as needed.

Account representatives will communicate the target date to

groups and provide more details during the next few months.

As a reminder, EINs will be required for any new accounts

or benefit agreements starting in July and for all existing

group accounts by October 2009.

As this is a federal mandate, we must work together to

achieve compliance. While no specific details have been

provided regarding penalties, CMS is authorized to issue

fines up to $1,000 per member, per day for noncompliance.

For more information, go to the CMS website at

www.cms.hhs.gov/MandatoryInsRep.

If Someone You Know is Losing Group CoverageIf you have a friend, neighbor, or family member who is losing group coverage, we offer a range of individual

plans that can work for nearly any budget and may provide a more affordable option to COBRA coverage. Our

individual medical plans now also include optional dental coverage. Information is available at

www.bcbsnm.com or by calling 866-445-1396.

• CMS Mandate Requires New Reporting Information

• 2010 HSA Adjusted Inflation Rates

• Educational Mailings to Dental Members Begin

• Translation and TTY Services Available for Our Members

• Two Online Wellness Tools – Just a Click Away!

• Be Smart. Be Well.TM Features New Topic on Childhood Obesity

• Member Rights and Responsibilities

• If Someone You Know Is Losing Group Coverage

Blue Update July/Third Quarter 2009

Educational Mailings to Dental Members

Translation and TTY Services Available for Our Members

As part of BlueCare Dental ConnectionSM (BCDC), cer-

tain members with dental coverage are sent educational

mailings. Members began receiving this year’s mailings

around mid-June.

BCDC, an integrated medical-dental and preventive

outreach program that compares individuals’ medical

and dental data, reaches out to members considered to

be high-risk (or already diagnosed with certain condi-

tions). This proactive wellness program includes mail-

ings to these members to help educate them about

potential risks and preventive steps to help maintain or

improve both oral and overall health.

BCBSNM is one of the only carriers with a proactive

preventive dental component to its program. These

mailings are a cost-efficient way to reach members who

may benefit from prompt attention to their oral health.

The ultimate goal of this program is to improve health

outcomes and reduce overall costs for both the member

and employer. Members must have both dental and

medical coverage to receive the high-risk educational

mailings; but to receive the preventive mailings, mem-

bers need only dental cov-

erage.

Topics for the 2009

mailers include:

• Periodontal disease

• Diabetes

• Cardiovascular

disease

• Expectant and new

mothers

• Dental sealants

To assist our members with special communication

needs and whose first language is not English, we offer

several services.

Members may ask to speak to a bilingual (English-

Spanish) representative when they call the Customer

Service number on the back of their member ID card.

Our Customer Service Advocates also have access to a

telephone-based translation service to assist with other

languages.

Some forms and member materials are available in

Spanish and may be requested from your BCBSNM

Account Executive. For some employer groups, we

may conduct bilingual group enrollment meetings.

For our deaf, hard-of-hearing, and speech-disabled

members, we can communicate using the New Mexico

Relay Network. By dialing 711, the caller is connected

to the state transfer relay service for TTY and voice

calls.

Be Smart. Be Well. Features New Topic on Childhood ObesityNearly 25 million children, or one out of three kids, are

obese or at risk of becoming obese. Studies show over-

weight kids have less energy and a harder time focus-

ing in school. In fact, the quality of life for kids with

obesity is similar to kids with cancer. Unless the cur-

rent trend is reversed, this will be the first generation to

live sicker and die younger than their parents.

Childhood obesity, the latest topic to be covered on

www.besmartbewell.com, addresses the causes and

dangers associated with this serious health epidemic as

well as what families can do to prevent it. Your

employees can learn about portion control, reversing

bad eating habits, the benefits of making healthful food

choices, and getting plenty of exercise.

Be Smart. Be Well. is a website designed by Blue Cross

and Blue Shield to help build consumer awareness of

health and safety issues. The website also includes

archives of previous topics such as caregiving, drug

safety, mental health, and traumatic brain injury.

Blue Update July/Third Quarter 2009

Two Online Wellness Tools – Just a Click Away! If your employees are ready to stop smoking or manage their weight, BCBSNM offers two online wellness tools

that give specific educational information on Smoking Cessation and Weight Management. These programs focus

on enabling members to take a more active role in improving their overall health and well-being.

The Weight Loss and Stop Smoking icons

appear in the For Your Health section of the

Personal Health Manager home page. After

clicking on an icon to view a description of

either program, the member can then select

“yes” to enroll. It’s that simple.

For members who want to quit smoking, the

Smoking Cessation program offers stop-smok-

ing information plus targeted guidance in

response to self-reported assessments. This pro-

gram emphasizes understanding the barriers to

quitting smoking, provides support and motiva-

tion, and addresses treatment options.

For members who want to better manage their

weight, the Weight Management program pro-

vides information that will enable them to learn a whole new way to think about food, exercise, and their health.

This educational online self-management program focuses on understanding what being overweight means, why it

matters, and what to do about it.

2010 HSA Adjusted Inflation RatesEach year, the Treasury Department and Internal Revenue Service determine guidelines for deductible minimums,

out-of-pocket maximums, and contribution maximums for high-deductible health plans that must be used in con-

junction with health savings accounts. (BCBSNM plans already meet these requirements.) The table below pro-

vides these updates:

Requirements for HSAs2010 2009

Single Plan Family Plan Single Plan Family Plan

Maximum Deductible $1,200 $2,400 $1,150 $2,300

Maximum Out-of-Pocket $5,950 $11,900 $5,800 $11,600

Contribution Maximum $3,050 $6,150 $3,000 $5,950

Catch-up contributions (ages 55 and older): $1,000

Member Rights and ResponsibilitiesMember rights and responsibilities are listed in their Benefit Booklet or Member Handbook and in denial and

appeal letters. Most members can also find these documents on www.bcbsnm.com.

Blue Update July/Third Quarter 2009

Educational Mailings to Dental Members

Translation and TTY Services Available for Our Members

As part of BlueCare Dental ConnectionSM (BCDC), cer-

tain members with dental coverage are sent educational

mailings. Members began receiving this year’s mailings

around mid-June.

BCDC, an integrated medical-dental and preventive

outreach program that compares individuals’ medical

and dental data, reaches out to members considered to

be high-risk (or already diagnosed with certain condi-

tions). This proactive wellness program includes mail-

ings to these members to help educate them about

potential risks and preventive steps to help maintain or

improve both oral and overall health.

BCBSNM is one of the only carriers with a proactive

preventive dental component to its program. These

mailings are a cost-efficient way to reach members who

may benefit from prompt attention to their oral health.

The ultimate goal of this program is to improve health

outcomes and reduce overall costs for both the member

and employer. Members must have both dental and

medical coverage to receive the high-risk educational

mailings; but to receive the preventive mailings, mem-

bers need only dental cov-

erage.

Topics for the 2009

mailers include:

• Periodontal disease

• Diabetes

• Cardiovascular

disease

• Expectant and new

mothers

• Dental sealants

To assist our members with special communication

needs and whose first language is not English, we offer

several services.

Members may ask to speak to a bilingual (English-

Spanish) representative when they call the Customer

Service number on the back of their member ID card.

Our Customer Service Advocates also have access to a

telephone-based translation service to assist with other

languages.

Some forms and member materials are available in

Spanish and may be requested from your BCBSNM

Account Executive. For some employer groups, we

may conduct bilingual group enrollment meetings.

For our deaf, hard-of-hearing, and speech-disabled

members, we can communicate using the New Mexico

Relay Network. By dialing 711, the caller is connected

to the state transfer relay service for TTY and voice

calls.

Be Smart. Be Well. Features New Topic on Childhood ObesityNearly 25 million children, or one out of three kids, are

obese or at risk of becoming obese. Studies show over-

weight kids have less energy and a harder time focus-

ing in school. In fact, the quality of life for kids with

obesity is similar to kids with cancer. Unless the cur-

rent trend is reversed, this will be the first generation to

live sicker and die younger than their parents.

Childhood obesity, the latest topic to be covered on

www.besmartbewell.com, addresses the causes and

dangers associated with this serious health epidemic as

well as what families can do to prevent it. Your

employees can learn about portion control, reversing

bad eating habits, the benefits of making healthful food

choices, and getting plenty of exercise.

Be Smart. Be Well. is a website designed by Blue Cross

and Blue Shield to help build consumer awareness of

health and safety issues. The website also includes

archives of previous topics such as caregiving, drug

safety, mental health, and traumatic brain injury.

Blue Update July/Third Quarter 2009

Two Online Wellness Tools – Just a Click Away! If your employees are ready to stop smoking or manage their weight, BCBSNM offers two online wellness tools

that give specific educational information on Smoking Cessation and Weight Management. These programs focus

on enabling members to take a more active role in improving their overall health and well-being.

The Weight Loss and Stop Smoking icons

appear in the For Your Health section of the

Personal Health Manager home page. After

clicking on an icon to view a description of

either program, the member can then select

“yes” to enroll. It’s that simple.

For members who want to quit smoking, the

Smoking Cessation program offers stop-smok-

ing information plus targeted guidance in

response to self-reported assessments. This pro-

gram emphasizes understanding the barriers to

quitting smoking, provides support and motiva-

tion, and addresses treatment options.

For members who want to better manage their

weight, the Weight Management program pro-

vides information that will enable them to learn a whole new way to think about food, exercise, and their health.

This educational online self-management program focuses on understanding what being overweight means, why it

matters, and what to do about it.

2010 HSA Adjusted Inflation RatesEach year, the Treasury Department and Internal Revenue Service determine guidelines for deductible minimums,

out-of-pocket maximums, and contribution maximums for high-deductible health plans that must be used in con-

junction with health savings accounts. (BCBSNM plans already meet these requirements.) The table below pro-

vides these updates:

Requirements for HSAs2010 2009

Single Plan Family Plan Single Plan Family Plan

Maximum Deductible $1,200 $2,400 $1,150 $2,300

Maximum Out-of-Pocket $5,950 $11,900 $5,800 $11,600

Contribution Maximum $3,050 $6,150 $3,000 $5,950

Catch-up contributions (ages 55 and older): $1,000

Member Rights and ResponsibilitiesMember rights and responsibilities are listed in their Benefit Booklet or Member Handbook and in denial and

appeal letters. Most members can also find these documents on www.bcbsnm.com.

PRESORT STD MAIL

US Postage Paid

Albuquerque, NM

Permit No.1439Business Communications

PO Box 27630

Albuquerque, NM 87125-7630

Blue Update July/Third Quarter 2009A Division of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association.

Experience. Wellness. Everywhere.SM

In This Issue

Route to:

________________ _______________________ _______________________ _______________________ _______________________ _______________________ _______

Membership ContactsAnnette Griego Alliance . . . . . . . . . . .962-7128

Sabrina Gordon Groups A-G . . . . . . .962-7177

Cheryl Nava Groups H-P . . . . . . . . .962-7135

Barbara Rankin Groups Q-Z . . . . . . .962-7129

Fax Numbers

Membership . . . . . . . . . . . . . . . . . . . . .837-8950

Sales . . . . . . . . . . . . . . . . . . . . . . . . . . . 837-8600

Proposals/New Groups . . . . . . . . . . . 837-8757

Donna Blackhat . . . . . . . . . . . . . . . . . . . .962-7140

Jermaine Brown – Supervisor . . . . . . . .962-7149

Toll-Free . . . . . . . . . . . . . . . . . . . . . .866-288-6773

For billing inquiries, call 800-414-7147.

Past issues of Blue Updateare available on bcbsnm.com.

BlueUpdate A quarterly publication for our customer groups

July/Third Quarter 2009

CMS Mandate Requires New Reporting Information Health plans are now required by Mandate S111 from the

Centers for Medicare & Medicaid Services (CMS) to report

certain member and employer information that had been

optional. As a Responsible Reporting Entity (RRE) under

CMS Mandate S111, BCBSNM has implemented the meas-

ures needed to comply with the additional data reporting

requirement on our groups’ behalf. At this time, we are col-

lecting the following information from all group accounts:

• Social Security Number (SSN) – for any Medicare-

eligible members and any members over the age of

45, regardless of Medicare eligibility

• Health Insurance Claim (HIC) Number – for

Medicare-eligible members, regardless of age

• Subscriber Employment Status – to properly report

active employment status, as well as determine

Medicare primary or secondary payment status

accurately

• Employer Identification Number (EIN) – to identify

the subscriber’s employer by their official taxpayer

identification number

BCBSNM is working to obtain missing SSNs. In July, we

will send a letter to all existing subscribers with members in

the target group whose SSNs are missing. The target group

includes:

• Subscribers

• Spouses or domestic partners

• Members age 45 or older

• Medicare-eligible subscribers

Going forward, we will send letters to new members in the

target group for their SSNs during the enrollment process.

Also, we will send a letter to members asking for their SSN

six months before their 45th birthday, as well as an annual

letter in April to all members who still have not provided

their SSNs.

Members can reply via mail, call the Customer Service toll-

free number on the back of their member ID cards, or send a

secure e-mail via Blue Access® for Members. In addition to

the mailings, our Customer Advocates will request this

information when a member whose SSN is missing calls

with an inquiry.

BCBSNM is also reviewing if updated employment status

information is needed for subscribers. With the new regula-

tion, the only allowable employment status categories are

Active, COBRA, or Retired. If your company uses other

status categories, account representatives may contact you to

obtain clarification. In the future, we will also need to

receive timely updates when a subscriber’s employment

status changes. Failure to provide timely updates may

impact members’ claim payments.

Automated Eligibility Processing (AEP) accounts will be

contacted with a target date for adding the Medicare

Subscriber Employment Status to their file as needed.

Account representatives will communicate the target date to

groups and provide more details during the next few months.

As a reminder, EINs will be required for any new accounts

or benefit agreements starting in July and for all existing

group accounts by October 2009.

As this is a federal mandate, we must work together to

achieve compliance. While no specific details have been

provided regarding penalties, CMS is authorized to issue

fines up to $1,000 per member, per day for noncompliance.

For more information, go to the CMS website at

www.cms.hhs.gov/MandatoryInsRep.

If Someone You Know is Losing Group CoverageIf you have a friend, neighbor, or family member who is losing group coverage, we offer a range of individual

plans that can work for nearly any budget and may provide a more affordable option to COBRA coverage. Our

individual medical plans now also include optional dental coverage. Information is available at

www.bcbsnm.com or by calling 866-445-1396.

• CMS Mandate Requires New Reporting Information

• 2010 HSA Adjusted Inflation Rates

• Educational Mailings to Dental Members Begin

• Translation and TTY Services Available for Our Members

• Two Online Wellness Tools – Just a Click Away!

• Be Smart. Be Well.TM Features New Topic on Childhood Obesity

• Member Rights and Responsibilities

• If Someone You Know Is Losing Group Coverage