Blue Cross Blue Shield Deductible Discount Information

This past year, benefit-eligible employees had two opportunities to earn a 20% discount on the deductible for eligible SMU medical plans (the $2,500 high deductible plan is not eligible) offered through Blue Cross Blue Shield of Texas (BCBSTX). If you completed the onsite health screenings and paper health risk assessment through Concentra in the spring, or the onsite health screenings and online health questionnaire through Baylor this fall, you’ve earned the discount. We emailed spring participants in the fall to confirm completion, and emailed fall participants on December 20, 2011.

Didn’t get a confirmation email, but think you should have? Contact us at wellpower@smu.edu.

May I still earn the discount for 2012?
Unfortunately, the deadline for earning the discount for 2012 has passed. We will have screenings again in January 2012 and you may earn the discount for 2013 by participating. Look for details via an email from Wellpower in early January.

When will the deductible discount be applied?
Because it’s a manual process for BCBSTX, it typically takes a few weeks for all the entries to occur.

How do I know the discount has been applied?
Here’s the tricky part! The discount really isn’t a “discount” in the traditional sense of the word. In mid – to late January 2012, SMU will make a payment to BCBSTX equal to 20% of your deductible. So your deductible actually stays the same, but you will have already satisfied 20% of it once the SMU payment is made.

Unfortunately, this doesn’t trigger an “Explanation of Benefits” or EOB, so you don’t ever see it. We will email participants when BCBSTX verifies that the payments have been entered. The only way you can verify the payment is to call the customer support line at 1-877-768-2005 and ask how much of your deductible has been met. Ask the customer service representative to look for a payment of $200 (for the $1,000 deductible plan) or $400 (for the $2,000 deductible plan). The representative won’t know anything about the deductible discount program, so refer any additional questions to Wellpower. Please don’t do this, however, until late January so that BCBSTX has time to apply the payments. Also, please remember that the discount cannot be applied to the high deductible ($2,500) plan.

What if I have a procedure done on January 1, 2012, before the payment is applied?
BCBSTX will refund any excess payment toward your deductible. Contact us at benefitsu@smu.edu if you need help with that issue.

Why does SMU offer this incentive for getting a screening and completing the health risk assessment?
SMU values the health of its employees and wants to support them in their wellness goals. Healthy employees are more productive for the University, and obviously we want the best performance from our staff and faculty. In addition, SMU is striving to manage rising healthcare costs, and by providing these screenings, staff and faculty get an annual check on their vital, health-related measurements. Sometimes these screenings are the first indicator that an employee needs to consult his/her physician to head off a potentially major health issue. Catching potential problems early saves the employee and SMU significant dollars in the long run.

In addition, SMU gets a “group snapshot” that reports on our total population and tells us about our potential areas of risk and where we’ve improved or worsened. This information helps us shape our wellness education and programming for the future. Be assured that we take your private health data seriously, and no individual data is ever viewed or shared with anyone at SMU.  Email wellpower@smu.edu with any questions.

About Lorea Seidel

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