We're Giving Back to Our Members

Eligible fully insured subscribers with an active health plan as of September 30, 2020, will qualify. More than 600,000 subscribers across the state who are enrolled in individual under 65 and fully insured employer plans, including vision and dental plans, are eligible to receive a health and wellness retail card with a balance between $100 and $500 based on the plans they are enrolled in. 

* Vision plans refer to Blue 20/20^SM plans. Dental plans refer to Dental Blue^® and Dental Blue Select plans. Retail cards do not apply to Federal Employee Program vision or dental products.

Risk corridor funds were created to adjust for losses from ACA individual plans. We chose to distribute these funds back to ACA individual under 65 members, and commercial and fully-insured medical and ancillary plan members. While our Student Blue members were excluded from this initiative, they are eligible for and have received Medical Loss Ratio rebates in recent years.

No. If a subscriber from an eligible fully insured plan has a mailing address outside of North Carolina, he or she will receive a retail card. The cards can be used at participating retailers nationwide.

A subscriber is the health insurance plan policy holder. A member is any person, including the subscriber, who has coverage under a Blue Cross NC policy. For example, a family covered under a single policy will have one subscriber but may have any number of affiliated members (partner, spouse, children, etc.) also covered by the policy.

This year, our members have experienced unexpected hardship and uncertainty due to the COVID-19 pandemic, high levels of unemployment and an economic slowdown. Choosing to distribute these funds through health and wellness cards is the fastest, most flexible way to deliver financial support to our members when they need it most. 

While rebates and premium holidays may provide specific financial relief, health and wellness cards allow our subscribers to choose the best use of these funds for themselves and their families.

This method gets funds to the most people possible. Many members would either get no benefit or very little benefit from a premium waiver because the vast majority of our ACA members on an individual plan already get premium subsidies, or full subsidies, and pay very small or $0 monthly premium amounts. And many of our members in employer plans already have their premiums paid partially or in full by their employer.

These health and wellness cards help us achieve several important goals:

• getting funds to the most people possible, as quickly as possible, and

• focusing on our members’ health and well-being
   

While the cards can't be used for every purchase, they can be used for many essentials, including food, over-the-counter medications, first aid supplies, baby care items, exercise equipment, vitamins and more at a variety of retailers. And we're distributing these cards within a few weeks of receiving the risk corridor funds from the federal government, with as little delay as possible.

Subscribers enrolled in individual, small group and fully insured large employer plans, including vision and dental plans, are eligible to receive a health and wellness retail card with a balance between $100 and $500 based on the type of plans they have.

Yes. Eligible individual under-65 customers who get the cards include subscribers with On-Marketplace and Off-Marketplace plans, plus transitional plans. Eligible fully insured group subscribers who get the cards include subscribers on grandfathered and transitional plans.

Blue Cross NC is able to fund these health and wellness retail cards for the direct benefit of its members from monies received from the federal government following litigation related to the Affordable Care Act (ACA) temporary risk corridor program. We want to support our members during this time so they can continue to prioritize the health and well-being for themselves and their families. This is our first priority, and as such, we will immediately redistribute as much of the risk corridor funds as possible to our members.

After paying taxes and an estimated $8 million in MLR rebates for prior years, Blue Cross NC will issue $200 million in health and wellness retail cards to more than 600,000 eligible subscribers across North Carolina. Blue Cross NC applied the remaining risk corridor funds to help keep 2021 rates for many of its customers lower. The company has been working hard to contain rates for several years and has achieved results. For example, for 2021, ACA plans offered to individuals will be reduced by an average of 1% on a statewide basis, the third straight year that Blue Cross NC has lowered ACA rates and a three-year cumulative reduction since 2018 of nearly $1 billion.

Blue Cross NC is committed to helping as many of our customers as possible. When determining the specific amount for each health and wellness retail card, we aimed to provide amounts that are meaningful and helpful to members.

Many of our subscribers will receive a health and wellness retail card. Those who are not eligible include subscribers through self-funded Administrative Services Only (ASO) plans and balance funded plans, including the State Health Plan, Federal Employee Plans (FEP), Medicare and Student Blue plans.

Vision plans eligible for retail cards refer to fully insured Blue 20/20^SM plans. Dental plans refer to fully insured Dental Blue^® and Dental Blue^® Select plans. Retail cards don't apply to FEP or State Health Plan vision or dental products. Subscribers in these plans were not included because Blue Cross NC received these risk corridor funds from the federal government due to the substantial losses the company sustained on its fully insured commercial business during the first three years of the ACA. Since the risk corridor program didn’t apply to self-funded group or Medicare business, it would not be appropriate to distribute these funds to customers on self-funded group or Medicare plans.

Because the dollar amount is less than $600, there will be no 1099 issued. However, we encourage subscribers to consult their tax professional to determine taxability for their personal situation.

All of the funds we receive as a result of the risk corridor ruling will go to benefit our members. Of the total $356 million, approximately $75 million is owed in combined taxes and MLR rebates for prior years. Blue Cross NC will issue $200 million to directly benefit members through the health and wellness retail cards. Any remaining funds will be used to offset the cost of member premiums in 2021.

Members will get their health and wellness retail card in in the mail between October19 and November 7 of this year with instructions on how to activate the card and where it can be used.

Blue Cross NC is providing health and wellness cards to benefit members where they need it most. Health and wellness cards may be used for qualifying health-related expenses such as food, over-the-counter medications, first aid supplies, baby care items, exercise equipment, vitamins and more at a variety of retailers including Walmart, Walgreens, CVS, Rite Aid, Dollar General and Family Dollar. The cards cannot be used to pay for insurance premiums, prescription drugs, tobacco, alcohol or firearms.

Yes. The Blue Cross NC Health & Wellness Retail Cards will be retired - that is, they will be "deactivated" and no longer function, on October 31, 2021.

To check your card balance, call 888-682-2400 or go to OTCNetwork.com. 

If you misplaced your card or have any questions, call 877-277-7912 (TTY: 711).

Blue Cross NC will notify external agents and applicable employer groups of this program by email, the employer portal and the agent portal by early October. We'll share samples of member materials at that time.

Yes. If a Blue Cross NC customer has one of our vision (Blue 20/20) or dental (Dental Blue and Dental Blue Select) plans on September 30, 2020, they are eligible for a health and wellness card. These ancillary products are sold to individuals of any age.

In addition, in January 2021, Blue Cross NC plans to issue health and wellness cards to Medicare Advantage customers, as part of a separate wellness initiative, unrelated to the risk corridor program funds.

Health and wellness retail cards will not arrive in the mail until late October 2020. If you’ve received your retail card in the mail and have questions, please call the number in the welcome kit that comes with your card. If you haven’t received your retail card after November 7, call us using the number on the back of your member ID card, to confirm your eligibility and mailing address.

Cards can be used starting November 1, 2020.

Independent pharmacists are invited to participate in the retailer network for InComm Payments, a third-party vendor Blue Cross and Blue Shield of North Carolina (Blue Cross NC) sourced to send health and wellness retail cards to members. Blue Cross NC continues to work with independent pharmacies across the state to support integration into the InComm Payments retailer network. A number of North Carolina independent pharmacists are already participating in the OTC network and more are in the process of being connected.

Interested pharmacies in North Carolina not yet participating, but interested in integrating into the OTC Network can apply here. Please contact your local pharmacy for more information on their InComm Payments OTC Network status. Once established as a retailer in the InComm Payments OTC Network, your local pharmacy is able to accept your health and wellness retail card as a form of payment.