Transcend AHP Updated 10/17/19:
As stated in our last communication, we promised to provide more information regarding TranscendAHP 2020 plan renewals. Despite Transcends best effort, there is not an apparent path forward for the current TranscendAHP program. All groups and sole proprietors must transition back to their prior-to-Transcend rating structure; Blue Cross® Blue Shield® of Michigan or Blue Care Network small group and community rating or an individual plan with a January 1, 2020, effective date of coverage. All claims with a December 31, 2019, or earlier date of service will be honored under the terms of the contract and plan selected with Transcend. For more details, please see below.
We want to make transitioning your group or sole proprietors to a Blue Cross Blue Shield of Michigan or Blue Care Network plan as simple as possible!
BCBSM is working on steps that will allow moving groups back to an appropriate rating through a more streamlined approach with reducing the paperwork and underwriting process for you and your customers.
DECISION BACKGROUND AND DETAILS
Over the last several months, Transcend has been working with our legal counsel, the Department of Labor (DOL), and Blue Cross Blue Shield of Michigan in the hope of finding a path forward for our current Association Health Plan (AHP) TranscendAHP. In a lawsuit known as New York vs. Department of Labor, in March of 2019, the D.C. Circuit court vacated many of the Department of Labor regulations that allowed what became known as Pathway 2 AHPs. TranscendAHP is a Pathway 2 AHP.
- In late March of 2019, the decision in New York vs. Department of Labor was made public.
- On April 26, 2019, the DOL appealed the decision and asked that the case be heard on an expedited basis. All parties agreed to this.
- Through our national AHP association, Transcend participated in the submission of an Amicus Brief (friend of the court) outlining the importance of group purchasing of health insurance for the small business community.
- The DOL provided a memo of non-enforcement on April 29, 2019, meaning that current Pathway 2 AHPs could continue operating until the end of their plan year.
- TranscendAHP’s plan year expires on December 31, 2019.
The DOL and all interested parties hoped that because so many AHPs operated on a calendar year, the case would be concluded before the end of 2019. However, we now know that the judges will not be selected until later this month, the oral arguments will not be heard until November 14, 2019, and the case will not be decided until, most likely, sometime in the first quarter of 2020. So much for expedited.
We had hoped the DOL would extend the non-enforcement period. However, we learned that the attorneys at the Department of Justice would not allow this, nor, due to the wording of the DOL non-enforcement memo, can we extend our plan year. Therefore, TranscendAHP will end at the conclusion of its plan year on December 31, 2019.
To say that the lawsuit and all that follows is political would be a gross understatement. The 11 attorneys general who brought the lawsuit are from states that already prohibit the group purchasing of health insurance by small businesses and individuals in their states. Please see this for what it is: an attempt by these 11 AGs to dictate to the rest of the country what national and individual state rules must be regarding small group health insurance. It is also an attempt to preserve many of the provisions of the Affordable Care Act, including those that result in many small businesses paying more for their health plans than otherwise might be required. TranscendAHP proved that there is a way to purchase high-quality health insurance for small businesses at a lower rate. New York vs. Department of Labor takes that opportunity off the table – at least for the time being.
Transcend is closely monitoring the possible outcomes in New York vs. Department of Labor. The appeals court could overturn the lower court ruling and allow Pathway 2 AHPs to continue. The court could also rule that Pathway 2 AHPs can continue with modifications, or the court could uphold the lower court ruling. Additionally, we are in the preliminary review stage and looking at rules which are not impacted by the court’s decision. As things become clearer, we will provide more information.
We appreciate you and your customer’s confidence in Transcend. As a thank you, we are extending all Transcend memberships through the end of 2020 for FREE keeping your customers eligible for other Transcend products and services currently under review, including Association Retirement Plans, attendance at webinars and our small business conference planned for early 2020.
The decisions made in Washington regarding group purchasing of health insurance are infuriating, but Transcend will continue. New York vs. Department of Labor is a perfect example of why small businesses need a voice in the decision-making process. Over the past several months, we have come to know many of the most important people nationally in the discussion of group purchasing via Association Health Plans. These connections will prove valuable in the future. Because we represent the interest of small businesses by helping them through daily business life, with a primary focus on their human resources needs, compliance solutions, and having the right resources to thrive in the Michigan business community, we must continue.
Helpful hints when transitioning your groups
- Your agent is available to help with your transitioning groups.
- Pay attention to the prescription formulary because any groups who had Community Blue 250, 5000, and BCN 1500 plans are currently on Custom Rx plans with Transcend.
- If you have a group of one enrolled member group that is not a common-law employee, you will want to enroll them in an individual plan. Annual open enrollment is from November 1 through December 15 for a January 1 effective date.
- For small groups, you may need to consider including Pediatric Dental.
- Check that you have Medicare-eligible members set up correctly.
Transcend AHP Update 5/15/19:
Over the past month, there was a court ruling as well as a new Department of Labor (DOL) statement regarding association health plans (AHP). TranscendAHP is in full compliance with the Department of Labor (DOL) regulations; however, on March 28, 2019, a federal court ruling stated that AHPs are not in compliance with ERISA standards. The latest DOL Advisory Statement details were then released on April 29, 2019. From this Statement, it is clear that groups currently enrolled in TranscendAHP plan will continue to have coverage through the year (December 31, 2019). Transcend is working closely with Blue Cross® Blue Shield® of Michigan to determine a recommended strategy for those companies upon renewal. The appeal is being expedited with a possible conclusion as soon as September.
Effective immediately TranscendAHP is temporarily suspending quoting and enrollment for new business. Quotes that have been completed for a June 1 or later effective date, also cannot be enrolled.
Now Offering TranscendAHP
We are excited to announce that we have become a recent affiliate of Transcend, a non-profit association. This means we can offer greater resources to our members through this partnership.
Part of their offering includes a new insurance solution, TranscendAHP which offers our members the advantage of an association health plan. To learn more about Transcend, visit their website.
Advantages of an Association Health Plan:
- Access to an exclusive menu of health insurance plan options from BCBSM and BCN, many of which are not available to small business owners outside of the Association Health Plan. All plans have been selected to appeal to the varying needs of Michigan small business owners.
- Access to the vast BCBSM and BCN network of physicians and hospitals
- Special pricing that could lower your premiums
- You continue to use the independent insurance agent of your choosing
- Enhanced billing, enrollment and customer service
How it works:
Notify your licensed health insurance agent that you would like a quote from the team at Transcend. The Leelanau Chamber is proud to have partnered with two local insurance agencies: Riske, Brown & Associates and Larkin Agency. Both will work with you to provide the best options from Transcend.
To receive these benefits, you must be a member of Transcend. However, we have negotiated significant savings on dues to give you access to all that Transcend has to offer. Make certain that you tell your agent that you are a member of the Leelanau Peninsula Chamber of Commerce.