Three Common Questions We’re Hearing: ACA, Open Enrollment, & the Marketplace
by Catherine Boggs and Leah Mararo
To folks who don’t work in insurance – and even to some who do – a lot of the terminology sounds more like a foreign language than a benefit. We’ve answered the phones and assisted members for more than five years combined at BCBSNC, and there is definitely some commonality in some of the issues our members find confusing. In an effort to help, below are some of the most common questions our members call to ask.
Marketplace or BCBSNC – who do I call for what? How do you work together?
If you bought your health plan from BCBSNC, either through an authorized agent, from bcbsnc.com or a BCBSNC retail store, then you call us for everything. That’s easy!
If you bought your plan through the Health Insurance Marketplace at healthcare.gov, an authorized agent or on bcbsnc.com, it can be a little confusing deciding who to call for what. Hopefully this helps. Note: As stated above, you can buy a Marketplace policy on bcbsnc.com. Only the Marketplace can determine subsidies, so if you have a subsidy, you have a Marketplace policy.
- Contact the Health Insurance Marketplace for the more administrative functions of your plan. They will determine which plans you can apply for, if you could possibly get a subsidy, and if so, for how much. They determine what you will pay monthly for whatever plan you choose.
Later on, if you have a change in income, address, need to add dependents or take them off, cancel your policy, etc. – you would have to do that through the Marketplace. The Marketplace regularly sends us files of these changes so we can update our records.
- Contact BCBSNC if you have questions about your health plan. What are your benefits? What doctors and hospitals are in-network? What is your deductible for prescriptions? While the Marketplace determines how much you pay for your health plan, you pay us for your health plan, so you would call us about any billing issues or questions.
How can I pay my bill?
Your monthly premium payment is due on or before the 1st of the month. There are three easy ways to pay your bill.
- Online – Make secure payments online at BlueConnectNC.com. You will need to log in or register first. Choose either one-time or recurring payments. Pay either by credit/debit card or by bank draft using your checking or savings account.
- Mail – Send your check or money order. Include with your payment coupon or simply write your account number on your payment and mail it to:
For a 2015 payment – on or off exchange payments
BCBSNC
PO Box 580012
Charlotte, NC 28258-0012
For a 2016 Payment– on or off exchange payments
BCBSNC
PO Box 580094
Charlotte, NC 28258-0094
The overnight address – – on or off exchange payments
BCBSNC Attn: Retail Lockbox
580012 5130 Parkway Plaza Blvd.
Charlotte, NC 28217
- Phone – Call 1-800-333-7009 and use our free, secure automated bill payment system. You will pay using your checking or savings account. Please have your bank routing and account numbers ready.
It is important to keep your plan current!
- If you don’t pay your premium on time each month, your plan will be cancelled. If that happens, you may not be allowed to reinstate your policy or buy a new policy until open enrollment for 2016 starts on November 1, 2015.
- If you missed a payment, it’s really important that you contact us within 30 days to make your missed payment.
How can I make my first payment for the plan I bought from the Health Insurance Marketplace?
To make your first payment, you can use the Initial Payment Line at 1-888-802-2386.
Initial premium payment on exchange payments only you can mail to:
BCBSNC
PO Box 1732 Durham, NC 27702
For payments after this one, please use one of the methods above.
Why did I get a negative or a negative one cent bill?
A negative bill, or a bill that has a minus in the total amount due part of your invoice, means that you have a credit on your account. In other words, you don’t owe anything until the next bill is generated. There are several reasons that you may have a credit…….
- You receive an Advance Premium Tax Credit (APTC) that pays the full cost of your premium. If your APTC pays the full cost of your premium, we advance a $0.01 credit every month. Our system doesn’t register accounts with a $0 monthly premium, so we do this for our record keeping. As the monthly invoice generates, it reduces that credit by a $0.01 debit for the current month premium. This will continue until the end of the benefit period when the last invoice should generate for $0.00. The good news is if you receive a negative invoice, no payment is due!
- You paid more than the previous balance due or made an advance payment. Congratulations – you’re all caught up!
- You had a change in your APTC. You can contact the Health Insurance Marketplace if you need more information.
Leah Mararo is a Customer Service Professional at BCBSNC. She loves her job, “because I know what I do matters.” Leah is originally from Kenya and enjoys spending time with her family, playing table tennis and reading.
Catherine Boggs is a quality auditor with BCBSNC. A passion for helping people powers her career in the BCBSNC service center. Catherine enjoys anything outside, like hiking, camping, bonfires and 4-wheeling.
