Health insurance open enrollment primer

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Most Americans were required to have health insurance coverage in 2014 as a result of the Affordable Care Act (also known as Obamacare). Those who do not comply with the individual mandate in the health care reform law may have to pay a tax penalty to the government when filing their taxes for 2014.

The tax penalty for not having qualifying coverage in 2014 is $95 per adult and $47.50 per child, or 1 percent of annual taxable income, whichever is greater. During the 2015 tax season, taxpayers will be asked if they had insurance coverage when filing their 2014 income tax returns. Those who did not have insurance may be assessed the tax penalty. The percentage of income tax penalty is capped at national average premium of a bronze level plan.

2015 open enrollment

Individuals and families can enroll in 2015 health insurance coverage during the next open enrollment period from November 15, 2014 to February 15, 2015.

Most Americans will need to enroll in a qualifying 2015 health insurance plan during the open enrollment period to avoid paying a tax penalty when filing their 2015 income taxes in early 2016.

Tax credit calculator

You can click on the “Tax Credit Calculator” button on BCBSND.com to find out if you qualify for a tax credit to reduce your health insurance costs for coverage purchased on the online Health Insurance Marketplace at www.healthcare.gov.

If you do not qualify for a tax credit, you can buy the same Blue Cross Blue Shield of North Dakota metallic level plan at BCBSND.com at the same cost as plans offered on the marketplace. If your employer offers health insurance coverage, you can also enroll in health insurance coverage through your job.

Get started

You can search, select and apply for plans at www.BCBSND.com/shop or by calling 1-800-280-BLUE (2583).

Let us know if you have any questions. We’re here to help.

Ryan Schuster is an editor in the Communications department at Blue Cross Blue Shield of North Dakota.

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Find out how to apply for health insurance

If you are interested in applying for health insurance, you have a number of options.

You can visit www.BCBSND.com/shop to compare and shop for different Blue Cross Blue Shield of North Dakota plans that fit your needs.

Some employers also offer health insurance to employees, so you may be able to enroll in health coverage through your employer.


This short video explains how you can apply for insurance coverage.

If you have any questions, you can contact one of our health benefits consultants at 1-800-280-BLUE (2583).

Most prospective members will need to sign up for health insurance coverage from us during an open enrollment period. The next open enrollment period begins on November 15, 2014, for coverage starting in 2015.

If you recently got married, moved to North Dakota, experienced the birth of a child or have other qualifying life events, you may be eligible to enroll in health insurance coverage from us outside of the typical open enrollment period. Give us a call if you have any questions or if you’re not sure if you qualify.

Ryan Schuster is an editor in the Communications department at Blue Cross Blue Shield of North Dakota.

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How to update your address with us

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One of the most common questions we get from members is how they can update their address with us.

Current Blue Cross Blue Shield of North Dakota members can update their address when it changes on our website at www.BCBSND.com. Members first need to register before visiting the secure online portal at www.BCBSND.com/manage-my-benefits to enter their updated address.

If you haven’t set up an online account with us yet, you can also call the phone number on the back of your ID card and one of our customer service representatives can update your address in our system.


This short video explains how members can update their address with us.

Some companies that offer our insurance ask that their employees update their address through their human resources department. If your address has changed, you might also want to make sure you have updated your address with the U.S. Postal Service, so you continue getting mail from us.

Ryan Schuster is an editor in the Communications department at Blue Cross Blue Shield of North Dakota.

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See our 2013 annual report, financial performance

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We faced many challenges during 2013, including the implementation of the Affordable Care Act (also known as Obamacare), rising health care costs and higher than expected member claims. While the challenges led us to post a financial loss in 2013, our focus on our members as a not-for-profit member-owned company has not changed.

Through it all, we remain committed to delivering affordable solutions to improve the care and health of those we serve. With 98 percent of the state’s hospitals, clinics and health care professionals participating with us, our members continue to have access to nearly every doctor and every hospital in the state. We also continue to provide our members with best-in-class customer service. Blue Cross Blue Shield of North Dakota led all Blue Cross and Blue Shield plans in quality assurance ratings for customer service, customer satisfaction and claims accuracy during the second half of 2013.

We believe in transparency and being accountable to our members. That is why we are mailing a copy of our 2013 annual report to all of our voting policyholders along with a letter introducing you to North Dakota native Tim Huckle, our new president and CEO. While Tim has recently been named as our top executive, he has been our longtime chief operating officer, and he has worked for us for nearly 29 years. Our 2013 annual report has been posted to our website, including a breakdown of our 2013 financial performance and more information on our direction and accomplishments.

We take our responsibility to serve our members’ best interests seriously. At about 8 percent, our administrative costs are among the lowest in the nation. Roughly 93 cents out of every premium dollar we collected from members in 2013 was used to help pay for members’ medical care.

We remain a strong and stable company with sufficient reserves to pay member medical claims. We have been providing North Dakotans with affordable, high quality health insurance for 74 years and we plan to continue doing so for many more years to come. Let us know if you have any questions.

Ryan Schuster is an editor in the Communications department at Blue Cross Blue Shield of North Dakota.

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Shoes for Kids delivers 1,000 shoes to Fargo-Moorhead schools

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Going back to school is being made a little easier for some local elementary school students in need in the Fargo-Moorhead area.

This week 1,000 pairs of new Nike running shoes are being delivered to elementary schools in Fargo, West Fargo and Moorhead as part of the Shoes for Kids program. This is the third year in a row that the program has donated 1,000 free running shoes to deserving kids in local schools.


This video shows shoes being delivered to West Fargo’s Freedom Elementary in 2013.

This year $1 was donated from each Fargo Marathon Friday Night 5K registration. Friday Night 5K co-sponsors Blue Cross Blue Shield of North Dakota and Discovery Benefits and the Dakota Medical Foundation matched donations to help provide shoes to local kids.

Online donations and additional funds this year helped raise enough money to purchase 1,500 new pairs of Nike shoes at a steep discount. The remaining shoes will be provided to schools later in the school year as they run out of their initial supply.

The new shoes are provided to students, often kids in financial need, by teachers who notice children in need of appropriate running shoes.

As The Official Sponsor of Recess, we are proud to be part of the Shoes for Kids program. We think all children, regardless of their family’s financial situation, deserve the opportunity to be active. We support programs like this that remove barriers to help North Dakotans live healthier lives.

Ryan Schuster is an editor in the Communications department at Blue Cross Blue Shield of North Dakota.

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Which insurance plan pays for that?

If you are covered by more than one health insurance plan, it can be confusing knowing which one pays for what.

This may impact you if you and your spouse each receive health insurance coverage through your jobs, or if you have insurance coverage through us but also receive benefits from another program such as Medicare or Medicaid.


This short video explains how to find out what plan pays first.

Health insurance companies follow specific rules that govern which insurance plan pays in which order. Members do not need to do anything. We will help sort out which plan is required to pay when and how the process works for ensuring covered benefits are paid by the correct plan. If you have questions or think your claims should have been processed differently, please don’t hesitate to give us a call.

We can help answer any questions you may have. The best way to find out the order that different insurance plans should kick in is to give us a call at the phone number listed on the back of your Blue Cross Blue Shield of North Dakota ID card.

Ryan Schuster is an editor in the Communications department at Blue Cross Blue Shield of North Dakota.

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Health reform basics

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Health care reform can be confusing. We’re here to help.

The landmark Affordable Care Act (ACA) federal health reform law was passed by Congress in 2010. Some of the major provisions of ACA that are in place now include:


Here’s a brief video explanation of health reform.

Here is a look at some resources that help explain the basics of health care reform:

How to Purchase Insurance
A look at how you can enroll in insurance coverage, including how to navigate the online marketplace.

Health Insurance Requirement
Most Americans are now required to have a basic level of health insurance coverage or face a tax penalty from the IRS.

Health Insurance Marketplace
A brief overview of health insurance marketplaces.

New Health Plans
A look at the four basic levels of coverage available on online marketplaces and some other insurance plans.

Essential Health Benefits
Brief overview of the types of health care services that health insurance plans are required to provide a basic level of coverage to members on insurance plans.

Tax Credits on the Marketplace
Those who qualify based on income requirements can receive help paying their premiums if they purchase coverage online on a health insurance marketplace.

More information about health reform is available on our website and on Tips & Insights blogs.

Let us know if you have any questions.

Ryan Schuster is an editor in the Communications department at Blue Cross Blue Shield of North Dakota.

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Mother and daughter undeterred by Type 1 diabetes

Julie Kinneberg’s gut was telling her something was terribly wrong with her    10-year-old daughter.

It all started days earlier with Hannah drinking a lot of water and losing weight because her stomach hurt too much to eat. Doctors first diagnosed a viral bug and when she didn’t improve, she was diagnosed with strep throat, although a throat culture was not performed.

Hannah continued to lose weight. At 11 p.m. on Sept. 5, 2012, Hannah started vomiting. A few hours later, Julie and Aaron rushed their daughter to the ER in Grand Forks. Aaron carried Hannah who was now too weak to walk. In all, Hannah had lost 12 pounds since “coming down with the flu.”

Unbeknownst to Julie and Aaron, their daughter’s blood sugar level had soared to 800—nearly eight times the normal range.  Hannah was dangerously close to slipping into a coma.

Julie and Aaron felt “blown away” when the doctor informed them that Hannah had Type 1 diabetes, a condition in which the body no longer produces insulin. While the cause of the disease remains a mystery, insulin injections are needed for survival.

Let’s learn this
From day 1, the Kinnenbergs adopted the attitude of “it is what it is” and “let’s learn this!” During the three-day hospital stay in Grand Forks, Julie and Hannah learned about the disease and how to do insulin injections. “She was a trooper, she really was,” Julie says.

“It was like coming home with a new baby,” Julie says. “It was a whole new world. They send you home with a book as thick as a Bible.” 

Hannah begins doing injections as soon as she is released from the hospital.


In addition to working with a diabetes educator, Julie and Aaron did their own research online. Julie connected with a 21-year-old Grand Forks woman who was diagnosed with Type 1 when she was about Hannah’s age.

The world of type 1 diabetes (formerly known as juvenile diabetes or insulin-dependent diabetes) can turn school lunches, birthday parties and sports into challenges to monitor and master. Even a slight change in the school menu could affect Hannah’s blood sugar.

“I am her biggest advocate,” Julie says. “I made it known that she has Type 1. If she needs candy or a juice box, give it to her.” If Hannah’s blood sugar drops too low, she needs to quickly consume carbohydrates.

The whole family, including Isaac, 9, and Abbey, 7, practiced their math skills to figure out the insulin-to-carbohydrate ratio required to determine how much insulin Hannah needed.

Meal preparation took on a new level of importance as Julie wanted Hannah’s blood sugar to be perfect. Through trial and error, they learned which food would cause a spike. “Nothing is off limits. If you want a caramel roll, it’s OK. You can cover it with insulin. I want her to be a child,” Julie says.

Role model
Hannah has not let Type 1 slow her down. Active in student council, Hannah also plays soccer and swims like a fish. Hannah’s artistic side shines through in playing guitar and creating art. She sews clothing and perhaps someday will design fashion-savvy cases for diabetes supplies, unlike the camouflage one she received in the hospital. “I would rather have diabetes than a nut allergy,” Hannah says. 

Hannah became a role model for her classmates, teaching them about her disease and creating games with friends on how to count carbs. Hannah attends birthday parties and drinks pop just like any other kid—only her choice is now Diet Sprite. 

Since her hospital discharge, Hannah has handled her own injections. However, they became increasingly painful due to scar tissue. Her doctors recommended an insulin pump to address that and other concerns. 

Hannah proudly wears her insulin pump, which she describes as “uber fantastic.”

The Kinnebergs live in Grand Forks and have Blue Cross Blue Shield of North Dakota (BCBSND) health coverage. “Insulin pumps require lots of education and responsibility for the patient. That’s why we worked with Hannah and Julie to make sure the pump was the right fit through the prior approval process,” says Kirsten, who works as BCBSND’s medical management review coordinator.

 

 

 

“The pump is just a helper,” Kirsten explains, “Hannah still needs to be in control of her health—what she eats and drinks and her activity level.”

In April 2014, Hannah received an insulin pump, which she proudly wears. In fact, you could easily mistake it for a cell phone.

“The pump is uber fantastic,” Hannah says. The pump releases a steady flow of insulin throughout the day. At mealtime, Hannah tells the pump her blood sugar and how many carbs she will eat. The pump calculates the amount of insulin she needs. When she plays sports, the pump will also adjust the flow based on her activity level.

Camp Sioux is a highlight of the summer for the Kinnebergs. The camp gives children with diabetes an opportunity to have fun. The staff is well trained with diabetes. “We all get a week off from thinking about diabetes,” Julie says.

The Kinnebergs participated in the Step Out: Walk to Stop Diabetes event in Grand Forks as Team Hannah in October 2013 and ranked in the top five for fundraising.

Know the warning signs
Julie wants everyone to know the symptoms of Type 1 diabetes in children because they can develop quickly over a period of weeks. 

  • Increased thirst and frequent urination
  • Extreme hunger
  • Weight loss
  • Fatigue
  • Irritability or unusual behavior
  • Blurred vision
  • Yeast infection 

And if you’re a parent who has just learned your child has Type 1 diabetes, Julie offers this encouragement: “It gets easier. Anything gets easier with time, it’s not the end of the world that at first it seems like,” Julie says.

The Kinnebergs are now living their new normal. “Don’t be afraid to ask questions and get help,” Julie says.

“Diabetes is a piece of me, but not the whole picture,” Hannah says. 

Denise Pinkney is an editor in the Communications department at Blue Cross Blue Shield of North Dakota.

 

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How do I find out what insurance covers and how much I owe?

 

 

 

 

 

 

 

 

 

We send Blue Cross Blue Shield of North Dakota (BCBSND) members an Explanation of Benefits form (also known as an EOB), in the mail after they receive medical care. EOBs, which you can also sign up to receive electronically, include important information about how your medical claims were processed.

EOBs explain where and when you received medical care with your insurance coverage, how much of the original claim your insurance will take care of, and the remaining out-of-pocket amount that you owe the health care facility. We recommend that members compare their EOBs and medical bills to make sure they match. If there are discrepancies or you have questions, you can always call the phone number on the back of your BCBSND ID card or your medical provider.


This short video explains what an EOB is and how you can track your health expenses.

Your paper EOB will show the amount your insurance coverage reduced your out-of-pocket total. EOBs will also show how your deductibles, coinsurance and copayment levels may impact your medical bill.

Here’s a complete breakdown of how to read your EOB. Here’s an explanation of what common insurance terms like coinsurance and copayment mean.

Let us know if you have any questions. We’re here to help.

Ryan Schuster is an editor in the Communications department at Blue Cross Blue Shield of North Dakota.

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BCBSND honored for improved communication, collaboration with North Dakotans

We are constantly looking for ways to improve communication with our members, provide better customer service and help explain the complexities of health care and health insurance. As a nonprofit that is governed by a member-elected board of directors, serving our members is at the heart of everything we do every day.

That’s why we are so excited by the news that we have been awarded with a prestigious Silver Anvil award for improving reputation and brand management by the Public Relations Society of America. The award demonstrates our commitment to respond to member concerns and better educate and inform North Dakotans about health care, health care costs and health care reform.

“We are humbled to win such a prestigious national award,” said Tim Huckle, Blue Cross Blue Shield of North Dakota’s interim president and CEO and chief operating officer. “This award is a testament to all the great work our employees do every day to provide North Dakotans with high-quality, affordable health insurance and first-class customer service.”

What we’re doing to serve members better
During the last five years we have taken steps to be more approachable and address member concerns. We are listening to our members more and trying to be more responsive. We have made our website easier to use and have become more active in social media, engaging with North Dakotans and answering questions.

We have also played a major role explaining health care changes. We have distributed health reform surveys to members and held forums across the state to help explain how health reform will impact their health insurance and coverage.

While we are honored to receive such a coveted national award, we understand that our most important goal remains continuing to serve our members. Let us know if you have any questions.

Ryan Schuster is an editor in the Communications department at Blue Cross Blue Shield of North Dakota.

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