BCBS Composite Rating Form Required with Initial Group Submission

BCBS Composite Rating Form Required with Initial Group Submission
Does your group desire the Composite Rate Billing option? If so, BCBS requires the completion and submission of the BCBS Composite Rate Billing and Method Declaration Form for existing and new fully insured groups with 2 to 50 employees. To declare Composite Rates, the required form MUST accompany the group submission. If the form is not included in the group submission, then Individual Age billing applies; no exceptions.

BCBS Retro Request Not Honored for Composite Rating Exceptions
It has been BCBS experience that some groups did NOT submit the Composite Rate Billing Method Declaration Form with the group submission and therefore the group is automatically established as Individual Age rated. As a result, BCBS has received several inquiries requesting a retro exception to recognize the group as Composite Rated and going back to the original requested effective date. BCBS stands very firm that they will not honor these retro requests.

BCBS Composite Rates Conditions
Composite billing is only available for accounts that select Affordable Care Act or metallic benefit plan options. To select composite billing, accounts MUST complete and submit the Composite Rate Billing Method Declaration Form to BCBSTX.

  • Blue Cross will develop composite rates for a 12 month cycle only.
  • The group must accept a renewal date change to a new future date when BCBS can apply the composite rates.
  • Accepted Plans must be currently marketed products at the point of the new effective date in which composite rates are applied.
  • Blue Cross is currently able to adjust rates if the group needs to move from one quarter to the next. 
  • If the group is moving to a new effective date within the same quarter, the rates for the same plan should not change. However, if the census changes, then the overall premium will change.

Please note, upon acceptance of composite rates, an account's billing method cannot be changed until the account's next renewal. No exceptions.

Important Billing Rules
1. Composite billing will be effective for 12 months.
2. Only one billing selection is allowed per account.
3. Accounts may not select a combination of plans with age billing AND composite billing (excluding pediatric dental plans that will continue to be age-rated for December renewals).
4. For existing accounts, composite billing is only available at the time of the account's renewal.
5. If an account selects composite billing for their medical plan, composite billing would also be applied to the account's dental plan (if applicable).

Take Time to Review the Enclosed Composite Rate Billing Method Declaration Form
The form includes the required submission form, a reference guide, and paperwork and submission requirements.

Contact your carrier representative for more information or guidance.