Blue Cross & Blue Shield of Massachusetts for Businesses and Non-Profits Large and Small
Request a Quote for Available Health Plans
NASRO is a third party administrator of group health, dental and vision plans.
NASRO rates Blue Cross of Massachusetts as the top Health plans in Massachusetts and we highly recommend it to Massachusetts employer groups. Their network of providers is extremely vast and their experience as the state's most experienced PPO continues to make them a top choice among employers seeking to provide employees with the maximum of provider choice. Their national and international reputation makes them a popular choice among employees whose jobs include travel. Blue Cross of Massachusetts is an independent organization that has managed to avoid the fate of so many Blue Cross plans that were swallowed up by aggressively for-profit, Wall Street dominated Well Point/Anthem Co.
Rate Proposals -
Call NASRO at 800-638-8113
for up to date rate, benefit and provider information
NASRO as a non-profit welcomes the opportunity to serve the community. Please call our offices at 800-638-8113 for your rate proposal by email. But, if you have the time, set up an appointment with NASRO Group Health Plans Administrator, Barbara Gibson to discuss your group's benefits situation in depth and to learn more about NASRO. Below is listed provider, plan benefits and enrollment information on the health plans available in 2010.
Provider Directory of Doctors, Hospitals and Other Providers
PPO Plans
The Blue Cross PPO products deliver exceptional hospital and physician discounts, an extensive nationwide in-network access to the entire Blue Cross Blue Shield network, protection against balance billing, and lower costs per service.
To improve the quality and affordability of health care, we will be implementing several enhancements to our standard plan designs. Learn about the plan changes designed to make health care more affordable.
Members have access to a national network of providers—more than 1,000,000 physicians and 6,100 hospitals throughout the U.S. and Puerto Rico—through the BlueCard® Program.
You can also view an overview of the whole small group portfolio.
Available
as of
10/01/09 for
1-50 Employees Available
as of
10/01/09 for
51+ Employees Closed
Plans
Tiered Network Blue Options
How Tiers Work Within Massachusetts
Each time members seek care from a PCP or hospital, their cost sharing is based on which of the three tiers* the provider is assigned to. This helps encourage members to consider the cost and quality of their PCP or hospital each time they get care and rewards them for choosing providers in enhanced or standard benefits tiers.
- Enhanced Benefits Tier —Lowest member cost sharing—Includes Massachusetts PCPs and hospitals that met our quality benchmark and our benchmark for lowest cost.
- Standard Benefits Tier —Mid-level member cost sharing—Includes Massachusetts PCPs and hospitals that met our quality benchmark and our benchmark for moderate cost. Also includes providers without sufficient data for measurement on one or both benchmarks. In limited circumstances, the Standard Benefits Tier includes certain providers whose scores would put them in the Basic Benefits Tier to provide geographic access for members.
- Basic Benefits Tier —Highest member cost sharing—Includes Massachusetts PCPs and hospitals that scored below our quality benchmark and/or our benchmark for moderate cost.
Outside Massachusetts
Depending on the plan design selected, tiering will work differently.
- HMO Blue New England Options—A network provider who is listed as a general practitioner, internist, family practitioner, pediatrician, obstetrician/gynecologist, nurse practitioner, rural health center, or general hospital is considered an Enhanced Benefits Tier provider. Other providers in our New England network carry the higher, specialist copayment.
- Preferred Blue PPO Options/Blue Precision—Employers have the option to access the tiered network in Massachusetts or on a national basis*. Members can check our national network to see if there are tiered providers in the locality where they are receiving care. In states where a tiered network is available, member's cost sharing would follow that tiering. In local PPO service areas where different levels of preferred providers are not available, providers would carry the lower Enhanced Benefits Tier cost sharing.
Provider Search
To see individual provider tiers, or how they've performed against our cost and quality benchmarks used for tiering just use our Find a Doctor tool.
You can also download a copy of our  Blue Options hospital tiering list to see how individual hospitals are tiered.
Additional Information and Resources
You have access to the tools and information that can make selling the Blue Options plans easy. To see all that is available to you, please watch our brief video.
Value Based Benefits
The Value-Based Benefits riders use tailored health incentives and disincentives to help manage costs over the long term and help keep members and their families healthy.
By enhancing traditional PPO and HMO plans with Value-Based Benefit riders, which reduce or eliminate copayments for certain chronic disease medications, diabetic monitoring care and routine care, employers can encourage their employees to take their medications as prescribed, follow treatment plans, get timely preventive care and form stronger relationships with personal physicians—all important to controlling costs over the long term.
For example, research indicates that a combination of lower prescription copays, health education, and support can result in up to 15 percent more members becoming adherent to chronic disease treatment plans (among those previously considered out of compliance) in just the first year. This lowers the risk of future complications and hospitalizations, and could reduce claims by up to $628 in year-two and $924 in year-three for a diabetic member who is newly compliant with a drug regimen.
You can review the  overview brochure for more information.
Plan Choice
Value-Based Benefit riders are available to groups of 50 or more employees on both a self- or a fully-insured basis.
Employers with 100 or more employees can integrate Value-Based Benefit riders into many PPO and HMO plans as part of a long-term health management strategy. For smaller employers with 51-99 employees, Value-Based Riders are available on the following select PPO and HMO deductible plans.
Standard Plan Summaries
How the Plans Work
Value-Based Benefit riders encourage preventive care and medication adherence to promote better health and to minimize future complications.
Members with value-based benefits have no copayments for preventive care services such as:
- Routine adult physicals and well-child visits
- Routine OB/GYN exams
- Routine hearing and vision screenings
- Family planning
To encourage compliance with recommended diabetic monitoring care, diabetic members have no copayments for the first two diabetic monitoring medical office visits in a calendar year, which can include diabetes evaluation and management, diabetic foot care, and/or diabetic eye exams.
To facilitate medication adherence, members with Diabetes, Coronary Artery Disease or risk of Cardiovascular Disease, and Asthma have no copayments on certain medications used to treat their condition, as well as reminders when there is a gap in their refill history. Members with these conditions also have no copayments on certain medications used to treat depression and those used for smoking cessation.
Increased cost share, when appropriate, to discourage overuse and/or misuse of healthcare services, keeps the plans affordable. Members have higher cost share for non-preventive care (PPO) or for specialist care (HMO), high tech radiology services and emergency room services. For prescription medications, members have to use their Select Network—a broad national pharmacy network. It is a slightly smaller network of retail pharmacies compared to our Traditional Network; however, it provides lower costs for prescription medications.
Member and Employer Support
Effective member education and support are key to making Value-Based Benefit strategies work. To maximize engagement, they support members with comprehensive member education, reminders and decision-support tools. For members with Diabetes, Coronary Artery Disease or risk of Cardiovascular Disease, and Asthma, BCBSMA also reaches out to the members' doctors to make sure they are aware of potential chronic disease medication savings for their patient as well as important resources available to the member such as one of BCBSMA's Disease Management Programs.
Employers also play a key role in helping to educate their employees and create a culture focused on health in the workplace.
To support employers, it offer tools to inform and educate their employees prior to plan launch, effective open enrollment education materials, and content and tools to maintain and reinforce member behavior change during the plan year, including:
- Interactive online benefits and claims information
- Hospital cost and quality comparison tools
- Medication cost and coverage options lookup tools
- Health care cost lookup tools
- Health and wellness information
These tools help members become more informed consumers of health care, choose the best option for their situation, and make healthier decisions.
Resources
HMO Blue Plan:
HMO Blue New England
National Association of Socially Responsible Organizations Affordable Health Insurance
Two Canal Park, fifth floor
Cambridge, MA 02141
800-638-8113/617-308-1525
Fax - 800-562-8588
bgibson@nasro-co-op.org
Hours of Operation Are 9am to 8pm
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