With the premiums on BCBSVT and MVP Exchange plans confirmed to increase by 11.5% and 13.3% in 2024, your health care choices can make a big difference. For Vermont businesses insuring 5 employees or more, Blue Edge Business is an important alternative to consider as businesses are eligible to earn money back on annual premiums.
Over the past three years, 67% of businesses enrolled in Blue Edge Business have received an average refund of $1,400 per employee — each year.
Call us at (802) 865-4560 or fill out the form below to find out if these plans are the right choice for your business.
Now more than ever, health plan choices can make a big difference. As costs continue to rise, employers must understand all of the options available in order to identify the best solution for their business.
Through a partnership with Blue Cross and Blue Shield of Vermont, Blue Edge Business health plans combine the flexibility of self-funding with the peace of mind of predictable and capped monthly costs.
These plans are best suited for employers who:
What criteria does a business need to meet to be able to apply for Blue Edge Business coverage?
The group must be a Vermont-based company with at least 5 enrolled employees. In addition, the company must be or become a member of BRS (Business Resource Services).
What company size is ideal for Blue Edge Business coverage?
The companies that are the best fit for Blue Edge Business typically have between 10 and 100 full-time employees.
Do I need a broker to apply for Blue Edge Business?
Yes, a broker is required. Because Blue Edge Business is part of a captive, it’s important to work with someone that can explain its requirements as well as the two potential opportunities for a refund of premiums.
What does the application process entail?
To obtain a quote, we need:
What is the timeline of a Blue Edge Business application?
A company can apply for a quote as early as July 1st. However, quotes are not issued until September – in the order the requests were received. The last quotes are issued by Thanksgiving. Once the quote is issued, the group has 45 day to accept or until December 15th, whichever is earlier.
When is a group entitled to a refund?
There are two situations that could result in a refund to a group:
How and when are refunds issued?
Refunds are calculated 8 ½ months after the end of the plan year and distributed via check or a credit to the employer’s account in September. For example, refunds related to plan year 2023 will be received in September of 2024.
How many groups participating in Blue Edge Business have received refunds and what’s the average refund?
Over the past three years, 67% of businesses enrolled in Blue Edge Business have received an average refund of $1,400 per employee – each year.
Benefit | Cost-share |
Deductible (stacked) | $850 / $1,700 |
Coinsurance | 30% after deductible |
Out-of-pocket maximum (stacked) | $4,500 medical / $1,600 prescription |
Preventive | Covered at 100% |
Office Visits (PCP/Specialist) | $30/$50 not subject to deductible |
Emergency Room | $500 after deductible |
Urgent Care | $40 not subject to deductible |
Ambulance | $50 not subject to deductible |
Hospital Services | Subject to deductible and coinsurance |
Prescriptions | Generic: $5 Preferred and Non-Preferred: $100 deductible the $50 preferred and 50% for non-preferred |
Benefit | Cost-share |
Deductible (stacked) | $3,000 / $6,000 |
Coinsurance | 0% |
Out-of-pocket maximum (stacked) | $9,450 / $18,900 |
Preventive | Covered at 100% |
Office Visits (PCP/Specialist) | $30/$50 not subject to deductible |
Emergency Room | $500 after deductible |
Urgent Care | $50 not subject to deductible |
Ambulance | $500 after deductible |
Hospital Services | Outpatient: Deductible then $2,000 Inpatient: Deductible then $500/day |
Prescriptions | Generic: $10 Preferred: $50 Non-Preferred: $75 |
Benefit | Cost-share |
Deductible (aggregate) | $2,750 / $5,500 |
Coinsurance | 0% |
Out-of-pocket maximum (aggregate) | $2,750 / $5,500 |
Preventive | Covered at 100% |
Office Visits (PCP/Specialist) | Subject to deductible |
Emergency Room | Subject to deductible |
Urgent Care | Subject to deductible |
Ambulance | Subject to deductible |
Hospital Services | Subject to deductible |
Prescriptions | Subject to deductible then*: Generic: $5 | Preferred: 40% Non-preferred: 60% *wellness drugs are not subject to the deductible first, will process as $5/40%/60% |
Benefit | Cost-share |
Deductible (aggregate) | $6,550 / $13,100 |
Coinsurance | 0% |
Out-of-pocket maximum (aggregate) | $6,550 / $13,100 |
Preventive | Covered at 100% |
Office Visits (PCP/Specialist) | Subject to deductible and coinsurance |
Emergency Room | Subject to deductible and coinsurance |
Urgent Care | Subject to deductible and coinsurance |
Ambulance | Subject to deductible and coinsurance |
Hospital Services | Subject to deductible and coinsurance |
Prescriptions | Subject to deductible then*: Covered at 100% *wellness drugs are not subject to the deductible first, will process as $12/40%/60% |
Take better control of your businesses healthcare costs, and put your wellness plans to work.