Date:
October 7, 2016
Market: Groups 2-50 & 51+
2017 Blue Rewards Program Changes
Marketing Materials Now Available for All Group Markets
As mentioned in the August 5, 2016 Sales Flash, wellness program regulations issued by the U.S. Equal Employment
Opportunity Commission (EEOC) provided clarification around the voluntary nature of wellness programs, their
associated incentives and requests for genetic information. These regulations impact certain aspects of the
CareFirst Blue Rewards program and other account-administered wellness incentive programs.
We have received regulatory approval for all jurisdictions, including Maryland (2-50 and 51+), District of
Columbia (2-50 and 51+) and Virginia (2-50 and 51+) to make the necessary Blue Rewards program changes
required by the EEOC regulations. These changes will be effective upon a group’s renewal starting January 1,
2017. A recap of the regulations and the program’s major changes are noted below:
1. Wellness programs may not incentivize the collection of ‘genetic information’ for dependent children,
regardless of age or blood relation. Therefore, only policyholders and their covered spouse/domestic
partner are eligible for the Blue Rewards program. Dependent children of any age will no longer be
eligible to earn a reward. To alleviate confusion, references to maximum family reward amounts will be
omitted from the 2017 marketing materials and My Account.
2. Incentive amounts for participation- and results-based rewards may not exceed 30 percent of the cost for
self-only coverage (this includes employee and employer contributions). As a result, some reward amounts
for the policyholder and spouse/domestic partner in the 2-50 DC and VA markets will be reduced as
noted in red below:
VA 2-50 Reward Amounts
Participation-based Reward
Amounts
Metal Level
Results-based Reward
Amounts
Total Reward Amounts
PCMH
PCMH Plus
PCMH
PCMH Plus
PCMH
PCMH Plus
Platinum & Gold
$100
$200
$200
$400
$300
$600
Silver
$100
$200
$200
$300
$300
$500
Bronze
$100
$200
$200
$200
$300
$400
DC 2-50 Reward Amounts
Participation-based Reward
Amounts
Metal Level
Results-based Reward
Amounts
Total Reward Amounts
PCMH
PCMH Plus
PCMH
PCMH Plus
PCMH
PCMH Plus
Platinum, Gold &
Silver
$100
$200
$200
$400
$300
$600
Bronze
$100
$200
$200
$300
$300
$500
CareFirst BlueCross BlueShield is the shared business name of CareFirst of Maryland, Inc. and Group Hospitalization and Medical Services, Inc.
CareFirst BlueCross BlueShield and CareFirst BlueChoice, Inc. are both independent licensees of the Blue Cross and Blue Shield Association.
® Registered trademark of the Blue Cross and Blue Shield Association.
Reward amounts for the policyholder/domestic partner will remain the same in 2017 for DC/VA 51+ groups and
MD groups of any size. Groups offering additional incentives on top of the Blue Rewards program should consult
with their legal counsel to ensure compliance.
3. An individual must give prior, voluntary, knowing and written authorization before genetic information is
obtained. CareFirst is developing participant notifications explaining the voluntary nature of Blue
Rewards and the disclosure of medical information to address this EEOC regulation.
The following 2017 Blue Rewards marketing materials have been added to the broker portal (post login) and
additional materials will be posted as they are available. Materials are available under the Resources tab by clicking
on Blue Rewards under Group Resources.
MD Fully Insured:
 Blue Rewards account flier (detailed): includes details about the reward steps and incentive card rules
 Blue Rewards member flier (detailed): includes details about the reward steps and incentive card rules
DC/VA Fully Insured:
 Blue Rewards account flier (detailed): includes details about the reward steps and incentive card rules
 Blue Rewards member flier (detailed): includes details about the reward steps and incentive card rules
Benefit Summaries
2017 benefit summaries have been updated for the Blue Rewards program and are currently available on the Sales
Ordering System and broker portal.
Member Website
The member website at www.carefirst.com/bluerewards has been updated to reflect the 2017 Blue Rewards
program.
Note: For those who use Print-on-demand (POD) member enrollment books
The 2017 MD and DC/VA POD descriptions are now available on the Sales Ordering System and are clearly labeled
for 2017 new sales and renewals. There are differences between the 2016 and 2017 Blue Rewards programs so it’s
very important to select the correct Blue Rewards description for print-on-demand member enrollment books.
Should you have any questions, please contact your broker sales representative.
C. Shekar Subramaniam
Vice President, Sales
Small Medium SBU
Blue Rewards is not available for grandfathered plans or over 65 plans.
CareFirst BlueCross BlueShield is the shared business name of CareFirst of Maryland, Inc. and Group Hospitalization and Medical Services, Inc.
CareFirst BlueCross BlueShield and CareFirst BlueChoice, Inc. are both independent licensees of the Blue Cross and Blue Shield Association.
® Registered trademark of the Blue Cross and Blue Shield Association.