Tag Archives: UPMC

Benefits Network and VCS Group Complete Consolidation

Benefits Network and Somerset-based VCS Group Inc. finalized the consolidation of the two businesses in July. As part of the transition, the VCS Group name changed to Benefits Network and Your Health Insurance Shop became a Benefits Network company continuing to serve the Medicare and individual health insurance markets.

Benefits Network President and CEO David Straight credited VCS Founder Glenn E. Miller, Jr. with spear-heading the smooth transition along with the Somerset staff who will continue to serve clients from the Somerset Office. With the consolidation, Benefits Network is now one of the leading brokers of UPMC and Highmark insurance products in the region.


UPMC OnLine Billing

To access the online billing system, employers should login to Employer OnLine. (If they don’t have an account, they should sign up here .) Once inside the secure website, they should select the Payment/Billing tab to view their premium bill. The new payment system:

  • Offers the ability to view bills online 24/7.
  • Connects medical, UPMC Dental Advantage, and UPMC Vision Advantage billing data in one central location.
  • Provides the opportunity to go green: Employers can opt out of paper bills and manage payments online only. (Instruct your groups to choose this option by logging in to the payment system and selecting the “Go Green: Paper-Free Invoicing” button.)
  • Accepts payments via direct debit (ACH), debit cards, and credit cards (Visa, MasterCard, Discover, American Express).
  • Allows the employer to save payment information so it doesn’t have to be reentered each month.
  • Includes exporting functionality: Employers can export their employee roster into Excel format – a great way to reconcile files and reports!

We hope that your employer groups take advantage of this new functionality and we remind you that the client is able to provide you as their agent/broker access to their information.  Please contact our office for details on single sign on.


UPMC Correction to Creditable and Non-Creditable Coverage Letters

The letter below will be issued to groups who have received an incorrect notice.  BNGA has requested a list of impacted clients and will outreach to the appropriate agencies upon receipt.  Letters are scheduled to be sent from UPMC to the clients no later than January 27th, 2014. For additional information regarding employer responsibility and creditable coverage click here.

Dear Valued Customer:

UPMC Health Plan inadvertently sent incorrect information to you regarding your creditable or non-creditable prescription drug coverage. This mailing, which you received sometime in the past two weeks, included a letter and a Centers for Medicare & Medicaid Services (CMS) model language document.

Please disregard the documents that you previously received. A corrected package of information is included with this letter. If you already shared the earlier information with your employees, please make sure you share the corrected information as well.

We apologize for any inconvenience this error may have caused. If you have any questions, please contact your account manager.


UPMC Health Plan



UPMC SHOP Process Clarification

There are two distinct processes involved in taking advantage of your small business tax credit.  This tax credit is currently the only clear advantage to utilizing the SHOP.

For more details on tax credit eligibility click hereIf you or your client feel they are eligible for the tax credit they will need to get an official eligibility determination from the SHOP Marketplace.  In order to apply for the Small Business Healthcare Tax Credit use the application below.

SHOP Health Coverage Application for Employers.

 If your contact information is contained in Step 3 of the application you will have the ability to check on the status of the determination.  The final notice of eligibility is provided to the group directly.

If your client is eligible for the tax credit, in order to claim it, the group must be enrolled in a SHOP eligible plan. The credit will be claimed on their 2014 federal income tax return. The employer will need to have their SHOP eligibility notice from the SHOP Marketplace in order to do so.

For specific questions regarding tax credits and eligibility please advise your client to speak with a tax professional.

The UPMC SHOP Eligible plans are as follows:

  • Premium Platinum $25 – PPO Platinum 25 RX 8/38/76/95
  • Enhanced Bronze $3500 – EPO Bronze 3500 RX 8/38/76/95
  • Enhanced Bronze $4500 -EPO Bronze 4500 RX 8/38/76/95
  • Enhanced Bronze $5500 – EPO Bronze 5500 RX 8/38/76/95
  • Enhanced Silver $1500 – EPO Silver 1500 RX 15/45/90/50%
  • Standard Platinum LoCap $750 – HMO Platinum LoCap 750 RX 8/45/90/50%
  • Standard Gold $1000 – HMO Gold 1000 RX 15/45/90/50%
  • (InsideAdvantage) Premium Silver $5000 – IA PPO RX 8/38/76/95
  • (InsideAdvantage) Premium Platinum $500 – IA PPO Platinum 500 RX 8/38/76/95
  • (InsideAdvantage) Premium Platinum$1250 – IA PPO Platinum 1250 RX 8/38/76/95

 After the webinars last week, we were alerted to some additional UPMC plans that appear as SHOP eligible on the healthcare.gov website. UPMC has confirmed they are working to deliver more information on these products, including pricing and plan descriptions.

  • Prmium Gold $1000 (90%)
  • Enhanced Gold $2000 – EPO Gold 2000 RX 8/38/76/95
  • Standard Silver $3000 – HMO Silver 3000 RX 15/45/90
  • Premium Platinum $40 – PPO Platinum 40 RX 38/76/95
  • Premium Platinum $250 $10/$40  – PPO Platinum 250 RX 8/38/76/95
  • (HealthyU) Rewards Rx HSA Silver $2000 – EPO Silver HIA Healthy U $2000/75% RX 8/38/76



  • New business – Go through the normal BNGA quoting and enrollment process.
  • Renewing Groups – Plan rates will appear on the client’s renewal rate page.