Excellus BCBS Broker News Vol. 20 No. 10

ACTION REQUIRED: Multi-Factor Authentication Launching This Month For Broker And Employer Web Accounts

To improve account security, multi-factor authentication (MFA) will be enabled toward the end of October.

What you can do to prepare for this change:

1. Log into your broker web account and go to Account Settings in the upper right corner.
2. Verify that your email address and security question are correct and up to date. If your information is not up to date, you will not be able to access your web account once MFA is enabled.
3. Simplify account management by consolidating multiple accounts under one agency umbrella account:
   
   1. This will allow you to manage all your groups with one login.
   2. Without an umbrella account, MFA will need to be completed separately for each account.
   3. For help with broker umbrella accounts, please contact Brokercontractsexcellus@excellus.com or your account manager.

To stay informed on key dates and instructions, please refer to the banner notifications on the broker and employer websites. Taking these steps now will help ensure a smooth transition and prevent login issues once MFA is live. For more details, please review the FAQ (PDF) linked here.

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Small Group Underwriting Updates

Standalone dental single contract groups

As a reminder, any groups that have a standalone dental product with only one contract enrolled do not qualify for coverage and will be non-renewed starting with 1/1/2026 renewals. This only applies to groups that only have dental as a product. If they have additional products (Medical, Healthy NY, Medicare or Vision) their dental product will remain active.

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Change in AGIF Mailing process

In an effort to streamline the AGIF mailing process, changes will be made to the mailing dates for 2026. These changes will allow for the team to review the forms in a timely manner and reduce complexity in mailing schedule. The breakdown by group renewal month is as follows:

• April – December renewals: Will be sent out on Jan 2, 2026.
• January renewals: Will be sent out on April 1, 2026.
• February - March renewals: Will be sent out on July 1, 2026.

Please note, AGIF responses will not be accepted prior to the date mailings are sent. In addition, groups renewing on 4/1/2026 with zero enrollment will be included in the AGIF mailings. In order to remain compliant, these groups will be reviewed upon receipt of their AGIF and non-renewed if they do not have enrollment.

If you have any questions on these updates, please reach out to your account manager or dedicated underwriter.

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Leadership Announcement: Dr. Martin Stallone To Join Excellus BCBS Executive Team

Excellus BCBS is pleased to announce that Martin Stallone, M.D. has been appointed Executive Vice President and Chief Healthcare Services Officer for Excellus BlueCross BlueShield and its parent company, The Lifetime Healthcare Companies.

Dr. Stallone currently serves as CEO of Centralus Health. In his new role, beginning December 1, 2025, he will lead efforts to improve our community’s access to high-quality care that’s as affordable as possible.

“We’re thrilled to welcome Dr. Stallone to our team,” said Jim Reed, CEO and president of The Lifetime Healthcare Companies. “His clinical leadership in health care delivery, combined with his understanding of our regional health systems, will help us drive innovation and deepen our provider partnerships to better serve our communities throughout upstate New York.”

Learn More About Dr. Stallone

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2025 Gag Clause Attestation Process & Separate Letter Notification

As part of the ongoing support for the Consolidated Appropriations Act (CAA) gag clause attestation, Excellus BlueCross BlueShield (BCBS) will continue to attest on behalf of fully insured and minimum premium groups in 2025, unless the group instructs us otherwise.

For Self-funded, Rx carve-out, and Article 47 groups, Excellus BCBS has provided a Certificate of Compliance, enabling them to submit their attestation directly to the Centers for Medicare and Medicaid Services (CMS).

Key details for 2025:

• To complete the attestation for fully insured and minimum premium groups, Excellus must obtain authorization from each group. Renewal forms have been updated for this purpose.
• Fully insured and minimum premium groups that submitted renewal forms in 2025 before the language updates (as mentioned in Updated Fully Insured And Minimum Premium Documentation For 2025 CAA Gag Clause Attestation) will receive a separate letter in the coming weeks. This letter will confirm that Excellus BCBS will attest on their behalf unless they decide to opt out.
• If a group chooses to opt out of our CMS submission, they must notify their account manager by December 1, 2025.

View Group Letter (PDF)

Please note, if a group terminated in 2025, Excellus BCBS will not be filing on their behalf for the 2025 gag clause attestation. They will send a certificate of compliance to the group upon request so that they can file the gag clause attestation directly to CMS.

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2026 Annual Rate Notices Being Mailed

The New York State Department of Financial Services (DFS) has finalized the 2026 rate adjustments for the following products:

• Small Group
• Individual
• Large Group HMO
• Medicare Supplement

Annual Rate Notices (ARNs) will be mailed to groups by the end of October.

Medicare Advantage, Simply Prescription, Dental prospective pooled and dental/vision standalone group notices and rates will be mailed to the groups later in the year.

Also, in late October, brokers will be able to access the Monthly Rate Summary Report for January 2026 renewals via Information Connection.

Any rate increase places a burden on members and employer partners. That’s why Excellus BCBS continues to collaborate with the broader health care system to identify opportunities to improve health outcomes and address rising costs. Visit their website to learn more.

Please contact your account manager with questions.

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Donate Life Registry Question Added To Health Plan Applications

A new question regarding the New York State Donate Life Registry has been added to select health plan enrollment forms and online tools. This update is in response to a new state mandate and applies to both paper and digital enrollment processes.

This requirement applies to the following plan types: Individual qualified health plans (QHPs) – on and off exchange, small group plans, large group plans, student health plans, dental plans, child health plus and the essential plan.

What’s Changing? Subscribers will now see a question asking if they’d like to join the New York State Donate Life Registry.

Important Guidance on Donate Life Registry Question

Brokers and employers using the web to submit enrollment requests from paper applications should enter exactly what they see on the application.

• If the subscriber checked “Yes”, select Yes.
• If the subscriber checked “Skip this question”, select Skip this question.
• If the subscriber did not check either box, do not select either option in the system.

A disclaimer has been added to indicate that the health plan will not reject applications if neither box is selected.

The health plan will send NYS a weekly file of subscribers that checked ‘Yes’. In turn, NYS will send a letter to the subscriber to confirm their interest in being added to the registry. The subscriber will have 30 days to respond to the letter (opt out) before they are officially added to the registry.

If you have questions on the updated enrollment forms, please reach out to your account manager.

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3 Practical Ways You Can Help Your Small Business Clients Manage Rising Healthcare Costs

At Excellus BlueCross BlueShield, they understand the pressures your small businesses clients face in today’s economic climate. Rising costs and growing demand for health care - especially for hospital services and prescription drugs – are driving up premiums, making it harder for employers to feel confident in their health plan decisions. But they don’t have to face this alone.

As your local, nonprofit Health Plan, they are committed to helping small businesses find meaningful ways to manage costs while improving the quality of care for employees.

Here are three programs that can help your small business clients get more value from their health plan.

Small Businesses Tips To Manage Health Care Costs

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2026 Medicare Star Ratings

The Centers for Medicare & Medicaid Services (CMS) has released its 2026 Medicare Star Ratings. These ratings measure a plan’s performance in areas such as quality of care provided to members, clinical outcomes and preventive care, member satisfaction and operational performance. Excellus BCBS is thrilled to announce that their HMO and PDP plans ranked above average for the 13th year in a row.

This year’s ratings include:

• 4.5 out of 5 stars for their Medicare Part D prescription drug plan (PDP)
• 4 out of 5 stars for their Medicare Advantage HMO plan
• 3.5 out of 5 stars for their Medicare Advantage PPO plan

While performance improved across many quality measures, updates to CMS methodology—including higher thresholds for nearly 60% of metrics—presented new challenges in achieving top ratings.

Excellus BCBS remains committed to advancing member health outcomes and delivering exceptional care.

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