New-plan-year reminders for small group clients
As the new plan year begins, please share these reminders with small group clients.
No additional cost virtual care visits
In 2026, employees pay $0 for Blue KC virtual care visits. This includes primary care and behavioral health visits. A few housekeeping details:
- Members can access no additional cost virtual care on the MyBlueKC app or at MyBlueKC.com (under Find Care)
- No appointment is needed for primary care visits
- Appointments are required for behavioral health visits
- Refer clients to our Virtual Care flyer for more information about health conditions, downloading the app, and benefits of virtual care
Review Blue KC invoices for accuracy
Employer groups should review Blue KC premium invoices and, if they find an error or eligibility discrepancy, update their enrollment systems as soon as possible. Blue KC allows a 60-day grace period for enrollment adjustments, though we prefer enrollment updates prior to eligibility changes.
While Blue KC takes every precaution to deliver accurate invoices, it is a best practice and customer responsibility to ensure they’re not being billed for employees who may no longer be eligible for coverage.
SmartShopper cash incentive program has ended for small groups
The SmartShopper cash incentive program, which rewarded members for shopping and choosing cost-effective sites of care, sunset December 31, 2025, for small groups.
SmartShopper is one of several member programs and tools provided by Zelis. There is no impact to Zelis Find Care online provider search and cost estimator tools.
Deductible and out-of-pocket credit guidelines for new groups
For small groups moving to Blue KC from another carrier, pro-rated deductible and out-of-pocket credits are not automatically applied to their accounts. Rather, Blue KC will apply exact credits as provided by the previous carrier and will accept one file within 60 days of the new group effective date.
For new groups with effective dates of January 15 and later, please instruct the previous carrier to send the accumulator file to Small_Group_Special_Handling@BlueKC.com and include:
- Subject Line: Group accumulator credit file
- Group Name
Please contact your Blue KC representative if you have questions about the topics listed here.
