For 2025, Excellus BlueCross BlueShield will continue to attest on behalf of our fully insured and minimum premium groups for the Consolidated Appropriations Act (CAA) gag clause attestation, unless directed otherwise by the group. For self-funded groups, we will continue to send the Certificate of Compliance so they can file the gag clause attestation directly to CMS.
Going forward, we will be obtaining group sign off from all groups that we will be attesting on behalf of. To obtain the sign off, we are updating our AGIF WebTool, the downloadable Annual Group Information Form (AGIF), the Healthy New York (HNY) Recertification Form and our rate sheets. *
Updated versions of the AGIF WebTool, downloadable Annual Group Information Form (AGIF), the Healthy New York (HNY) Recertification Form are now available. Updated versions of the 2025 rate sheets will be available by July 1. Forms & rate sheets received on or after July 1 will be required to be the updated versions.
For groups who are not required to complete these forms or that have already completed required submissions in 2025, a separate letter / communication will be mailed in 2025 notifying them that the Health Plan will attest on their behalf for 2025 unless they notify us otherwise.
There will be more information released in an upcoming newsletter about the separate communication to groups.
*The AGIF, HNY recertification, small group rate sheets, and the large group rate sheet FTA exhibit will contain the following language:
- “Unless you notify Excellus BlueCross BlueShield otherwise, you are authorizing Excellus BlueCross BlueShield to complete and file with CMS a gag clause attestation on your behalf annually up until the date services are terminated as long as all of your benefits are entirely insured by Excellus BlueCross BlueShield. You agree to provide Excellus BlueCross BlueShield with any information that may be necessary in this respect.”
The minimum premium Additional Services Exhibit will contain slightly different language:
- “Unless you notify Excellus BlueCross BlueShield otherwise, by signing this rate sheet, you are authorizing Excellus BlueCross BlueShield to complete and file with CMS a gag clause attestation on your behalf for the time period indicated on this rate sheet. You agree to provide Excellus BlueCross BlueShield with any information that may be necessary in this respect. (Note: This is applicable to Minimum Premium groups only with medical and pharmacy coverage through Excellus BlueCross BlueShield).”
If you have any questions, please reach out to your account manager.
Healthy New York Recertification Form (PDF)
