Dec 21, 2023
The transition to the web-accessible, cloud-based Facets core administration platform for enrollment, billing, claims, and customer service marks a transformative moment for CareFirst, their groups and members, and their business partners.
The updated platform will lead to short-term and long-term improvements for internal and external clients—such as easier access to member data, enhanced service for important administrative functions, and better alignment with industry trends.
On November 1, 2023, CareFirst began this transformation with the launch of the updated platform for a limited pilot group of 11 moderately sized employer groups totaling approximately 1,000 members. As with any pilot, the purpose of this initial launch was to confirm the platform’s ability to function on a larger scale. For CareFirst, that also meant identifying and resolving any gaps in integration with other systems prior to upgrading a larger subset of groups and members.
CareFirst has intentionally planned all phases of this upgrade, initially selecting the pilot population before moving to a scaled launch, where segments of the business will upgrade upon renewal. After their initial evaluation and enhancements, CareFirst will move forward with this scaled launch as noted below, with dedicated support teams available upon these upgrades.
Next Steps: Facets Upgrades Scheduled for January 1, 2024
On January 1, 2024, the following fully insured segments currently on Facets will be upgraded to the updated Facets platform:
- All fully insured Small/Mid/Large groups (medical) that are renewing or effective on January 1, 2024.*
- Includes groups that have a January rate renewal as well as groups that have a January benefit renewal (also called calendar year groups).
- Consumer Direct Over 65 (MedPlus/Medigap products) and Under 65 grandfathered plans that share associated group numbers.
- Fully-insured standalone dental groups (Consumer Direct and Group, on/off exchange and non-ACA, no associated medical coverage).
- Fully-insured standalone vision groups (Consumer Direct and Group, on/off exchange and non-ACA, no associated medical coverage).
- Life and disability groups (regardless of benefit renewal period).
* Does not include DC Small Business Health Options (SHOP) January groups (February forward will be included), Congressional group, and Federal Employee Health Benefits Plan (FEHBP).
Please note: Individual/Consumer Direct Under 65 groups (on- and off-exchange), Administrative Services Only (ASO) groups on Facets, and Nasco groups are not in scope for the January 1, 2024, upgrade, and will be scheduled for a future date.
CareFirst anticipates moving the remainder of Facets groups and members to the upgraded platform upon their renewals on February 1, 2024, and monthly thereafter.
Core Consolidation Issues and Questions
The updated version of Facets will eventually feature a new user interface. At this time, however, your read-only access will continue to look and feel the same. This upgrade has been designed to have a minimal impact to the member, provider, broker, or vendor experiences and no impact on any existing business capabilities.
Please note: There is no change to how you or mutual customers interact with CareFirst. For those of you who have “read” access to Facets today, CareFirst is currently developing instructions on accessing the new Facets via a new icon on CareFirst Workspace. Those will be sent via email. Please contact your assigned Broker Services Representative if you do not receive these instructions.
As with any upgrade, there is always the possibility of transitional system issues. Should those occur, CareFirst has staffed teams to address any issues quickly, accurately, and securely, and to ensure the best possible customer service.
Frequently Asked Questions – NEW
1. Has CareFirst identified and/or resolved any issues resulting from the November 1 pilot upgrade?
As expected, there were some systems issues identified with the 11/1 pilot, the most critical being inability to verify coverage in certain portals and brokers being unable to view the updated system. Root causes were identified, and all fixes are expected to be complete in time for the January 1, 2024, upgrade.
2. Are all portals currently functional?
The MyAccount member portal, the employer portal and the provider portal have been fully updated after the November upgrade. All “legacy” information showing in the broker portal will be replaced by January 1, 2024.
Frequently Asked Questions – Previous (Updated)
1. Will all lines of business on Facets be upgraded upon renewal?
- Though most individual (Consumer Direct) plans renew on January 1 each year, the ACA Individual Under 65 segment (on- and off-exchange) will not be moved as part of the January 1, 2024, upgrade. This segment will be upgraded to the new Facets at a later date based on program strategy and finalized approach.
- If all lines of business (medical and ancillary) are on Facets today, then all may be upgraded upon renewal. However, if a group is on split platforms (i.e., medical on Nasco and dental on Facets), dental will be upgraded at the time medical moves to the web-based environment. Please note: As stated earlier, this does not include ASO groups.
- While Nasco groups are “in scope” for the overall project plan, groups with medical on Nasco will not upgrade until sometime in 2024 (firm timeline for these groups are still TBD).
2. Will there be any impact to the My Account member portal and/or customer service?
No. Members will continue to have access to the same information on My Account as they have now and should call the same number on the back of their ID cards with questions.
3. Will the upgrade impact how we utilize the HUB?
No. The upgrade should have no material impact on how you utilize the HUB, and day to day functionality will not change.
4. Will Group numbers and/or Member IDs stay the same?
Yes. Group numbers and member IDs will remain the same.
5. Will members receive new ID cards as a result of the upgrade?
No. New ID cards will only be issued under normal circumstances (changes to group benefits and/or new enrollees on the plan).
6. Will employer groups need to do anything different as it relates to group structures or enrollment file layouts?
No. There is no action required by employer groups, brokers, or members, unless groups make a change during Open Enrollment that requires group structure or enrollment file layout changes.
If you have questions on this transition, please reach out to your Amwins Connect Sales Representative.
