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Posts Tagged ‘Blue Cross and Blue Shield of Illinois’

Pharmacy Program Quarterly Update: Changes Effective July 1, 2019

Wednesday, May 1st, 2019

Applies to: Group Markets

Learn about the revisions to the drug list for members with prescription drug benefits administered by Prime Therapeutics®.

Drug List Changes
Based on the availability of new prescription medications and Prime’s National Pharmacy and Therapeutics Committee’s review of changes in the pharmaceuticals market, some revisions and/or exclusions will be made to the Blue Cross and Blue Shield of Illinois (BCBSIL) drug lists, effective July 1, 2019. Changes by drug list are listed on the chart links below.

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BCBSIL to Stop Offering SHOP Plans (Small Group 1-50) Starting Jan. 1, 2018

Friday, August 4th, 2017

Blue Cross and Blue Shield reports:

“We want to let you know that Blue Cross and Blue Shield of Illinois (BCBSIL) will not be participating in the Federally Facilitated Small Business Health Options Program (FF-SHOP) marketplace with BCBSIL health insurance plans starting Jan. 1, 2018.

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Obamacare rates in Illinois could climb next year

Friday, August 4th, 2017

The Chicago Tribune reports:

“Health insurers want to raise premiums next year for Illinois consumers who buy coverage through the Obamacare exchange — in many cases citing uncertainty surrounding the health care law as a reason for the proposed jumps.

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Only one insurer will offer PPO plan on state Obamacare exchange

Monday, October 31st, 2016

The Chicago Tribune reports:

“Blue Cross and Blue Shield of Illinois will be the only insurer offering PPO health insurance plans on the state’s Obamacare exchange next year, according to information released Friday by the state Department of Insurance.

That’s down from five insurers that offered individual PPO plans on the exchange this year. Many consumers prefer PPO health plans because, unlike HMO plans, they allow patients to see specialist doctors without a referral and see physicians who are out-of-network, albeit at higher costs.

The reduced choices were not unexpected, following the exit of several insurers from Illinois’ exchange. Aetna, its Coventry brand, UnitedHealthcare, UnitedHealthcare subsidiary Harken Health and Land of Lincoln all announced this year they wouldn’t offer individual plans on the exchange next year. Many insurers have cited financial struggles as their reason for abandoning the exchange.

The information was released Friday along with final rates for insurance plans on the exchange, which on average, are largely the same as rates submitted to the federal government in August. Rates will increase by an average of 44 percent for the lowest-priced bronze plans, 45 percent for the lowest-priced silver plans and 55 percent for the lowest-priced gold plans.

The information released Friday, however, also shows for the first time which insurers will offer what types of plans in each county on the exchange next year:

• In Cook County, insurer Celtic will offer an HMO plan, Cigna will offer an HMO and Blue Cross and Blue Shield will offer an HMO and a PPO.

• In Lake and McHenry counties, Blue Cross and Blue Shield will be the only on-exchange insurer offering HMO and PPO plans.

• In Kane and DuPage counties, Cigna will offer an HMO, Celtic will offer an HMO to part of the area and Blue Cross and Blue Shield will offer an HMO and PPO.

The federal government will release specific premiums, deductibles and information about networks by Nov. 1, when consumers can begin shopping for insurance on the exchange.

This year, Blue Cross and Blue Shield of Illinois stopped offering its broadest PPO plan for individuals on the exchange, instead offering a smaller PPO network that didn’t include popular academic medical centers at Northwestern University and the University of Chicago or hospital chain NorthShore University HealthSystem.

“We will continue to work with state and federal regulators and legislators to ensure a stable and sustainable insurance marketplace and to improve the quality and cost of care for all of our members,” Blue Cross and Blue Shield of Illinois said in a statement Friday.

Illinois is not unique in how few insurers will offer on-exchange PPOs next year, said Katherine Hempstead, a senior adviser at the Robert Wood Johnson Foundation.

Options will be more plentiful for Illinois residents who buy individual insurance off the exchange, but people who buy off-exchange plans aren’t eligible for federal subsidies that offset insurance costs. About 75 percent of Illinois residents who buy insurance on the exchange now get those subsidies, which will allow those consumers to pay less than $75 a month next year, even with the rate increase, Jonathan Gold, a spokesman for U.S. Department of Health and Human Services, said in a statement.

Five insurers will offer off-exchange PPO plans next year in different parts of the state. In all, 14 insurers will offer plans off the exchange. Consumers typically can buy off-exchange insurance through brokers or through insurance companies directly.

Oftentimes, insurers are more inclined to offer plans off the exchange because they may believe they’ll get healthier customers, said Larry Levitt, a senior vice president for special initiatives at the Henry J. Kaiser Family Foundation.

Most consumers, he said, are most concerned about making sure insurance plans’ networks include their doctors and that their monthly premiums aren’t too high. “It means consumers have to shop around carefully, as options are changing,” he said.

What will you see on Obamacare exchange for 2017? Details start to emerge

Monday, October 31st, 2016

The Chicago Tribune reports:

“Though full details won’t be released until later this month, some information is starting to trickle out about what Illinois residents will and won’t find when they shop for health insurance on the state’s Affordable Care Act exchange.

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Land of Lincoln coverage will end Oct. 1 for individual enrollees

Wednesday, July 20th, 2016

The Chicago Tribune reports:

“Land of Lincoln Health’s insurance coverage for its individual enrollees will end Oct. 1, according to the Illinois Department of Insurance.

The agency posted the news on Land of Lincoln’s website. A green banner now greets visitors to the website with the headline, “Important notice to all members” with a link taking them to information about the Chicago-based insurer’s impending shutdown. The notice comes a week after the agency moved to seize control of the financially troubled Chicago-based insurer.

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Blue Cross Blue Shield Confirms Obamacare Death Spiral

Thursday, April 28th, 2016

According to The Beacon:

” The Blue Cross and Blue Shield Association, which represents 36 Blue Cross and Blue Shield plans covering 105 million Americans, has just released a study of its members’ claims data in Obamacare exchanges 2014 and 2015. It confirms that Obamacare exchange enrollees are sicker and more expensive than enrollees in pre-Obamacare individual plans or employer-based plans.

Here I quote four of the study’s findings:

  • Members who newly enrolled in BCBS individual health plans in 2014 and 2015 have higher rates of certain diseases such as hypertension, diabetes, depression, coronary artery disease, human immunodeficiency virus (HIV) and Hepatitis C than individuals who had BCBS individual coverage prior to health-care reform.
  • Consumers who newly enrolled in BCBS individual health plans in 2014 and 2015 received significantly more medical care, on average, than those with BCBS individual plans prior to 2014 who maintained BCBS individual health coverage into 2015, as well as those with BCBS employer-based group health insurance.

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Blue Cross, Advocate team up on new health insurance plan

Monday, January 11th, 2016

Crains Chicago Business Reports:

“Blue Cross & Blue Shield of Illinois and Advocate Health Care are teaming up to offer a health plan that will be one of the cheapest options the insurer offers on and off the Obamacare exchange.
The plan, called BlueCare Direct, is a marriage of two giants. Blue Cross is the largest health insurer in the state, and Downers Grove-based Advocate is the largest health care system, with 12 hospitals and more than 4,000 doctors.

The BlueCare Direct network will include 250 of Advocate’s sites of care in Cook, DuPage, Lake, Kane and Will counties, including nine of its hospitals and a children’s hospital with two campuses. Enrollees can stick with their primary care doctor outside of Advocate’s system, but the plan will not cover it, said Dr. Lee Sacks, chief medical officer for Advocate.

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