BCBS-Illinois: News and Updates

[AllenChicago]

Agents/Brokers,
Be aware that new ACA fees are being deducted from your payable commissions, starting this month.

Excerpt from the 2014 BCBS-IL Compensation Agreement:

"For purposes of determining commissions and service/renewal fees, any Affordable Care Act Health Insurer Fee or Reinsurance Fee included within premium will be excluded. In no event will compensation be payable with respect to any such fees."

ac

 

[AllenChicago]

Since BCBS-IL communicates with the field frequently, it can be easy to overlook some important announcements. Here is a recent one that you may find relevant now, or in the future.


"News and Updates
Hot Topics for Wednesday, Feb. 19, 2014
Here is the day’s hot topic related to the individual, retail market segment. As a reminder, we encourage you to reach out to your clients to share this information.
New members who purchased on and off exchange policies have to meet guidelines in order to make policy changes.

Policies Purchased Directly from Blue Cross and Blue Shield of Illinois (BCBSIL)
Individual members who purchased their policies directly from BCBSIL (off-exchange) have the opportunity to make changes to their current policies through March 31, 2014 — the end of this year’s Open Enrollment. These members must adhere to the effective date guidelines and must make changes by the 15th of the month to ensure the new policy is effective on the first day of the next month. If policy changes are made after the 15th, then the new policy will not be effective on the first of the next month and instead will become effective on the first of the month after. (For example, if changes are submitted on Feb. 18, the new policy effective date will be April 1.)

Policies Purchased Through Get Covered Illinois, the Official Health Marketplace of Illinois
Individual members who purchased policies through Get Covered Illinois, and have either made their first payment and/or have their policy in effect, may not make changes to their policies at this time."

 

[AllenChicago]

March 6, 2014

Be aware that there is a glitch in the system that will not allow subsidy-eligible applicants to purchase certain plans at the Blue Cross website. They'll receive an "Invalid Plan" error after hitting the Finish/Submit button.

BCBS Tech Support says that this affects a "few" Bronze/Silver plans. The workaround is to conduct the entire purchase at HealthCare.gov. (Note: You cannot make a BCBS-IL payment at HC.gov. BCBS-IL will contact the applicant to set up the desired payment method)

This problem suddenly arose in Mid-February and will "hopefully" be fixed around March 15th, according to BCBS-IL Tech Support.
-ac

 

[stuy119]

March 6, 2014

Be aware that there is a glitch in the system that will not allow subsidy-eligible applicants to purchase certain plans at the Blue Cross website. They'll receive an "Invalid Plan" error after hitting the Finish/Submit button.

BCBS Tech Support says that this affects a "few" Bronze/Silver plans. The workaround is to conduct the entire purchase at HealthCare.gov. (Note: You cannot make a BCBS-IL payment at HC.gov. BCBS-IL will contact the applicant to set up the desired payment method)

This problem suddenly arose in Mid-February and will "hopefully" be fixed around March 15th, according to BCBS-IL Tech Support.
-ac

I'm surprised that they are having issues. Normally they are spot-on with their systems.

 

[AllenChicago]

I'm surprised that they are having issues. Normally they are spot-on with their systems.

NORMALLY they are Stuy119. But I'm sure you've been reading all the e-mails from BCBS where they're asking agents and customers for patience, and/or apologizing for something that was done incorrectly, or not done at all. To this day, I'm still filling out auto-draft forms and making manual OrbitPay premium payments for clients because BCBS-IL's computer LOST checking account info somehow. Hell, it might have been hacked/stolen and BCBS-IL isn't divulging that it happened...for obvious reasons.

 

[AllenChicago]

April 2, 2014

"The Blue Cross and Blue Shield Association, which represents the nation’s Blue Cross and Blue Shield plans, says “80-85″ percent of newly enrolled individuals buying plans under the Affordable Care Act are paying their premiums."

Full Story at: Blue Cross Says '80-85' Percent Of Obamacare Enrollees Are Paying - Forbes
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[AllenChicago]

May 2, 2014

Of the 217,000 Marketplace enrollees in IL, BCBS enrolled 200,000. That's a whopping 92% of all enrollees choosing a Blue Cross health plan!

With their name recognition, comprehensive provider network(s), and premiums that are significantly lower than Aetna, Humana and the new Land of Lincoln federal government-sponsored cooperative, it's no wonder that Blue Cross shut out the "competition".

In addition to the 200,000 FFMarketplace enrollees, another 150,000 enrolled off-exchange, directly at the BCBSIL.com website.

SOURCE: Blue Cross Emerges As Winner In Illinois

Will Blue Cross keep the 2015 premiums low? Will Aetna and Humana set their 2015 premiums lower in order to get more than a tiny slice of the Illinois individual health insurance pie? We'll know around September 2014.
ac

 

[AllenChicago]

Tuesday, August 5, 2014

I'm not sure why Doctors and Hospitals would voluntarily join an Accountable Care Organization (ACO), but Blue Cross of Illinois is assigning approximately 800,000 of it's customers to the ACO providers before the end of 2014.

Full Story: http://www.chicagobusiness.com/arti...ss-patients-in-illinois-to-be-assigned-to-new

Does anyone know why medical providers would join an ACO if it means less income, more oversight, and the potential for $$$ penalties as punishment?

Also, BCBS-IL can't take their PPO customers and tell them where to go for care, can it? That freedom is supposedly one of the benefits that a PPO has over an HMO.

ac

 

[AllenChicago]

August 7, 2014

Someone with knowledge of how rate-filings are structured, please tell me if the attached .pdf document filed by HCSC is stating that Illinois BCBS-IL premiums will be increasing by 26.8% on 1/1/2015? It's referring to Individual Major Medical plans, but I'm not sure which ones.

As posted yesterday in the "Insurer Filings" thread, proposed rate increases from all Illinois carriers is located at the now public accessible SERFF link: https://filingaccess.serff.com/sfa/search/filingSearch.xhtml
ac

 

[stuy119]

Not sure what you guys are seeing, but I'm looking at a few 12/1 renewal docs coming in, and they aren't pretty. Groups that have seen under 10% the past couple of years are now looking at 45-54% increases. I'm not happy, especially considering they have limited claims.