Blue Cross of Illinois - 2016 News of Interest

[AllenChicago]

Here's the problem with the Blue Choice PPO as it stands today...

A Client lives in Crystal Lake. Zip 60014. On Blue PPO.
Closest In-Network Hospital is 4 miles away.. Centegra, in Woodstock.

With Blue Choice PPO, the closest hospital is 14 miles away...Presence St. Joseph, in Elgin.

That pattern is repeated all over McHenry / Kane / Lake counties, and is why so many people up that way chose Land of Lincoln Health for 2015. In fact, there's not a single Blue Choice PPO Hospital in McHenry county..population 307,000. In Lake County, population 703,000, there's only ONE hospital in Blue Choice, and that's VISTA in Waukegan.

If you have a heart-attack, or one of your children are injured, you certainly don't want to take a 14 mile trip under those conditions, when you can get the same care just 4 miles away.

If that chart posted in the main forum is accurate, and Land of Lincoln Health goes away, clients who insist on a PPO vs an HMO can choose Coventry or United Healthcare. (Not sure of Humana. Too many conflicting signals)

I have a handful of clients on the Blue Cross HMO. One did get very upset and change to Land Of Lincoln Health because the HMO told her that she had to take her son all the way to Joliet (she lives Cary) for specialist care. The other HMO clients are young and/or healthy and don't use medical care. Not yet.

Here's a ray of Hope.. At the Blue Cross training, it was pointed out that the company is not using the Blue Choice PPO as we know it today. It will be the "Blue Choice Preferred" PPO. Don't know if there's much difference, but we can hope that it's better.
ac

 

[Pancur]

When I was at the BC training they said that basically Blue Choice Preferred PPO would be bigger than Blue Choice PPO mostly because they expand the network downstate. In Chicagoland we will not see a big change. However, as I said in Land of Lincoln Shread, we may see some of current Broad PPO provider to sing into Blue Choice Preferred PPO. We'll see.

 

[SamIam]

Since you guys went to the training did they mention when the rates will be released?

 

[AllenChicago]

Since you guys went to the training did they mention when the rates will be released?

Because the rate increase requests are so high (ave 32%), CMS still has not approved them. Probably a lot of behind-the-scenes "talks" going on between HCSC and the Govt.. The HCSC-owned Blue Cross in New Mexico had their rate increase request turned down by the Feds. As a result BCBS-NM is cancelling all IFPlans and not selling there in 2016. The government thinks it can force a business to operate at a loss. They're in another universe.

 

[Pancur]

BC is supposed to mail letters with new plan proposals on Oct 23rd. In this letter they will include 2015 APTC when applicable. Meanwhile Marketplace is supposed to automatically recalculate 2016 APTC.
As far as I understand the recalculation is supposed to be done based on the new benchmark plan (2nd lower silver plan). But will it be also based on new age? Most people will be one year older then in 2015?
Do you guys know when Marketplace is going to do the recalculation?
Will it be also automatically applied to 2016 plan or you would have to login to hc.gov and click couple of times to push it to BC?

 

[FRJ]

Here's the problem with the Blue Choice PPO as it stands today...

A Client lives in Crystal Lake. Zip 60014. On Blue PPO.
Closest In-Network Hospital is 4 miles away.. Centegra, in Woodstock.

With Blue Choice PPO, the closest hospital is 14 miles away...Presence St. Joseph, in Elgin.

That pattern is repeated all over McHenry / Kane / Lake counties, and is why so many people up that way chose Land of Lincoln Health for 2015. In fact, there's not a single Blue Choice PPO Hospital in McHenry county..population 307,000. In Lake County, population 703,000, there's only ONE hospital in Blue Choice, and that's VISTA in Waukegan.

If you have a heart-attack, or one of your children are injured, you certainly don't want to take a 14 mile trip under those conditions, when you can get the same care just 4 miles away.

If that chart posted in the main forum is accurate, and Land of Lincoln Health goes away, clients who insist on a PPO vs an HMO can choose Coventry or United Healthcare. (Not sure of Humana. Too many conflicting signals)

I have a handful of clients on the Blue Cross HMO. One did get very upset and change to Land Of Lincoln Health because the HMO told her that she had to take her son all the way to Joliet (she lives Cary) for specialist care. The other HMO clients are young and/or healthy and don't use medical care. Not yet.

Here's a ray of Hope.. At the Blue Cross training, it was pointed out that the company is not using the Blue Choice PPO as we know it today. It will be the "Blue Choice Preferred" PPO. Don't know if there's much difference, but we can hope that it's better.
ac

Nice analysis. That is why I mostly did my biz with Land of Lincoln (I'm in Lake County) - there were so many medical offices with signs posted "We don't take Blue Choice" or something to that effect. It's going to really suck if LOLH doesn't manage to right the ship.

 

[AllenChicago]

October 16, 2015

Blue Cross has updated the "Provider Finder" tool to show the new "Blue Choice Preferred" 2016 network for individually purchased plans. No hospitals in McHenry county, and only Vista Hospital (Waukegan) for Lake county.

It for my clients in those areas, it will either be a Blue HMO plan, or they'll have to change to another health insurance company.

 

[AllenChicago]

Friday, October 16, 2015

Today the Illinois DOI and/or HHS approved, and in some cases, adjusted premium increase requests for not only BCBSIL, but what looks like every other company that will be listed on HC.gov for Illinois in 2016.

You can see all the details at: https://filingaccess.serff.com/sfa/home/il

But in summary, Blue Cross will have a wide swing in premiums from one end of the state to the other. Some areas will see a 17% decrease from 2015. Other areas will see a 52% increase over 2015.

Also, I remember one of you saying that Blue Cross is doing away with the Out-Of-Network limit on how much an insured would have to pay for his/her medical care. Well, you were 100% correct. I've attached to this post one of the actual 2016 policy jackets that I downloaded from SERFF. It's for the BCBS-IL Silver PPO. Also, it looks like Silver will be a 70/30 coinsurance cost-sharing product, instead of the current 80/20. There are likely more areas where the 2016 BCBSIL plans have been diluted over 2015, but those are the two that immediately stand out when looking at the policy certificate.

ac

 

[AllenChicago]

Monday, October 19, 2015

Blue Cross and Advocate have teamed up to launch a new On/Off Exchange HMO Product, called "Blue Care Direct". Also, the article says that state of Illinois budget and staffing issues have delayed Blue Cross's expected 10-18-2015 date for seeing 2016 plans at Health Insurance Illinois | Blue Cross and Blue Shield of Illinois

Ref: PressReader.com - Connecting People Through News

 

[AllenChicago]

October 21, 2015

You can now login to Blue Access for Producers and see the 2016 plan comparison sheets. They are in the "Downloadable Forms and Documents" section for Individual plans.

Also, the 2016 plan/procedure overview (a slide-deck) is now posted in the Training section.