Blue Cross Blue Shield of Minnesota- individual and family health insurance market change

Blue Cross has released a Q&A regarding their recent announcement.

Background:

Blue Cross and Blue Shield of Minnesota and Blue Plus (Blue Cross) has made a recent announcement regarding changes to the individual and family plans market. Blue Cross has made a decision that we will refocus our offerings in the individual market for 2017 and will limit them to our Blue Plus plans. Blue Cross will be discontinuing all individual and family insurance plans sold to members in Minnesota directly, through an agent or broker, or on MNsure. As a result, members will not be able to renew their current plan or select another Blue Cross plan for coverage in 2017. The last day of coverage in their current Blue Cross plan will be December 31, 2016. This change does not impact Blue Plus individual and family plan members. Members will receive a letter in the mail starting June 28, 2016.

Q: What is happening?

A: After careful consideration of all options, Blue Cross and Blue Shield of Minnesota has made the difficult but necessary decision to refocus our individual insurance plan offerings in 2017. At that time, Blue Cross and Blue Shield of Minnesota will be reducing our footprint within the individual market. This includes offerings for individual and family insurance plans sold to members either directly, through an agent or broker, or on MNsure. Blue Plus offers Accountable Care Organization (ACO) options where members receive care within a select health care system. These offerings will be available for members to renew or purchase as they have in the past. 

Q: Why is Blue Cross taking this action?

A: As Minnesota’s largest health plan with more than 80 years of history in this state, we did not make this decision lightly. Ultimately, we needed to confront the potential risks that could affect stable coverage for all of our 2.9 million members. 

Q: How many members are impacted?

A: About four percent of our members are currently enrolled through the individual markets. As much as we do not want to place these members in the challenging position of having to seek other health insurance options, we believe it is a necessary step at this time. 

Q: When is this effective?

A: This change takes effect for the 2017 plan year. Current members who are enrolled in individual Blue Cross and Blue Shield policies that will be discontinued in 2017 will continue to have coverage through December 31, 2016. However, they will not be able to renew their current plan or select another Blue Cross plan for 2017. Our Blue Plus products still offer Accountable Care Organization (ACO) options where members receive care within a select health care system.

Q: Will the Blue Plus ACO products still provide coverage in all counties in Minnesota?

A: The Blue Plus ACO products will still provide coverage in all of the same counties as they do today. There are currently 11 counties that are not served by our ACO product offerings. 

Q: What is Blue Cross doing to help their members understand their options?

A: Blue Cross is communicating with members currently enrolled in the affected plans to ensure they understand their options to obtain coverage for 2017 through MNsure or in the insurance market outside of an exchange. Members are able to shop for new plans during the next open enrollment period, starting Nov. 1. Through the termination date of December 31, 2016, these plans will continue to operate as usual. Blue Cross will continue to meet all claims, benefits, and provider payments during the transition as outlined in members’ plans. 

Q: Will Blue Cross be on MNsure?

A: We will be offering Accountable Care Organization (ACO) options on MNsure for 2017 where members receive care within a select health care system. ACOs work within their system to provide coordinated care to ensure effective treatment at an affordable cost. 

Q: How do the Blue Plus ACO products compare with my current Blue Cross policy?

A: Blue Plus offers Accountable Care Organization (ACO) options where members receive care within a select health care system. ACOs work within their system to provide coordinated care to ensure effective treatment at an affordable cost.

Q: How much in losses has Blue Cross incurred as a result of the ACA?

A: As a nonprofit organization, our estimate for the period of 2014-16 is that our losses will approach or exceed $500 million dollars. 

Q: Why doesn’t Blue Cross just take another rate hike instead of leaving the market?

A: We very carefully considered all options, and this is a very difficult and challenging decision that we did not enter into lightly. Increasing rates would not confront the level of potential risks that could affect stable coverage for all of our 2.9 million members. 

Q: Why can’t you stay in the individual market when you appear to have strong reserves on hand from other parts of your business?

A: It’s not sustainable, or permitted under law, to subsidize one part of the business from another part of the business. That won’t work in the long-run.

Q: What changes would need to occur for Blue Cross to offer additional plans in the state’s individual market?

A: Blue Cross remains committed to Minnesota, and we want to ensure that our operations and financial structure support long term success within the state — preserving our ability to provide stable coverage for our nearly 3 million members. 

Q: Blue Cross has built its reputation on broad provider networks and offering a choice to its members. How will this move impact your brand and your mission in the long term?

A: We’ve been serving Minnesota for more than 80 years and are deeply connected to the people and communities in every part of the state. We continue to pledge that Blue Cross will continue to work every day to make a healthy difference on the lives of Minnesotans. Blue Cross remains committed to being Minnesota’s healthcare leader with the development of patient-focused care programs that emphasize prevention, wellness and coordinated care so that Minnesotans get healthy faster, and stay healthy longer through high quality, affordable care. 

Q: Which 11 counties are not in the Blue Plus ACO service area?

A: The Blue Plus ACOs will be available in all counties in MN, with the exception of these 11 counties: Benton, Crow Wing, Kitson, 

Lake of the Woods, Meeker, Mille Lacs, Morrison, Roseau,Sibley, Stearns and Todd

Q: Does the discontinuation of Blue Cross individual and family plans apply to grandfathered plans, non-marketed and marketed plans? A: Yes. The plan discontinuation applies to all Blue Cross individual and family plans, including grandfathered plans and non-grandfathered plans (both actively marketed and non-marketed).

Q: Is a member in a Blue Cross version of an ACO impacted by this change?

A: Yes. There are a small number of members, approximately 700, who have remained in the Blue Cross versions of the BluePrint and BlueConnect ACO plans that were originally offered in 2014. As with all of our Blue Cross individual and family plans, these plans will no longer be offered after December 31, 2016. However, these members will have the option to enroll in a BluePrint or BlueConnect plan through Blue Plus in 2017.

Q: How does this change impact the Aware networks?

A: Individual and family plans that use the Aware network will no longer be offered beginning on January 1, 2017. Blue Cross individual and family plan members that currently have a plan that utilizes Aware will be discontinued on December 31, 2016.

Q: Do the Blue Plus ACO plans include travel benefits?

A: The Blue Plus ACO plans provide coverage outside of Minnesota and out of the country for nonemergency services through the BlueCard program.

Q: Can a member still enroll in a Blue Cross plan through a special enrollment for the remainder of 2016?

A: Members can still enroll in a Blue Cross individual plan with a qualifying special enrollment event, however their coverage in a Blue Cross individual plan will only be effective until December 31, 2016. They will need to select a new plan option during open enrollment for coverage beginning on January 1, 2017.

Q: When will we know more about the product rate filing?

A: Filed (proposed) rates will be made public on August 1, 2016 through healthcare.gov. Final and approved rates will be made available approximately 30 days in advance of the open enrollment period, which begins on November 1, 2016.

Q: Did you consider coverage with a St. Cloud ACO offering?

A: Blue Cross and Blue Plus will continue to evaluate provider and network opportunities. In 2017, our individual ACO options will be limited to offerings in partnership with Allina (BluePrint), Sanford (BlueConnect), St. Luke’s and Mayo.

Q: What is the Blue Cross license impact to the ancillary products?

A: There is no impact to the Blue Cross dental products.

Q: What would it take for Blue Cross to fully re-enter the market?

A: In one word: stability. We need to make sure we are taking steps to create a more stable market so everyone obtains and maintains continuous coverage. We want to continue to provide coverage to Minnesotans as we have for more than 80 years. We are working with regulators at all levels to help stabilize the marketplace so people can continue to get the affordable coverage and care they need to get healthy faster and stay healthy longer.