A couple weeks ago, I wrote a blog post about the insurance "race to the bottom", whereby carriers are following Affordable Care Act (ACA) rules in ways that make sense for the bottom line but not the consumer who needs coverage. That post helps explain what happened this week with Blue Cross of Illinois.
Namely, that the organization sent a letter to all of its members with ACA plans using the PPO network, writing "your current Blue Cross and Blue Shield of Illinois plan will be discontinued on December 31, 2015." It goes on to explain that the member will receiver more information about their available options before November 1, 2016.
A save-the-date for a wedding is a nice reminder. This feels more like a veiled threat, despite the fact that the company writes that members will have "plenty" of time to make a decision.
If you call Blue Cross or any of its licensed agent forces, the only thing that they can tell you is that the Big PPO network is going away for anyone who took an ACA plan issued after January 1, 2014, and that current plans are being redesigned. There is no official information about plans, deductibles, what providers will be in a network, co-pays, or cost.
With the Big PPO network going away, it's not necessarily common knowledge that going out of network can mean your stated out of pocket maximum may not match with your experience. We advise our PPO clients that being out of network can result in 50, 60, or even 70+ percent of the total cost falling on them, regardless of what their PPO contract says.
We feel that the lack of clarity around Blue Cross's handling of its elimination of the PPO network for those with ACA Individual/Family plans clearly shows that the act creates a clear incentive to de-service membership. This creates an even greater need for the consumer to be informed about his or her choices. Blue Cross of Illinois PPO members need to make sure that they have a trusted expert to advise them though these tumultuous changes.