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January 2015

Recent Stories of Interest

From The AIS Report on Blue Cross and Blue Shield Plans - 2015 Outlook In most states, Blue Cross and Blue Shield plans have a dominant share of enrollment in public health insurance exchanges (see table, p. 10). But because Blues plans can’t abandon unprofitable markets, that dominance could cause problems if the Supreme Court determines that federal premium subsidies can be distributed only by state-run insurance exchanges. In 34 states, the exchanges are operated by the federal government. Read more

Competition from new insurers, a greater focus on health care consumerism and… Read more

In most states, Blue Cross and Blue Shield plans have a dominant… Read more

In a bid to add another market to its retail division —… Read more

From the Editor

Welcome to your AIS Report on Blue Cross and Blue Shield Plans subscriber-only Web page

Be sure to visit often, for PDFs of issues, archives of articles and more!

Please email me with comments on the last issue, story ideas for future issues, or any other suggestions you have that can make the newsletter more useful for you.

January 27, 2015
Anthem BCBS Eases Benefit Restrictions in CT Following Blizzard

Anthem BCBS revised medical and pharmacy guidelines for Connecticut enrollees affected by the blizzard. Through Feb. 6, the insurer said it is "• Allowing the affected members to see any physician necessary to provide access to care. • Waiving the notification penalty on utilization management (UM) review of in-hospital cases. • Suspending early refill limits for prescriptions. • Allowing replacement of medical equipment or supplies. • Extending filing deadlines for claims." Visit http://tinyurl.com/plrwrp9.

January 22, 2015
Cost of Hip, Knee Replacements Varies Significantly

BCBS plans find wide variation in hip, knee replacement costs. http://tinyurl.com/m6dm5zg

January 12, 2015
Excellus Agrees to Refund Customers $74k

New York Attorney General Eric Schneiderman announced a settlement with Excellus BCBS in which the insurer will refund $74k in "excessive" copays to its customers. http://tinyurl.com/lbb3trw

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