Blues

Top 10 Blue Cross and Blue Shield Plans in the Individual Market

December 3, 2018

by Carina Belles

Blue Cross and Blue Shield plans insure about 44% of the nationwide individual commercial market, with more than 6.6 million members. Florida Blue is the Blues’ market leader, and No. 2 to Centene Corp. in the overall rankings, serving 71.5% of all individual lives in Florida alone. In 2018, both Florida Blue and Blue Shield of California surpassed previous market heavyweight Anthem, Inc., which left four state Affordable Care Act exchange markets at the end of 2017, losing about 1.2 million individual enrollees since then. Anthem seems to be walking back on this move, as it will return to statewide exchange markets in Ohio and Virginia in 2019. Investment in the exchange marketplaces continues to drive growth in this sector, though overall enrollment is still down from 2017. The top 10 Blues plans in the individual market, listed below, currently enroll about 76% of Blues exchange members, and 34% of all exchange lives.

To access this post, you must purchase a subscription plan. Click Here to purchase.

Already a member? Click Here to login.

Blues Face Challenging MA-PD Market, Gain in Star Ratings

November 5, 2018

Blue Cross and Blue Shield-affiliated Medicare Advantage (MA) plans may find it difficult to win additional members for 2019 as new national and provider-owned plans jump into markets and more people select to stick with their current insurer.

To access this post, you must purchase a subscription plan. Click Here to purchase.

Already a member? Click Here to login.

New FEP Blue Focus Plan Ups Copays to Keep Cost Down

November 5, 2018

The Blue Cross and Blue Shield Federal Employee Program (FEP) is adding a new coverage option for 2019 featuring premiums that are nearly 30% lower than other FEP health plans. The new plan, called FEP Blue Focus, will be the cheapest national plan in the Federal Employees Health Benefits Program (FEHBP) for 2019. To get […]

To access this post, you must purchase a subscription plan. Click Here to purchase.

Already a member? Click Here to login.

Infographic: 2019 Star Rating Performance for Blue Cross and Blue Shield Plans

November 5, 2018

Click here for a pdf of the full issue

To access this post, you must purchase a subscription plan. Click Here to purchase.

Already a member? Click Here to login.

Blues Plans Compete in North Carolina for Lucrative Medicaid Contracts

October 4, 2018

by Jane Anderson

Two Blues-affiliated entities — Anthem, Inc. unit Amerigroup Corp. and a joint effort by Blue Cross and Blue Shield of North Carolina and AmeriHealth Caritas — will compete for chunks of North Carolina’s Medicaid business as the Tar Heel state moves from fee-for-service to managed care.

The state Department of Health and Human Services released a long-anticipated request for proposals (RFP) in August seeking insurers to provide health care to most Medicaid and NC Health Choice (Children’s Health Insurance Program) beneficiaries.

by Jane Anderson

Two Blues-affiliated entities — Anthem, Inc. unit Amerigroup Corp. and a joint effort by Blue Cross and Blue Shield of North Carolina and AmeriHealth Caritas — will compete for chunks of North Carolina’s Medicaid business as the Tar Heel state moves from fee-for-service to managed care.

The state Department of Health and Human Services released a long-anticipated request for proposals (RFP) in August seeking insurers to provide health care to most Medicaid and NC Health Choice (Children’s Health Insurance Program) beneficiaries. The RFP stems from a 2015 law directing the department to move 1.5 million of the state’s Medicaid recipients to private insurers beginning in November 2019.
North Carolina is the largest state in terms of Medicaid expenditures — approximately $13 billion — that has not yet moved to managed care, according to Barclays Capital.

To bid on the program, the North Carolina Blues plan partnered with Anthem, Inc.-owned Amerigroup Partnership Plan, LLC to launch “Healthy Blue,” which will use Amerigroup’s Medicaid expertise plus the North Carolina Blues’ local knowledge.

At the same time, AmeriHealth Caritas, formed in 2011 by Independence Blue Cross and Blue Cross Blue Shield of Michigan, is prepping its own bid for a slice of the North Carolina Medicaid managed care business.
Barclays Capital securities analyst Steven Valiquette says individual plan revenue from fully implemented North Carolina Medicaid contracts could be between $1.5 billion and $2.5 billion.

“Due to the limited number of statewide greenfield opportunities in the pipeline, this RFP is expected to be highly competitive with nearly all publicly traded MCOs expected to bid on the business,” Valiquette wrote. He notes that he considers Centene Corp. well positioned to compete for Medicaid business in North Carolina, since it has a strong presence on the individual exchanges and has partnered with the North Carolina Medical Society to collaborate in its Medicaid bid.

Managed care organizations in North Carolina have until Oct. 12 to submit their bids.

Overview of Blues Insurers in National Managed Medicaid Markets

October 1, 2018

by Carina Belles Blues insurers have sought to expand their managed Medicaid reach in recent years, and currently hold a presence in 20 states, with just over 11% of the national market share. The average Blues-branded Medicaid plan has about 243,000 members, and holds 23.1% of its state’s market share. Blues plans in Delaware, New […]

To access this post, you must purchase a subscription plan. Click Here to purchase.

Already a member? Click Here to login.