Archive for the ‘Highmark’ Category

Pennsylvania Health Insurers Offer Low Cost Non-Compliant Plans Through 2017

Sunday, April 27th, 2014

Pennsylvania is one of nine states that is giving health insurance customers a break before forcing them to adhere to Affordable Care Act guidelines.  According to the Pittsburgh Business Times’ Kris B. Mamula, Highmark health insurance is the latest company offering renewals that don’t meet all of the new insurance mandates.  In “Highmark prepares new renewal plan health insurance,” we learn that Highmark is following in the footsteps of UPMC Health Plan with their new renewal options.  UPMC was the first company in western Pennsylvania to offer these non-compliant health insurance plan renewals that are lower cost.  They started offering these plans four months ago.  Highmark Inc. will be offering new renewal plans to employers who provide health insurance coverage.  The options will be available during both the July and December enrollment periods.

Plans were introduced during an insurance broker meeting last week.  Although minor details were not yet given to the public, Highmark is calling the plans “grandmothered plans”.  These lower cost plan options do not meet the requirements of the Affordable Care Act.  Insurance companies in Pennsylvania and eight other states have a three-year window where they can continue to offer their existing health insurance plans without penalty.  They will have to meet the Affordable Care Act guidelines in 2017, but the added three years gives employers some time to plan out their course of action.  More details are expected to be released by Highmark soon.

When UPMC started offering their lower cost plans, premium increases were between 0 and 48%.  Plans that incorporate the mandated coverage from the ACA had premium increases 100% and greater.  Insurance brokers who were at the recent meeting said that Highmark will be offering more flexibility with their non-compliant health insurance renewal plans.  Highmark is also likely to see a large increase in sales of their Community Blue plans, which limit the network of providers available.  It’s good news to employers and others who will benefit from the three year reprieve given in Pennsylvania and eight other states.  But eventually they will all have to meet the new guidelines put into place by the Affordable Care Act.  They will save money and have added time to determine their best plan options starting in 2017.  But in other states, health insurance companies will already be settled into their new health plans and insurers in these nine states will have to play catch up.

Health Insurance Is Going the Way of Retirement Plans

Sunday, February 16th, 2014

Just a couple decades ago, American retirement plans made a big shift from pensions to 401k’s.  Instead of receiving a defined benefit pension, workers started contributing to plans and making their own decisions about how they would receive their money.  A lot of people are forecasting a similar change in the health insurance industry over the next 5-10 years.  Right now many employers offer health insurance in a defined benefit way.  They choose the exact health insurance options and you can choose to pay for the plan or opt to buy your own individual health insurance.  Insurance News Net posted an article from The Pittsburgh Post-Gazette’s Bill Toland which says that “In 2020, Workers Will Decide (their own) Health Benefits.”

Many experts believe that the face of health insurance will change dramatically.  They forecast that people will shop online and choose the specific health insurance options that they want for themselves from private exchanges.  Companies will pay a certain stipend to their employees via a health account and that will go towards their health insurance plan costs.  If people choose a health insurance plan that is more than their employer stipend, they will have to pay the rest of the bill themselves.  They will shop in online private health insurance exchanges run by health insurers, like Highmark, or benefits consultants or brokers..  If an insurance company is running the exchange, all of the plans will be from them.  But if the exchange is run by benefits consultants or brokers, there will be plans from multiple insurance companies.  Plans will differ in prices and coverage.  Each exchange will likely offer around 6-10 different plans.

It was easier for large companies to make the pensions switch because they almost immediately saw huge cost savings.  It is a little different with the health insurance plans because although they will not see huge cost savings, they will see a large reduction in the amount of administration.  They are also offering better benefits to their employees, making them more competitive as employers.  But small and mid-sized employers will see even more benefits initially than the larger companies.  Experts predict that many smaller companies will make this switch to private exchanges in the next year and a half.  Larger companies will switch as well, but it will take a large employer like McDonalds or WalMart making the big move before many other make the jump as well.

Highmark Blue Cross Blue Shield Sole Insurer in WV Exchange

Saturday, September 14th, 2013

Competition breeds lower costs when it comes to insurance plans and most other things.  So will the fact that there will only be one health insurance company in West Virginia’s exchange mean that premium costs will be less competitive?  We don’t know yet, but we will know more about pricing when the exchanges across America start offering plans October 1.  According to the Cumberland Times-News out of West Virginia in the article, “Insurance market in W.Va. will have one company,” two insurers applied and were accepted into the state’s health insurance exchange, but only one is following through with their plans.  Carelink/Coventry withdrew from the individual health insurance exchange marketplace in West Virginia.  Their parent company, Aetna, reevaluated their overall strategy and determined that they would wait to see what happened with the exchanges in 2014 before offering plans in this state.  They decided to focus on markets where they feel they can be the most competitive and offer the most value to consumers.

Highmark Blue Cross Blue Shield will be the only insurer participating in West Virginia’s exchange when it starts offering plans next month.  They will be offering eleven different individual plans and four small business plans in that particular marketplace.  Each plan will offer different coverage levels with differing costs.  Plan enrollment will start at the beginning of next month, while coverage will start at the beginning of next year.  West Virginians for Affordable Health Care’s executive director believes that premium prices would be better with more competition in the marketplace.  But Highmark Blue Cross Blue Shield might offer great pricing, it’s just not yet available for viewing.  He is hopeful that more health insurance companies will join the exchange in the future, making pricing more competitive.  There is always the possibility that Caremark/Coventry will start offering plans in the future, according to a spokesman for Aetna.

Buying Health Insurance From a Storefront

Sunday, January 6th, 2013

I must say that I’m really intrigued by the concept of store fronts where they sell health insurance.  According to The San Francisco Chronicle’s “Health care coverage sold in stores,” Alex Nussbaum says that UnitedHealth Group is one of the driving forces behind this change in the industry.  As the largest medical insurer in the United States, UnitedHealth Group is trying out this retail plan in anticipation of the health care changes taking place in 2014.  When the individual health insurance mandate goes into effect, there could be 85 million people comparing plans as they shop in public and private health insurance exchanges.  Those Americans account for nearly $600 billion in spending power.

UnitedHealth has already opened 8 retail health insurance stores in the U.S., mostly for helping current customers now, but hopefully to bring new business in as well.  Their storefront locations are located from New York to Los Angeles.  The company has also made 16 mall locations throughout the central U.S. permanent retail shops.  Opening retail storefronts is a way for health insurance companies to get their name out there and let potential customers know how much help they can offer when they can walk in just as they do to their bank.

Highmark, Inc. of Pennsylvania has already opened 9 storefronts, while Blue Cross Blue Shield of Florida has 11 places for customers to get health insurance information.  Experts point out that these retail stores have to provide valuable services to their customers and potential customers in order to gain any significant business from the storefronts.  They can’t just be a marketing tool; they have to add value and really help consumers.  Answer questions that no one else can, give discounts not available elsewhere, and really help consumers figure out how the new health care laws affect them and their health insurance.  But many people appreciate all of the extras offered in addition to information.  Some storefronts offer blood pressure and other health checks or are attached to medical care facilities.  Others have translators for many languages and toys to keep children occupied while parents get information on anything from healthy eating to health insurance quotes.  Next time you are walking down the street and see a health insurance storefront, you may want to stop in and check it out.

Highmark Hopes to Rival UPMC’s Health System

Wednesday, November 14th, 2012

Highmark, Pennsylvania’s largest health insurance company, is hoping to rival the hospital system of UPMC some day.  They have been looking to merge with West Penn Allegheny since earlier this year, but the deal soured recently.  According to Alex Nixon of The Pittsburgh-Tribune Review, leaders of both companies have been ordered by a judge to keep working on the deal, at least until the contract expires next May.  In “Highmark, West Penn Allegheny Meet to Resurrect Merger,” Nixon says that the companies put out a joint statement saying that they will work once again on the $475 million deal.

There are multiple issues that the company leaders are working through, most which pertain to the finances of West Penn.  West Penn is the second largest hospital system in the region, but is losing money and operating with a critical financial crisis.  Their pensions are underfunded by $280 million, so Highmark suggested that the federal Pension Benefit Guaranty Corp. take them over.  Bondholders are owed $750 million and Highmark is requesting that number be reduced to $400 million before the companies join forces.  William Penn’s operations lost $112.5 million during the fiscal year ending this June 30.

Highmark made these financial requests during an injunction hearing.  A judge allowed Highmark an injunction preventing West Penn from talking with other interested parties until May.  West Penn said that they had the right to talk with others because Highmark wanted them to go through bankruptcy because of the bond and pension debt.  They believed that Highmark had broken their contract with that request.  But now the two sides will be working together again and trying to secure a formal deal for West Penn’s five hospital health care system.  Acquiring the system is part of a $1 billion plan Highmark has to compete with UPMC.

 

Health Insurance Rates Only Part of Customer Satisfaction

Friday, April 29th, 2011

map PAPennsylvania health plans ranked higher in customer satisfaction than the national average in J.D. Power & Associates’ U.S. Member Health Insurance Plan Study.  According to “UPMC, Geisinger, Highmark lead Pa. customer satisfaction rankings” by Bob Graham of Insurance & Financial Advisor, UPMC Health Plan ranked the highest in Pennsylvania.  While health insurance rates are important to consumers, this study also looked at the coverage and benefits, customer service, communications, information, provider choice, claims processing, statements given, and the approval process.  UPMC scored 744 out of 1,000, well above the national average of 696 and significantly higher than Pennsylvania’s average of 714.

Geisinger Health Plan and Highmark BlueCross BlueShield followed UPMC in Pennsylvania’s rankings with scores of 737 and 735, respectively.  Capital Blue Cross and Independence BlueCross also scored higher than the state’s average.  Although Pennsylvania’s scores went down slightly in 2011, compared to 2010, four of the seventeen other regions surveyed saw much more significant declines.  Some of the insurance companies that scored lower than average in Pennsylvania were Highmark Blue Shield, CIGNA, HealthAmerica/HealthAssurance, Blue Cross of Northeastern Pennsylvania, Aetna, and UnitedHealthcare.  Of the 34,000 insurance plan members surveyed, 2,684 were in Pennsylvania.

Highmark Collaborates with Blue Cross Blue Shield

Monday, October 18th, 2010

Blue Cross Blue Shield of Delaware (BCBSD) is now working closely with Highmark Inc. of Pennsylvania.  According to Blue Cross Blue Shield’s press release “Blue Cross Blue Shield of Delaware Announces Affiliation Agreement with Highmark Inc.,” this business relationship will strengthen the cost-effectiveness of the two companies.  It will also allow Blue Cross Blue Shield to bring Delaware residents some new products and services.

BCBSD has been working for four years on new corporate planning techniques to save money while remaining a competitive and leading force in the local marketplace.  By working closely with Highmark, BCBSD will remain a non-profit organization while enhancing their operations in a cost effective way.  As it has gotten harder for small, independent companies to stay competitive because of cost increases in the medical field, affiliations like this will probably become more common.

Once the Delaware Department of Insurance finishes their approval process, the two companies will be able to work together on investments towards new systems and other business capabilities.  Compare health insurance costs and they will be better positioned to keep customers happy by sharing investment expenses and capital requirements.  They will reduce administrative costs by sharing not only costs but current capabilities and systems that the other may not have.

Highmark’s New iPhone App

Sunday, August 29th, 2010

phoneHighmark health insurance and A.D.A.M. have come out with a new iPhone application called Health@Hand.  A.D.A.M. provides health information and innovative solutions for benefits technology in the health industry.  They partnered with Highmark to launch this application which will be available to all members of Highmark through the online iTunes store.  Health plan members can now get a wealth of information right from their iPhones including articles, information on first aid, discounts on services, and local provider and facility information.

The Pennsylvania-based health insurance company’s Health@Hand was based off of their member’s specific plan and provider information.  It is possible that other Pennsylvania-based health insurers like UPMC health insurance could come out with similar plans through A.D.A.M. in the future.  Current Highmark plan members can use the GPS in their phone to locate specific doctors, specialties and facilities near them.  They can even get a map of the location and connect directly to the office via their phone.  Another unique option members have is the availability of information by simply touching a specific body part.  Members can even change the gender or age for specific information.  The product can also be downloaded by non-Highmark members through A.D.A.M. and iTunes.