As we enter the third year of ‘full’ PPACA (Obamacare) implementation, policy holders in Illinois and around the country are once again facing higher prices, smaller PPO networks and even more canceled plans. On October 20, 2015, 173,000 Blue Cross Blue Shield of Illinois policy holders received cancellation letters like this one. The letter, among other things notifies these policy holders that not only has their health insurance policy been canceled (AGAIN) but that they have also been auto enrolled in new plans that do no include access to the top hospitals in Chicago and the Northern suburbs.
Instead of the “Broad” PPO that these members chose in 2014 which guaranteed them access to the top teaching hospitals in Chicago like Northwestern Memorial hospital, University of Chicago hospital, Rush University Medical Center and the Ann & Robert Lurie Children’s Memorial hospital, they are now auto enrolled into plans that no longer include access to any of the aforementioned top hospitals. Worse yet, none of the new networks offered to individuals and families who seek to purchase health insurance with Blue Cross and Blue Shield of Illinois in 2016 include access to these hospitals. I’ll present guidance on how to retain access to these hospitals in the following paragraphs.
In the quaint old days the before the PPACA one would actually have to sign a legal contract before they would be enrolled in a new health insurance plan but I digress into nostalgia. Keep in mind that this for many, is the third time their perfectly good policies have been cancelled since Barack Obama promised “if you like your plan, you can keep your plan “. I miss the old days when we could actually call our clients and tell them that they have a plethora of lower priced options to choose from a variety of carriers in a vibrant and competitive market. Unfortunately, that is no longer the case since 16 health insurance carriers have either closed their doors or been ‘consumed’ by larger carriers since the implementation of the PPACA. Economics 101 taught us that fewer carriers means less competition which always leads to higher prices. Monopoly isn’t just a board game.
Worse yet, the new 2016 plans are much more expensive. When I say “much more” I really mean it. You see, the majority of my clientele do not qualify for taxpayer-funded health insurance subsidies. Since they do not, they are suffering 2016 premium increases of 45% and higher. Since 2010 they have suffered increases of more than 105%. I guess they’ll have to wait until 2017 for Mr. Obama’s promised “$2,500 premium reduction for a family of four.”
So, what are your alternatives if you wish to retain access to the aforementioned teaching hospitals in Chicago? In my opinion, you have only three choices. They are as follows:
1.) If your company is incorporated you can purchase a small group health insurance plan with as little as two people. The Broad PPO has not changed for group health insurance plans. Northwestern Memorial hospital, Rush University Medical Center, the University of Chicago hospital and Lurie Children’s Memorial are still participating in the “Broad” PPO that is still included with Blue Cross Blue Shield of Illinois small and large group health plans. If this is an option for you contact me directly or send me your census information online at this link.
2.) If you live in Cook county there is a new health insurance start up called Harken Health, an independently operated subsidiary of United Health Group, America’s largest health insurer. Harken Health entered the Illinois health insurance marketplace on November 1st and we are just now getting a look at their prices. They are much more affordable than the options available to those living outside of Cook county who wish to retain access to the top teaching hospitals in Chicago.
What is unique about Harken Health is their networks, their prices and the unique ability to visit one of their “Harken Health Centers” and pay nothing. Harken Health’s networks include their ‘Preferred’network which includes the aforementioned top teaching hospitals and their ‘General’ network which together include approximately 850,000 physicians and care professionals and 6,100 hospitals and other care facilities nationwide. Included in Harken’s Preferred network is Northwestern Memorial hospital, Rush University Medical Center, the University of Chicago hospital and the Ann & Robert Lurie Children’s Memorial hospital. The hospitals within the Northshore University Health system are also in their Preferred network. To view the outlines of coverage for the Harken Health plans click here.
3.) All Illinois residents can also purchase health insurance from Coventry One which is now owned by Aetna insurance company. Using the Coventry One PPO provider search tool you will also find that Northwestern Memorial hospital, the University of Chicago hospital and the Ann & Robert Lurie Children’s Memorial hospital are all included in the Coventry One PPO network. Click the graphic below to see 2016 plans and prices from Coventry One and Aetna insurance company.
4.) There is a fourth option but not one that I would recommend to anyone. That is Land of Lincoln Health, one of the 23 troubled health care ‘co-ops’ 22 of which lost money last year. LOL Health ended 2014 with a $17.7 million loss and in the first 6 months of 2015 LOL’s claims outpaced premiums by $26 million and ended 2015 with a $90.8 million total operating loss. Unfortunately, LOL Health is at the top of Northwestern Memorial hospital’s list of recommended replacement carriers to replace Blue Cross policies and I have no idea why. My clients are also reporting that University of Chicago hospital, Rush University Medical Center and the Ann & Robert H. Lurie children’s hospital are also recommending LOL Health as the alternative to replace Blue Cross coverage. Is anyone at these hospitals doing any due diligence on the dire financial situation of LOL Health?
Lastly, if you want to keep the plan that BCBSIL automatically enrolled you in for 2016, or you want to choose another plan please follow the instructions in this document and visit www.StayBlueIL.com to accept the new plan or choose a different plan with Blue Cross Blue Shield of Illinois for the year 2016. Visit HealthInsuranceMentors.com for more expert guidance throughout the 2016 ACA Open Enrollment period.