Blue Cross eliminates most popular individual plan
The state's largest health insurer is eliminating its most popular individual plan, called Blue PPO, which has the largest network of doctors and hospitals of any plan the company offers, because it was too costly for the company. The plan will still be available for employer groups next year.
"I'll be honest with you, I'm concerned," said Schor, a small-business owner. "I'm truly at the edge of my seat because I don't know what the new plan will look like."
Schor is one of 173,000 members enrolled in the Blue PPO who will have to find a new plan. It's a significant upheaval in the
"This is huge," said
"The amount of rate increase that would have been needed to cover the costs of the broad PPO would have been too high to justify offering it to the market,"
The decision to get rid of the broad PPO underscores the intense pressure insurers face to keep premiums low in the individual market. Networks that limit the number of providers help carriers reduce costs.
Tiered provider networks that offer consumers financial incentives to seek care with preferred providers and so-called narrow networks are highly prevalent in the exchange markets. The average provider networks for plans offered on the exchanges include 34 percent fewer providers than the average commercial plan offered outside the exchange, according to a recent report by
While initial evidence demonstrating the cost-effectiveness of smaller networks is promising, Avalere cautioned that more research is needed to measure the impact of this approach on quality and clinical outcomes.
Carriers can also reduce costs by changing their prescription drug benefits.
After the Tribune inquired about
Blue Choice didn't include some prominent
"It will be very interesting to see who's in and who's out," Fahn said. "We're all in the dark right now."
Fahn said he has a lot of clients in the northern suburbs who live near
The Blue Choice plans were less expensive than the broad PPO in 2015. The monthly premium for a silver Blue Choice plan for a 27-year-old male in
Brokers said they aren't sure if
"I wouldn't be shocked if all the PPOs are gone in a few years in the individual markets," he said.
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