CHAPEL HILL, N.C. – Blue Cross and Blue Shield of North Carolina (BCBSNC) is introducing two new products to better meet the needs of cost-conscious health care consumers. The newly unveiled Blue SelectSM and Blue ValueSM plans offer lower-cost options for health insurance, built on BCBSNC’s network of hospitals and doctors that provide access to high-quality health care professionals. BCBSNC is also launching an integrated health reimbursement account (HRA) to better meet the needs of employers.
“We’ve created two new products that offer more affordable premiums without sacrificing quality coverage,” said Brad Wilson, BCBSNC president and CEO. “Through market research, we’ve learned that a segment of consumers value price over a more traditional broad network of providers. These products appeal to these consumers.”
Blue Select for Employers
Blue Select is a new “tiered benefit” health plan that can save employers as much as 10 percent* compared to traditional PPO plans. BCBSNC used its provider relationships, claims data and expertise to organize in-network hospitals and selected specialists (general surgery, OB/GYN, cardiology, orthopedics and gastroenterology) into two tiers based on quality, cost efficiency and accessibility. This product includes the following benefit levels:
- Tier 1 represents the hospitals and selected specialists that receive BCBSNC’s top rating for clinical quality outcomes, cost efficiency or accessibility. Consumers pay less out-of-pocket costs when visiting a tier 1 provider compared to a tier 2 provider.
- Tier 2 represents the remaining network hospitals and specialists that reach BCBSNC’s high standards for clinical quality outcomes and/or cost efficiency. Customers pay more to visit these providers.
Within the tiered system, BCBSNC provides consumers with the information and tools they need to help them find a doctor within BCBSNC’s network that best meets their needs. By using the tiered benefit plan model, BCBSNC was able to reduce premiums over traditional BCBSNC PPO plans. Additional premium savings were found through a cost-saving plan for prescription drugs, which includes a closed formulary and a smaller, more streamlined pharmacy network.
Blue Select is designed to appeal to employers who want to control costs without compromising quality of care or access to an extensive network. Group plans include the following benefit ranges for in-network tier 1 and tier 2 and out-of-network services:
Blue Select Benefit Options** | |||
Tier 1 In-Network | Tier 2 In-Network | Out-of-Network | |
Primary Care Visit Copayments | $10-$40 | 30%-70% after the deductible | |
Specialist Visit Copayments | $20-$70 | $40-$120 | 30%-70% after the deductible |
Individual Deductibles | $0-$10,000 | $250-$20,000 | |
Family Deductibles | $0-$30,000 | $750-$60,000 | |
Coinsurance | 0%-40% | 20%-60% | 30%-70% |
Blue Value for Employers (available now) and Individuals (available in 2013)
Blue Value is a new lower-cost benefit plan for employers and individuals that relies on a smaller, more streamlined network of doctors and hospitals. Blue Value is designed to appeal to cost-conscious individuals and small businesses that live and work in the initial target markets of the Triangle, Wilmington and Winston-Salem.
BCBSNC was able to lower costs for the Blue Value plan by collaborating with regional health care systems – including UNC Health Care and Rex Healthcare, WakeMed Health and Hospitals, Key Physicians, Wilmington Health and Wake Forest Baptist Health – to reduce the price of coverage by as much as 15 percent* in certain market areas. This smaller, more streamlined network of providers helps consumers control their costs without sacrificing benefits. Initially, Blue Value will be sold across the state, except in the Charlotte region.
Additional premium savings were found through a cost-saving plan for prescription drugs which includes a closed formulary and a smaller, more streamlined pharmacy network.
Blue Value offers individual plans that include the following benefits for services:
Blue Value Individual Benefit Options** | ||
In-Network | Out-of-Network | |
Primary Care Visit Copayments | $15; $25 | 30% after deductible |
Specialist Visit Copayments | $30; $50 | 30% after deductible |
Individual Deductibles | $1,000; $2,500; $3,500; $5,000 | $3,000; $7,500; $10,500; $15,000 |
Coinsurance | 20%; 30% | 50%; 60% |
Blue Value offers group plans that include the following benefit ranges for services:
Blue Value Group Benefit Options** | ||
In-Network | Out-of-Network | |
Primary Care Visit Copayments | $10-$40 | 30%-70% after the deductible |
Specialist Visit Copayments | $20-$80 | 30%-70% after the deductible |
Individual Deductibles | $0-$10,000 | $1,000-$30,000 |
Family Deductibles | $0-$30,000 | $3,000-$90,000 |
Coinsurance | 0%-40% | 30%-70% |
**Your actual expenses for covered services may exceed the stated coinsurance percentage because actual provider charges may not be used to determine the health benefit plan's and member's payment obligations.
Pharmacy Benefits for Blue Select and Blue Value
BCBSNC applied the same lower-cost concept for the pharmacy benefits associated with Blue Select and Blue Value by creating a closed formulary (list of covered drugs) where only the drugs and devices listed on the formulary are covered. The closed formulary will be available online for searching, and members who have their pharmacy benefits with BCBSNC will have the option of filling prescriptions through PrimeMail or locally through most pharmacies.
Improved Health Reimbursement Account (HRA)
BCBSNC is also introducing a new integrated health reimbursement account (HRA) that gives groups more customization and funding options than ever before – with options to pair an HRA fund to most available medical plans, including Blue Select and Blue Value. A great option for cost-conscious employers, an HRA can help employers balance their need to manage health care costs with their goal of providing valuable benefits for employees.
Employers can get quotes now for both Blue Select and Blue Value, while individuals can begin receiving quotes for Blue Value in 2013. For more information about BCBSNC’s new products, talk with your local BCBSNC agent.
About Blue Cross and Blue Shield of North Carolina:
Blue Cross and Blue Shield of North Carolina is a leader in delivering innovative health care products, services and information to more than 3.6 million members, including approximately 900,000 served on behalf of other Blue Plans. For 78 years, the company has served its customers by offering health insurance at a competitive price and has served the people of North Carolina through support of community organizations, programs and events that promote good health. Blue Cross and Blue Shield of North Carolina was named one of the World’s Most Ethical Companies by Ethisphere Institute in 2012. Blue Cross and Blue Shield of North Carolina is an independent licensee of the Blue Cross and Blue Shield Association. Visit BCBSNC online at bcbsnc.com. ® Marks of the Blue Cross and Blue Shield Association. All other marks are the property of their respective owners.
*Actual cost savings will depend on geography and plan design(s) selected by group or individual. BCBSNC Internal Data; January 2013 premium difference for Blue Select compared to a comparable Blue Options PPO plan with $1,000 deductible and 80% coinsurance.
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