In May 2009, Blue Cross and Blue Shield of Illinois informed their Springfield Medicare Select members that St. John’s Hospital had elected to discontinue its status as a Medicare Select contracting network hospital effective June 17, 2009. BCBSIL has announced that St. John’s Hospital has reconsidered and will remain a Medicare Select contracting network hospital. There will be no disruption of services provided or benefits covered under the Medicare Select plan at St. John’s Hospital. A letter containing this updated information was mailed to BCBSIL Medicare Select members in Springfield on June 19, 2009.

If you are a Medicare Select client that requested a plan change as a result of the May 2009 notification and would like to reinstate your previous Medicare Supplement insurance plan, you can call BCBSIL (800) 624-1723 and a customer service representative will assist in reinstating your former plan and will make sure that you are credited for any increase in premium they may have paid to change plans.

Tags: Medicare Select Network, St. John's Hospital Blue Cross Blue Sheild of Illinois, St. John's Hospital Medicare Select

Blue Cross® and Blue Shield®of Illinois (BCBSIL) has removed the following Illinois residential requirement: “50% or more of the enrolled employees must reside in IL or the bordering states. The restriction still applies to group with 2-50 employees. BCBSIL is very competitive in this market and still uses a gatekeeper form, that means no individual underwriting on most groups.

In the past, this rule may have effectively removed BCBSIL as an option for many companies. If you are a group that has been affected by this rule in the past and would like get a Blue Cross and Blue Shield of Illinois group quote, please email us at info@ilhealthagents.com with the subject BCBSIL group quote or contact us.

Tags: Blue Cross Blue Shield of Illinois group health insurance, Blue Cross Blue Shield of Illinois Group Quotes

Effective June 1, 2009 Blue Cross and Blue Shield of Illinois gives existing and new members the option to cancel their SelecTEMP (short term medical plan) policy prior to the expiration period. Please note:

The cancellation date will be effective on the next monthly renewal date following receipt of the cancellation request.

• Any prepaid premium will be refunded to the member.
• Reinstatements will be permitted provided that the request to reinstate is received prior to the cancellation date. If reinstatement is requested after the cancellation date, the individual must reapply under the subsequent benefit period application guidelines.

Tags: Blue Cross Blue Shield of Illinois Short Term Medical Plans, Illinois Select Temp PPO Plans

New BlueEdgeSM HSA plan options for 2-150 groups are being introduced July 1, 2009. These additional plan designs offer $3,500 aggregate and embedded deductible options with either 100%/80% or 80%/60% coinsurance options, or a $5,000 aggregate or embedded deductible option with a 100%/80% coinsurance.

An aggregate deductible means the entire family deductible must be met before health plan benefits begin for any covered family member. An embedded deductible means each family member has an individual deductible amount; once it is satisfied,that member is eligible for health plan benefits.

The out-of-pocket maximum for in-network services is $5,800 for individual and $11,600 for family for the four $3,500 deductible options:

• $3,500 Embedded Deductible 100%/80% Option
• $3,500 Combined Deductible 100%/80% Option
• $3,500 Embedded Deductible 80%/60% Option
• $3,500 Combined Deductible 80%/60% Option

Tags: BlueEdge HSA Plans

In May Blue Cross and Blue Shield of Illinois launched a campaign on Blue Access® for Members to promote the Personal Health Manager and encourage members to earn Blue Points by using these online wellness and condition management resources. Blue Points can be redeemed for reward items such as health-related products and fitness gear, popular merchandise and gift certificates.

Set to run through July 14, the adult member who earns the most Blue Points during the campaign will win tickets for the hit Chicago musical, Jersey Boys. An e-mail announcing the promotion was sent to Blue Access for Members registrants with Personal Health Manager access, who have opted in to receive electronic updates.

To view more information about the campaign, go to the promotional Web page at www.bcbsil.com/jerseyboys.

Tags: BCBSIL Jersey Boys, Blue Cross and BlueSheild of Illinois Blue Points, Blue Cross Blue Shield of Illinois Personal Health Manager

Starting July 1, 2009, Life Time Fitness is introducing the following exclusive health club membership offer to BCBSIL members who are new to Life Time Fitness (this offer is not available to current Life Time Fitness members). Life Time Fitness centers are located in Illinois throughout the suburban Chicago area and across 17 other states.

BCBSIL members who are new to Life Time Fitness only:

• Will receive a free RiskPoint Health Screening at Life Time Fitness (valued at more than $100)
• Can join for a $0 enrollment fee. An administrative fee applies to all memberships ($85 for Single
  and $95 for Couple and Family memberships) upon joining Life Time Fitness.

Applicants for this Life Time Fitness program will be asked to show their active BCBSIL ID card as proof of BCBSIL membership.

Through the BlueExtras discount program, members are eligible to save money on value-added health care products and services that help support healthy lifestyles. There are no claims to file, no referrals and no pre-authorizations. Members can also use discounts for complementary alternative medicine services, weight management programs, and vision and hearing exams and products.

Tags: Blue Cross and Blue Shield of Illinois Life Time Fitness Discount, BlueExtras Discount Program, BlueExtras Life Time Fitness

Effective for new groups issued on or after June 1, 2009, or upon renewal dates on or after June 1, 2009, Blue Cross and Blue Shield of Illinois (BCBSIL) group plan members – will have the option to cover non-military dependents to age 26 and returning military dependents to age 30. This applies to all insured groups, as well as self-insured municipalities, counties and schools. These dependents must meet specific eligibility requirements in order to be covered under the policy, described below.

If members elect to extend coverage or add dependent coverage, this change must be made during the employer group’s initial 90 day open enrollment period. Dependents not added during this 90-day enrollment period may be added later during the next open enrollment period. This is separate from the current open enrollment for employees and spouses who previously declined coverage and wish to enroll as of this open enrollment.

Eligibility Requirements
The following requirement and qualifications apply:

For Non-Military Dependents

• Cannot be married
• Must be age 26 or younger
• Do not have to be enrolled as a full-time student or tax dependent
• Do not have to be living in Illinois
• Do not have to reside with the insured

Returning Military Dependents

• Cannot be married
• Must be age 30 or younger
• Do not have to be enrolled as a full-time student or tax dependent
• Do not have to be a resident of Illinois
• Do not have to reside with the insured

Tags: Blue Cross Blue Shield of Illinois dependent age

In an ominous sign for the health industry, Illinois’ largest insurer said its business may not grow for the first time in 25 years. The top executive at Blue Cross and Blue Shield of Illinois said the recession and rising number of unemployed consumers will lead to losses in the number of health plan subscribers.

Illinois Blue Cross, which grew its enrollment 2 percent, to 7.3 million plan members, last year from 2007, did not say how much it expected its membership to decline.

“I would be surprised if we grew,” said Paul Boulis, president of Blue Cross and Blue Shield of Illinois. “I don’t think since the 1984-85 cycle that we have lost business.”

Any reduction of members at the Illinois insurer is a national economic barometer for the health sector.

Illinois Blue Cross provides the bulk of the 12.4 million health plan members of its parent company, Health Care Service Corp.

The Chicago-based company is the nation’s fourth-largest health insurer, with Blue Cross plans also in Oklahoma, Texas and New Mexico.

Though Boulis said Health Care Service plans elsewhere are growing, Illinois Blue Cross is suffering partly because of its national accounts: companies with workers in multiple states, and unionized workers who get health benefits through health and welfare trusts. Such union workers losing their jobs include carpenters, plumbers and pipe fitters.

“We have 1 million members in health and welfare trusts,” Boulis said. “As the housing industry tanked, they were the [workers] immediately affected.”

When large health insurers lose business, it often means more people are joining the ranks of the uninsured. That, Boulis said, will put pressure on policymakers in Washington as they work to address the more than 45 million Americans without health insurance.

“It just makes the challenge for the Obama administration much more Herculean,” Boulis said.

Effective May 15, 2009 for Local Market Accounts, Blue Cross Blue Shield of Illinois members will automatically be set up to view and download their Explanation of Benefits (EOBs) online, through Blue Access® for Members, rather than receiving printed versions in the mail. This change is environmentally friendly, saves time, enhances the security of personal data and can help improve record keeping. If paper mailings are still preferred, members can call BCBS of IL toll free at (800) 316-1150 anytime or log in to Blue Access for Members, click on User Profile and change their user preferences

Tags: Blue Cross Blue Shield of Illinois EOB

Triessent®* is the new specialty pharmacy program offered by Prime Therapeutics’, BCBSIL’s pharmacy benefit manager. Triessent is a partnership between Prime and Walgreens Specialty Pharmacy. To further develop our specialty pharmacy program services and help control the rising cost of providing coverage for specialty medications, we will begin transitioning members using specialty pharmacy services to Triessent on March 1, 2009.

The Triessent program offers the following advantages:

• Integration of specialty pharmacy with the overall pharmacy benefit
• Integration of pharmacy and medical data, helping facilitate utilization management and case management
• Experienced benefit consultation and coordination for specialty medications
• Patient care coordinators to support members; condition-focused care management programs
• Prescriber alerts notifying them of patient nonadherence; assistance with prior authorization requests
• A Triessent team available to visit specialty physicians to educate them about the program

In addition, Triessent offers members services designed to help in managing their therapy – at no additional
charge – including:

• Coordination of coverage between the member, physician and BCBSIL
• Convenient delivery of medication to the member or physician’s office
• Condition-specific educational materials and information about managing medication side effects
• Syringes and other supplies with every shipment of self-injectable medications
• 24/7/365 phone access to a Triessent pharmacist for urgent medication issues

Letters were mailed to affected members, notifying them of the change and providing instructions for ordering through Triessent. In addition, outreach calls are being made to these members to assist them during the transition.

Tags: BCBS IL pharmacy, Triessent