Effective July 13, 2008, Blue Cross Blue Shield of Illinois will no longer print and mail Explanation of Benefits (EOBs) that relate to all patient share zero liability claims. Zero liability claims are those claims that are covered and paid for by Blue Cross and Blue Shield of Illinois and do not require any additional payment by members. Zero liability claims can still be viewed and downloaded online through Blue Access® for Members at www.bcbsil.com/members.

In mid-December, 2008, Blue Cross Blue Shield of Illinois will begin to bundle all EOBs into one envelope on a weekly basis. However, any EOB accompanied by a check will be excluded from the bundling process and instead will be immediately mailed.

Tags: Blue Cross Blue Shield, EOB, green, health care, illinois insurance, insurance

(BestWire Services Via Acquire Media NewsEdge)
An increasing number of employers are participating in employee health and wellness programs in a bid to reduce health care costs due to chronic illnesses, officials from Blue Cross Blue Shield companies and the National Business Group on Health announced. The Blue Cross Blue Shield Association of America also released a new report finding that workplace education efforts can increase worker participation in wellness programs by 21% or more.

Joined by participating companies, the insurers were in the nation’s capital to lobby Congress on the benefits of wellness programs.

With chronic conditions such as heart disease, diabetes, obesity and smoking accounting for approximately 75% of health care costs, employers have a strong incentive to utilize workplace wellness programs, panelists said at the National Press Club. Blues’ representatives did not provide national statistics on how many companies and employees have joined such plans.

Dr. Douglas Woll, senior vice president and chief medical officer for the Blue Cross Network of Michigan, said the nonprofit insurer gave participating member companies an up-front 10% discount on health insurance premiums in exchange for enacting health and wellness programs. In less than two years, 575 employers with 75,000 employees have signed up, a figure that is growing by about 1,000 employees monthly.

Insurers began offering wellness, disease management programs and pharmacy benefit management services over the past decade because they learned that employers were willing to pay for them, according to Edward Kaplan, national health practice leader with the Segal Co., a New York-based employee benefits consulting firm. These programs also are helping insurers boost revenue in an environment where they?re struggling to grow membership, he said (BestWire, June 16, 2008).

While anecdotal and qualitative findings show increased participation by employers and employees, Blue Cross and Blue Shield of North Carolina Vice President and Chief Medical Officer Don Bradley said insurers have to show hard numbers verifying cost savings from wellness programs.

Otherwise, he said, “I’ll be polishing up my resume.”

Tags: Blue Cross Blue Shield, health insurance, wellness

Effective June 19, 2008, Blue Cross and Blue Shield of Illinois and Advocate Health Care have announced they have reached an agreement that renews all of their contractual relationships through 2010. The newly signed contract will include all of the Advocate hospitals and expand to include Libertyville’s Condell Medical Center when its expected integration into Advocate Health Care is approved by federal and state agencies later this year.

Tags: Advocate Health Care, Blue Cross Blue Shield of Illinois

Effective October 1, 2008 the Michael Reese Physicians Group MG-189 will no longer participate in HMO Illinois or Blue Advantage HMO networks. There are approximately 6,000 members and 63 physicians impacted as a result of this medical group closing.

Letters will be sent to these members and their employers by end of June, and will inform members of the medical group closing along with the option to select a new physician group. If a member does not select a new physician group by Friday, August 22, Blue Cross Blue Shield of Illinois will automatically reassign them to a new medical group for an effective date of 10/1/08.

Tags: Blue Cross Blue Shield, michael reese physician group

Effective October 1, 2008 the Michael Reese Physicians Group MG-189 will no longer participate in HMO Illinois or Blue Advantage HMO networks. There are approximately 6,000 members and 63 physicians impacted as a result of this medical group closing.

Letters will be sent to these members and their employers by end of June, and will inform members of the medical group closing along with the option to select a new physician group. If a member does not select a new physician group by Friday, August 22, Blue Cross Blue Shield of Illinois will automatically reassign them to a new medical group for an effective date of 10/1/08.

Tags: Blue Cross Blue Shield, michael reese physician group

Cape Radiology Group of Southern Illinois has terminated their PPO contract with BCBSIL. Cape Radiology Group is a group of radiologists that are on staff at the following Southern Illinois PPO Hospitals:
• Memorial Hospital – Carbondale
• Carbondale Clinic – Carbondale (This is a professional provider satellite of Memorial Hospital)
• Herrin Hospital – Herrin
• St. Joseph Hospital – Murphysboro
• Union County Hospital – Anna

Because Cape Radiology is the exclusive radiology group contracted with the above facilities, all inpatient and outpatient radiological services are subject to non-PPO benefits. The member may be responsible for the balance billing above the amount covered under their group benefit plan. Notification letters went out last week to all group and individual market members who reside in the service areas of the above hospitals. Letters are also going to all employer groups affected by their employees residency in the service areas. To find a radiologist in the BCBS IL PPO network, use the Provider Finder on www.bcbsil.com.

Tags: BCBS IL, Blue Cross Blue Shield, Cape Radiology Group

As part of our BlueExtras discount program, Blue Cross Blue Shield of Illinois has arranged a vision discount program that offers all group members discounts on eye exams, contact lenses, frames, lenses and lens add-ons.

In addition, as part of their health care benefits, HMO members have a vision benefit that provides coverage for one eye exam every 12 months for the cost of their PCP copayment, when they visit a network provider. All HMO members are eligible to receive this vision benefit, independent of any vision benefit (materials allowance) your company may have elected to provide for your employees. Effective July 1, 2008, both the HMO vision discount program and vision benefit will be administered by Davis Vision, Inc. Davis Vision began administering the vision discount program for non-HMO groups on January 1, 2008.

All group members also have access to discounts on laser vision correction through Davis Vision, featuring the TruVision network (Yes, the network Tiger Woods endorses). Members can receive discounted pricing on disposable contact lenses through Davis Vision’s Lens 1 2 3 Mail Order Contact Lens Replacement Program.

Tags: Blue Cross Blue Shield of Illinois, vision insurance

Effective July 1, 2008, Blue Cross® and Blue Shield® of Illinois will be raising rates on their individual health insurance plans. If you are planning to get a new BCBS of IL policy, apply online ASAP to get new business rates and avoid the price increases. The plans will be increasing as follows:

* HSA Products (9.0% increase)
o BlueEdge Individual HSA
o BlueEdge Individual HSA 5000

* Series 3 Affordable Products (9.0% increase)
o SelectBlue Advantage
o BlueValue Advantage
o BlueChoice Select
o BlueChoice Value

* Series 3 Products (12.6% increase)
o Select Blue
o Basic Blue
o BlueValue
o Traditional Blue

* Select TEMP (11.7% increase)

Tags: Blue Cross Blue Shield

Effective July 1, 2008, for small group (2-150) new business and thereafter for renewing accounts, Blue Cross and Blue Shield of Illinois will introduce 17 new $3,500 deductible benefit plans to the Standard Products portfolio. The plans will be available with the following products:

• BlueChoice Select ® – 2 new plans
• BlueAdvantageSM Entrepreneur PPO (BAE) – 4 new plans
• BluePrint PPO – 10 new plans
• PPO Value Choice – 1 new plan

On average the new plan options will offer a 5 percent savings groups that have the $2,500 deductible plan with the same benefit design and will be available for quoting in mid-April.

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