Blue Cross and Blue Shield of Illinois (BCBSIL) is offering the Fitness Program as the newest value-added health and wellness option. The Fitness Program is an exclusive membership program that offers unlimited access to a nationwide network of fitness centers for a low monthly membership fee.

• Group Markets: As a new feature of Blue Care Connection®, the Fitness Program is now available to all group plan members (age 18 and older) who have Blue Care Connection. There is no additional cost to the employer or to the member’s premium for taking advantage of the Fitness Program.
• Individual Markets: The Fitness Program is available to all members (age 18 and older) with Individual Markets health care benefit plans, both Under 65 and Over 65.2 There is no additional premium cost to the member for the Fitness Program. (Under 65 Individual Members in the BCBSIL High Risk Pool may also participate in the program. Over 65 members with Part D coverage only are not eligible for this program.) Promotional postcards were mailed to individual members ages 18-55 and Over 55 at the end of 2009.

The Fitness Program offers:

• A one-time $29 enrollment fee and $29 monthly dues
• No long-term contracts with a flexible month-to-month membership
• Access to a nationwide network of popular fitness clubs, such as Bally’s Total Fitness, 24-Hour Fitness and participating YMCAs
• The option to work out close to home or work, near friends and family, or while traveling
• Easy online registration process through Blue Access® for Members
• Automatic direct billing through a major credit card or bank account
• Online fitness center location search, account management and customer service features
• Group Markets members and Individual Markets Under 65 members earn Blue PointsSM for joining the program and working out. [Note: Blue Points do not apply to Illinois Comprehensive Health Insurance Plan (ICHIP) members and Over 65 Medicare Supplement (Individual) members.]
• Tracking to earn Blue Points without self reporting. Fitness center visits are tracked via the membership card.

Enrolling is quick and easy. Members will be able to log in to their Blue Access® for Members account, click the My Health tab to find the Fitness Program button and use that link to search for participating locations and to complete their enrollment. Or, members can enroll by calling Customer Service at 888-762-BLUE (2583). The Fitness Program is available to members in addition to other fitness discounts available through the BlueExtras program.

Tags: BCBSIL Fitness Program, BCBSIL Wellness Discounts, BCBSIL Wellness Program, Blue Cross and Blue Shield of Illinois Gym Discounts, Blue Cross Blue Shield of Illinois

Individual members with policies associated with physician networks were issued riders as part of the November 2008 annual member mailing notifying them of the inclusion of Durable Medical Equipment (DME), Home Infusion Therapy (HIT), Advanced Practice Nurses (APN), Orthotics, Prosthetics and Optometrists providers in the PPO network. These provider types were made available for Group Markets members in 2007. For the most current PPO network information, members should visit the Web site at www.bcbsil.com and use the Provider Finder® tool. Once there, members should select their Individual health plan from the drop down menu, and select either provider name or provider type and click Go.

Tags: BCBS IL, Blue Cross Blue Shield of Illinois, blue cross blue shield of illinois individual plans

Effective January 1, 2009, NorthShore University HealthSystem (formerly ENH), has acquired Rush North Shore Hospital in Skokie, Illinois. Rush North Shore Hospital, which will be renamed Skokie Hospital, will remain a participating hospital in our PPO, BlueChoice Select and HMO networks.

The Rush North Shore Hospital listing in the Provider Finder® section of the BCBSIL web site and in the HMO provider directories will reflect the following:

• Skokie Hospital – (formerly Rush North Shore Hospital)

Individual physicians affiliated with Rush North Shore Hospital can still be found via a name search within our online Provider Finder. However, in the interim, members may still need to search for the hospital using the former name.

How will this name change impact BCBSIL members?
BCBSIL has an agreement in place covering the new entity. Members who use Rush North Shore Hospital and its affiliated physicians will not be affected by the name change and can continue to receive treatment and services. There should be no disruption in claims processing.

Tags: bcbsil, Blue Cross Blue Shield of Illinois, BlueChoice Select network, Rush North Shore Hospital, Skokie Hospital

Effective January 1, 2009, the current Members First discount program will be replaced with the BlueExtras discount program. All BCBSIL members enrolled in individual health plans are eligible for the BlueExtras discount program.

BlueExtras offers discounts on value-added health care products and services that can enhance health and well-being – as another advantage of BCBSIL membership. There are no claims to file, no referrals or pre-authorizations, and no fees to participate.

For additional information about the products and services offered through BlueExtras, log into Blue Access® for Members (BAM) at www.bcbsil.com. Click on the My Coverage tab, and then the BlueExtras Discount Program link.

Tags: BCBS IL, Blue Cross Blue Shield of Illinois, BlueExtras Discount Program, Members First Discount Program

Advocate Health Care’s is acquiring Condell Medical Center effective December 1, 2008. The new name of the hospital will be Advocate Condell Medical Center. As of the December 1 acquisition date, the Advocate Condell Medical Center will return to the Blue Cross Blue Shield of Illinois PPO and HMO networks. Advocate does not participate in the BlueChoice Select network.

Information regarding the formation of the Advocate Condell PHO for the HMOI physician network will be forthcoming.

Tags: Advocate Health Care, BCBS IL, bcbsil, Blue Cross Blue Shield of Illinois, Condell Medical Center

Blue Cross and Blue Shield of Illinois, the state’s largest health insurer, soon will no longer administer claims and provide customer service to employees of Wal-Mart Stores Inc., the world’s largest retailer, losing the business to another Blue Cross plan in Arkansas.

Starting in January 2010, Illinois Blue Cross won’t be performing administrative functions, such as staffing customer-service call centers, for employees of Wal-Mart, the health plan confirmed. Wal-Mart employees in the state still should be able to access benefits through Illinois Blue Cross because the new contract is largely related to behind-the-scenes work, the insurer said.

Such administrative tasks will begin in 2010 to transition over to Arkansas Blue Cross and Blue Shield, Illinois Blue Cross said.

Illinois Blue Cross would not disclose the financial impact of this change. Bentonville, Ark.-based Wal-Mart has more than 1.4 million U.S. employees and is known for its clout in negotiating with its many vendors.

“The membership in our four states will still be captured as part of our market share,” Illinois Blue Cross spokesman Jack Segalsaid of its parent, Chicago-based Health Care Service Corp., which also operates three other Blue Cross plans in Oklahoma, Texas and New Mexico.

In its new role, Health Care Service’s four Blue Cross providers will “become what’s known as ‘host plans’ for Wal-Mart’s approximately 200,000 members that live in our four states,” Segal said. “As host plans, we’ll provide our [medical-care provider] networks and our discounts, continue to reimburse providers and continue to determine claims pricing.”

As a home plan, Illinois Blue Cross has 445,000 members at Wal-Mart.

Wal-Mart would not confirm the change in the contract or financial terms of its relationships with any of the Blue Cross plans that process its health care.

“We regularly assess the quality and costs of the health-care plans offered by our providers, including those plans owned by Health Care Service Corp., and we don’t have any changes to those plans to announce at this time,” said Greg Rossiter, spokesman for Wal-Mart.

But Illinois Blue Cross said, “Wal-Mart was looking to consolidate into a single platform, so Arkansas [Blue Cross] decided to take this on and become the single home plan or administrator.”

Until the transition, Illinois Blue Cross will continue to share administrative duties with the Arkansas Blue Cross plan and Blue Cross and Blue Shield of Alabama.

Health Care Service had $865 million in net income last year on $14.3 billion in premium revenue. The nation’s fourth-largest insurer, the Chicago company has 12.4 million members, including 7.4 million in Illinois.

Tags: bcbs, Blue Cross Blue Shield of Illinois, Health Care Service Corp, health insurance illinois, illinois health insurance, illinois insurance, Wal-Mart, Walmart

CHICAGO, Aug. 11 — Blue Cross and Blue Shield of Illinois (BCBSIL) announced today its intent not to pay for costs resulting from hospital-based preventable medical errors known as “serious hospital acquired conditions” and “never events” (errors in patient care that can and should be prevented). BCBSIL said it will work with hospitals in its networks to put this new approach into operation and ensure that members are held harmless financially when these events occur.

In addition, BCBSIL reiterated its longstanding commitment to collaborating with contracted network providers to prevent medical errors before they occur.

“Blue Cross’ goal for years has been to work to prevent medical errors, which often go undetected. To this end, Blue Cross has and will continue to collaborate with hospitals and physicians in our communities to promote quality and safety and prevent medical errors before they threaten patients’ health and add to the cost of care,” Scott Sarran, MD, BCBSIL’s chief medical officer, said.

For years, BCBSIL has participated in initiatives designed to prevent medical errors. In 2001, for example, BCBSIL began an outcomes-based reimbursement program that provides incentives to hospitals when they provide care without complications. Designed to enhance quality and safety, this approach can reduce employer groups’ claims costs if hospitals’ services do not meet established quality criteria.

In addition to payment methodologies, BCBSIL participates in a variety of initiatives designed to help prevent medical errors, including:

* — Rewarding BCBSIL PPO and HMO physicians who complete the American Board of Medical Specialties’ Patient Safety Improvement Program, which addresses a host of inpatient and outpatient safety issues;
* — Encouraging hospitals (through letters, personal meetings, Blue Cross’ “Hospital Profile” scoring, and public reporting) to comply with and make public information about their progress towards meeting The Leapfrog Group’s patient safety standards. The Leapfrog Group’s goal is to reduce preventable medical errors and improve the quality and affordability of health care;
* — Measuring and reporting diverse indicators of hospital quality and patient safety. For the past six years, the results from the BCBSIL profile have been sent to hospital CEOs, and receive the attention of senior management;
* — Annually collecting data from Illinois hospitals on their participation in state and national patient safety and quality improvement programs and their procedures for addressing “near misses;”
* — Making information about hospital quality and safety available to members via our Blue Star Hospital Report, which is available at http://www.bcbsil.com; and
* — Starting up and providing the first $1 million in funding for a statewide e-prescribing system, which is open to network physicians, health insurance carriers, pharmacies, technology providers, professional societies, and others. Since its inception in April 2007, participating physicians have written approximately 467,500 electronic prescriptions – 41,573 in June 2008 alone. Moreover, in June, the system, which is designed to help prevent medication errors, detected more than 4,500 potential negative drug interactions, of which nearly 19% resulted in a change or cancellation of the proposed prescription. In addition, in June, the system detected more than 700 potential allergic reactions. As a result, physicians changed or cancelled more than 8% of prescriptions.

Tags: bcbsil, Blue Cross Blue Shield, Blue Cross Blue Shield of Illinois, health care, health insurance, illinois health insurance

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

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