Health Insurance Blog

In an effort to assist North Carolinians through tough financial times brought on by the global recession, Blue Cross Blue Shield of North Carolina (BCBSNC) has waived the co-payments on generic prescription drugs for the first half of 2009 (through June ‘09).  The waiver supplements a similar program that BCBSNC is running in 2008 called “Medication Dedication” which has saved members $13Million in out of pocket costs thus far.

About 1 Million BCBSNC members are eligible for the 2009 Program, including:

• Blue Advantage customers
• Medicare Supplement customers (whose plans include prescription drug coverage)
• Many members who are covered by BCBSNC through their employer groups and
• Members of self-funded employer groups if their group has pharmacy benefits through BCBSNC and have chosen to participate in the program.

BCBSNC first launched programs to waive co-pays on generic prescription drugs in 2004, and have seen a marked increase in generic prescription utilization as a result.  The shift to generics from brand name prescriptions is important to insurance companies because it helps keep health care costs down as generics cost a fraction of what brand name drugs cost, and contain the same active ingrediants.  The cost savings ultimately get passed back to the customers in the form of lower premiums based on the utilization costs.

US News and World Report recently released their health plan rankings for 2008, based on NCQA Data collection and analysis.  The 4th annual rankings provided via the collaboration between US News and the NCQA, aims to help health insurance shoppers select quality health plans.  Costs will likely always be one of the most if not the most important factor to shoppers when considering a health plan, but this report seeks to make factors such as preventing and treating illness, as well as customer service more transparent to health insurance shoppers.

The top 10 Commercial Plans according to their analysis were:

1. Harvard Pilgrim Health care
2. Tufts Associated HMO
3. Harvard Pilgrim Health care of New England
4. Grand Valley Health Plan
5. Geisinger Health Plan
6. Health New England
7. Anthem Blue Cross Blue Shield of Connecticut
8. Group Health Cooperative of South Central Wisconsin
9. Blue Cross Blue Shield of Massachusetts
10. CIGNA Healthcare of New Hampshire

126 health plans refused to furnish performance related data and were unable to be included in the analysis, the three largest of such plans were Blue Cross Blue Shield of Texas, Blue Cross Blue Shield of North Carolina, and Wellpath Select.

Check Back later for regional rankings that will be posted later in the week, as the US News national rankings seem to favor the New England region as a result of more stringent mandated benefits in that region of the country which skew results.

A brief prepared by Mark Farrah, ranks health insurance companies across the nation based on their enrollment of individuals & families in non-group health plans, i.e. individual health insurance.

In the private health insurance marketplace there are an estimated 17 million individuals enrolled in non-group health insurance coverage purchased directly from insurance companies, although only just over 11million in membership was captured in this analysis which relied on NAIC and CA Dept of Managed Care Data.

Major medical health insurance plans make up the vast majority of non-group health plans, but limited benefit plans make up a material portion and are growing in popularity as health insurance premiums continue to outpace wage increases.

The brief found that 229 health plans were offering major medical health coverage to individuals & families.

The rankings were as follows:

1. Wellpoint/Anthem (BCBS in 11 states)      21% market share
2. HCSC (BCBS in 4 states)                              7%
3. BCBSNC                                                      4%
4. BCBSFL                                                       4%
5. Regence (BCBS in 4 states)                         4%
6. United HealthCare                                     3%
7. Aetna                                                         3%
8. Humana                                                     3%
9. BCBSMN                                                     2%
10. Assurant                                                    2%
11. Other (219 companies)                            46%

In the limited Benefit Plan marketplace, United American maintains a dominant position with 70% market share.

The most surprising finding in the major-medical health insurance rankings is that Blue Cross Blue Shield of North Carolina as the 3rd highest membership across the country, covering over 350,000 individuals with their Blue Advantage offering for individuals despite covering a service area that is limited to the state of North Carolina.

Gary Bolt, and Bruce Allen deserve much praise for their work managing the individual direct sales unit at BCBSNC.

On August 7, Blue Cross Blue Shield of North Carolina celebrated 75 years of providing health insurance to North Carolina residents.

BCBSNC was founded as Hospital Care Association (a group health insurance plan) in Durham on Aug. 7, 1933, and merged with Hospital Saving Association based out of Chapel Hill in 1968 to form what it known today as Blue Cross Blue Shield of North Carolina.

In recognition of this milestone, Governor Easley proclaimed August 7 as BCBSNC day in North Carolina.