What rates are you currently quoting?

We are currently quoting rate increases for our HSA product averaging slightly over 3 percent and employer group rate increases that are averaging in the mid teens (effective for the first quarter of 2010). Our rates are approved by the North Carolina Department of Insurance. The rates of specific employer groups can vary because of a number of factors that affect the potential medical costs of those groups. The factors include the health circumstances of employees, age and gender of the workforce, benefit levels chosen and the medical costs of the counties in which the employees live.

What about individual rates?

We are currently quoting individual premium increases averaging 12.24 percent (for the first quarter of 2010). Our average rate increase for the HSA product is slightly over 3 percent. Our rates are approved by the N.C. Department of Insurance. Rates for individuals can vary because of a number of factors that affect the potential medical costs of those groups. The factors include the age and gender of the workforce, benefit levels chosen and the medical costs of the counties in which the employees live.

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Why are medical costs up?

BCBSNC is seeing recent increases in medical costs for several reasons.  We waived copays on generic drugs from January through June 2009 in an effort to encourage our customers to use generics where appropriate to reduce medical costs. Other factors include: H1N1 and the seasonal flu, as well as impacts from COBRA and the aging of groups (where layoffs are newer employees.) (Note: This finding is similar to recent announcements by our competitors.) The use of generic prescriptions went up nearly 2 percentage points from December 2008 to December 2009 to 68 percent.

We believe the copay waiver is an investment in improving health by making it possible for people to keep taking their medicine even in a down economy if costs are lower. The 2009 generic copay waiver program applied to nearly 1 million BCBSNC customers and eliminated customer copays for covered generic drugs.

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Employees 4,617-Customers 3.7 million (including nearly 900,000 served on behalf of other Blue Plans) -Customer calls annually 4.4 million -Customer claims (volume in 2009) nearly 47.2 million – Customer claims paid in 2009 over $11.3 billion (insured and self funded Consolidated net income $107.3 million

Key Points about Financial Results:

• Blue Cross and Blue Shield of North Carolina is a stable company that provides a valuable service to more than 3.7 million customers. We know North Carolinians depend on us.

• BCBSNC had a net income ratio of 2.1 percent for 2009. This profit of 2.1 cents for each dollar of revenue was down from 3.6 percent in 2008, and below the company’s target range of 3.5 to 4.5 percent. The company’s profitability was affected by many factors including the investment made in improving the health of our customers by waiving generic drug copayments for the first 6 months of 2009, higher medical costs due to more medical visits, prescription drugs and use of medical care due to H1N1 and seasonal flu (for example) and slower membership growth.

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From J. Bradley Wilson, president and CEO of Blue Cross and Blue Shield of North Carolina:  Mark Twain wrote, “Always do right. This will gratify some people, and astonish the rest.” It might astonish many people that Blue Cross and Blue Shield of North Carolina stands ready to implement what is likely to be the first of several waves of health care reform. 

For the past 14 months, insurance companies have been poster children for what’s wrong with health care. In the face of relentless attacks by politicians, abetted by the news media, health insurers have not done a good job of explaining the value of health insurance.  (more…)

Jerry Ballard & Associates, Inc. partners with Independent Benefit Advisors located in the Triangle area who was ranked NUMBER ONE agency in the State of North Carolina for Medicare products through Blue Cross Blue Shield and now handles all of our senior products.  See the doctor you prefer and enjoy all value-added discounts.  Keep control of your care, savings and peace of mind.  Medicare only covers some of your medical costs, which is why Blue Cross and Blue Shield of North Carolina (BCBSNC) offers Medicare Supplement plans for Medicare beneficiaries and helps cover costs that Medicare doesn’t.

With the largest market share of Medicare supplement policyholders in the state, BCBSNC serves more than 125,000 North Carolina Medicare beneficiaries with over 75 years of experience in the health care industry. (more…)

Health care reform became a reality when President Obama signed into law the Patient Protection and Affordable Care Act (PPACA) on March 23rd, 2010. A reconciliation bill, which made changes to PPACA, was signed into law one week later.

Health care reform will extend access to millions of people who need health insurance. It’s a historic step in the right direction. But there’s still a lot of work to do to give Americans a health care system that they can both depend on and afford.

In keeping with the needs of North Carolinians, Blue Cross and Blue Shield of North Carolina is preparing for the many changes the new law requires. However, because it’s more than 2,000 pages long, there’s a process to “translate” legislative language to best serve our customers. Federal regulations will also be required to implement many aspects of the law. When those regulations will be finalized is uncertain. (more…)

Save with generic drugs, they are the same as brand name drugs in dosage, safety, active ingredients, and quality.  Generic co-pays are usually lower too.

When a pharmaceutical company develops a new drug, it gets a patent that allows it to be the only seller of that drug. When the patent expires, other companies can offer medications with the same active ingredient which are referred to as generic drugs, and they are generally less expensive, they could be as much as 75% percent less than their brand name equivalents.

Generic drugs are approved by the FDA, and are identical to brand name drugs in terms of quality. Generic drugs also have active drug ingredients that are identical to their brand name equivalents. In fact, the FDA reviews data showing the drug is bioequivalent to the brand name drug, monitors manufacturing practices of the drug, and reviews the active and inactive ingredients used in the drug before it is marketed. (more…)

For the last year, the nation’s attention has been fixed on reforming our healthcare system. On behalf of our nearly 100 million members, Blue Cross and Blue Shield companies are committed to working with the Administration and all other parties to implement this new law.

As we have done throughout our 80-year history, we will continue to help people navigate the healthcare system, especially at this time when many people are confused and unsure of what reform means to them. Being a part of the Blue Cross and Blue Shield family is about so much more than a simple membership card. It is a commitment to service excellence regardless of where you live or what kind of health plan you have. It is financial security in times of healthcare necessity. It is investments in the communities where you live, work and play. (more…)

The federal health care reform legislation, known as the Patient Protection and Affordable Care Act, signed by the President on March 23, 2010, and the Health Care and Education Reconciliation Act approved by Congress, signed by the President today, will expand the availability of health care coverage to millions of Americans. While some of the measures will be implemented this year, many do not take effect until 2014 and some extend out to 2020.

Below is information we have received which is a high-level overview of the timeline.  It is important to note that many of these reforms and their effective dates are subject to the rules and regulations process both at the state and federal levels – which could alter the intended timing of implementation.  Also, keep in mind, anything is subject to change.

2010

New Programs:
* Temporary retiree reinsurance program is established
* National risk pool is created, small business tax credit is established
* $250 rebate for Medicare members who reach the ”doughnut hole”

Insurance Reforms:
* Prohibits lifetime benefit limits – based on dollar amounts
* Allows restricted annual limits on the dollar value of certain benefits
* Coverage rescissions/cancellations are prohibited (except for fraud or intentional misrepresentation)
* Cost-sharing obligations for preventive services are prohibited
* Dependent coverage up to age 26 is mandated
* Internal and external appeal processes must be established
* Pre-existing condition exclusions for dependent children (under 19 years of age) are prohibited
* New health plan disclosure and transparency requirements are created

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Historically, Blue Cross Blue Shield of North Carolina has not differentiated rates for children between the ages of 1 to 18. As the medical costs for children have increased, the company needed to begin studying the costs within life stages of the children, too. What was found was that the age cost curve for children does not progressively go up like all other age groups.

The company has seen that the costs of newborns to age 1 have the highest cost of any age under the age of 18. When these changes were made, the two year old rate was actually lowered to more properly reflect the lower costs children have after their first year. And the nine month-old  is also scheduled to get that lower rate when they turn two years old.  Without considering medical trends or other shifts, the decrease could be approximately 33%.

For more information on health insurance coverage in North Carolina, please visit our website at www.nchealthplans.com or call our toll free number 888-765-5400 and speak with one of our qualified agents. Our agency provides coverage for health insurance in North Carolina through Blue Cross Blue Shield of North Carolina (BCBSNC). You may qualify for a 15% healthy lifestyle discount if you are in excellent health. Call us for details.

Each year,  BCBSNC  rates are adjusted based on what is believed what medical trends will be overall, as well as how it will be distributed within the portfolio. Example, rating for male customers between the ages of 35-39 who live in the Triangle area of our state are currently less than females aged 50-54 that live in the eastern part of our state. In general, females submit more claims, and generally so do people as they get older, and the cost of care in the east is generally more than in the Triangle. As any of those factors shift relative to one another for those groupings of customers they will be adjusted, so that the low-cost customers are not unfairly burdened by the purchases and practices of the higher cost customers.

While high rate increases garner all the headlines, consumer -driven health plans continue to see lower medical trend. The good news is that in January, 3O% of new Individual customers chose HSA products.  We need to continue to tell the utilization story, something that the current debate on reform continues to ignore. To personalize this, just this week a family was at the doctor, and they asked whether the next wellness visit for their very healthy 12 year-old should be every two years or every year, and the physician replied, “Every two years is fine, unless it is covered by your insurance, in which case you may as well take advantage of it.”

Consumerism and personal accountability are the most powerful tools we have in the fight against higher medical costs. Consumer driven health plans incent both. It requires effort and understanding by the customer, the doctors and those who market the products, but it is the opinion, they will certainly be worth that effort. The more customers buy these products, and feel good about exercising their right to understanding what procedures cost, the more it will become a normal part of how care is delivered.

For more information on health insurance coverage in North Carolina, please visit our website at www.nchealthplans.com or call our toll free number 888-765-5400 and speak with one of our qualified agents. Our agency provides coverage for health insurance in North Carolina through Blue Cross Blue Shield of North Carolina (BCBSNC). You may qualify for a 15% healthy lifestyle discount if you are in excellent health. Call us for details.

As stated in the 2009 financial summary, BLUE CROSS BLUE SHIELD OF NORTH CAROLINA’S profit margin was 2.1% with 87% of premiums collected going towards medical expenses. As is statutorily required, rates are reviewed and approved by the North Carolina Department of Insurance. It is hard to measure market share in the individual market accurately because the people in the market move in and out regularly. However, member population helps BLUE CROSS BLUE SHILD OF NORTH CAROLINA negotiate lower rates with hospitals and other providers.

When shopping for your health coverage, rates do not vary between agents or the company. Rates are established and set each year, regardless who you purchase your coverage through.

Trust the agent you are working with – what makes the difference in who you purchase your coverage through – CUSTOMER SERVICE is the ONLY difference, don’t let any agent tell you their premiums are cheaper or their products are better. If you are told that, you need to find someone else to work with.

For more information on health insurance coverage in North Carolina, please visit our website at www.nchealthplans.com or call our toll free number 888-765-5400 and speak with one of our qualified agents. Our agency provides coverage for health insurance in North Carolina through Blue Cross Blue Shield of North Carolina (BCBSNC). You may qualify for a 15% healthy lifestyle discount if you are in excellent health. Call us for details.