Just when you thought you were happy or comfortable with your Blue Cross Blue Shield of Florida health insurance plan, here comes the bad news.  There is a large increase coming for everyone regardless of when you signed up.  Here is a list of the effected populations:

Rate Increase Products

• Individual U65 BlueChoice®,
• BlueSelect®
• Florida Farm Bureau
• BlueOptions® Products
• Large Group
• Small Group
• Individual Under 65
• Medicare
• Group Medicare

If you are a Blue Cross of Florida policy holder, now is  a good time to fill out the quote form above and start shopping health insurance plans!

Here is the agency email received by agents to give us a heads up of the coming news so we can break it to you our trustful clients.

The purpose of this bulletin is to provide you with information on the upcoming rate increase for all Individual Under 65 BlueChoice®, BlueSelect®, Florida Farm Bureau and most BlueOptions® products. (This excludes BlueOptions Temporary
Plans 562-563, all Hospital-Surgical products and GoBlue.) This year’s implementation continues to include the alternate offer process and the transition to the restructured rate environment for impacted members. Carefully review the following
information.

And here are some relative estimations,

Rate Increase Percentage, Effective Date & Implementation: The Office of Insurance Regulation (OIR) approved an 11.2% rate increase for BlueChoice (Underwritten & Guaranteed Issue), BlueOptions (Underwritten and Guaranteed Issue),
BlueSelect and Florida Farm Bureau products. The new rates are effective June 1, 2010 and will be implemented based on the subscriber’s first paid-to date that falls on or after June 1. Approximately 197,000 contracts representing 319,000
members will be impacted by this rate action. The last rate increase experienced by these members occurred June 1, 2009.

How you will find out

Customer Mailings: The first round of rate increase notification packages will be mailed April 13-16, 2010. These notification packages will be mailed using a staggered approach with daily mailings scheduled to continue through the third
quarter of 2010.

Your Choices

Remember, these letters were addressed to us, so these instructions are to agents not to policy holders.

Alternate Product Offer Including Rate Quote

In conjunction with this rate increase we are continuing the Alternate Offer program. This process has been very successful and has enabled us to retain over 95% of customers who contact us. With Alternate Offer, we suggest a
specific lower cost alternate insurance plan to the subscriber and we include the monthly premium that will apply to that subscriber’s coverage if they choose to transfer to the alternate product. This immediately displays to them the
monthly premium savings available.

Monthly Premium Criteria (Underwritten Customers Only)

If the monthly premium for the alternate product is equal to or less than the subscriber’s monthly rate today (pre-rate increase), then the customer will receive a specific Alternate Offer (presuming other criteria are satisfied).

If the monthly premium for the alternate product is more than the subscriber’s monthly rate today (pre-rate increase), the customer will not receive a specific alternate offer. Their letter will contain general verbiage around other lower
cost products that are available and will encourage them to contact us.

The Alternate Offer process was designed and built to support all Individual Under 65 products. There is a variety of different scenarios requiring different letters. All letters have been assigned unique letter codes that appear at the
bottom of each letter.

Depending on which rate increase letter you get, the alternative products are listed below.

A

. BlueChoice with optional maternity if the Alternate Offer is BlueChoice. The suggestion will be to increase their deductible in BlueChoice.
. BlueChoice without optional maternity when the Alternate Offer is BlueOptions.
. Most BlueOptions & BlueSelect Plans (with or without optional maternity).
. Most BlueOptions HSA-compatible plans.
. Florida Farm Bureau (FFB).

D

BlueChoice with optional maternity when the Alternate Offer would be BlueOptions. This letter does not include a specific Alternate Offer because the structure of the optional
maternity benefit available with BlueOptions is entirely different than what is available with BlueChoice. Further, there are two different BlueOptions optional maternity benefits
available with different and separate deductible amounts. Customers are encouraged to contact us for more information.

H

Guaranteed Issue (Choice & Options). There are no alternate products for this population.

The above categories represent the majority of subscribers involved in this rate action.

B

Criteria for alternate offer not met (i.e., the rate for the alternate offer product is higher than their pre-rate increase premium, they changed products within the last 180 days, they were a new sale within the last 180 days, etc.)

C

Current product is a non-HSA plan and the Alternate Offer would be an HSA-compatible plan.

F

. The current product is a non-HSA compatible plan with optional maternity and the alternate offer would be an HSA-compatible plan. This letter does not include a specific Alternate Offer. While enrollees are eligible to transfer into an HSA-compatible plan, optional maternity is not available with the HSA-compatible plans.
. BlueOptions Plans 81 and 98 (with or without optional maternity).
. Highest deductible HSA-compatible Plans with BlueRx Discounts Program

G

BlueOptions MyBasic Plans 82 & 582.

Sample letters are attached for your reference. Where an Alternate Offer is made, the applicable Benefit Authorization
Form and a Business Reply Envelope will be included in the package.

Restructured Rates

Impacted BlueChoice and BlueOptions customers will continue to be transitioned into the restructured rate environment. This transition plan was negotiated with and approved by the OIR. As a reminder, rate restructuring is a required routine
industry practice that insures continued financial integrity and regulatory compliance of our rates. It is revenue neutral to BCBSF. To ensure our rates remain correct, appropriate and consistent, we analyzed the rate relationships between
different benefit plans, different deductibles, different geographic areas, etc., along with structural factors for age, gender, county, etc. This detailed review resulted in the development of restructured rates that brought the entire state into
alignment so that everyone pays a fair and equitable premium for the coverage they maintain. Virtually every rate at every age in every county changed. On Oct. 1, 2006, restructured rates were implemented for all new sales into Individual
BlueOptions and BlueChoice products that occurred on or after that date. All new IU65 products introduced since that date have been developed at the Restructured Rate level.

Members enrolled prior to 10/01/06 are in the non-restructured rate environment. These are the customers who will be impacted by the transition and they will receive the following additional reminder message printed on the reverse of their
rate adjustment notification letter.

NOTICE OF RATE RESTRUCTURE

To ensure you’re receiving health insurance rates that are appropriate, accurate, and fair, our BlueChoice and BlueOptions Individual Under 65 products have undergone a rate restructure. This is a standard industry practice. It ensures your
premiums best reflect the appropriate rates for your age, gender, and county where you live. Rate restructuring is different from rate changes, which are typically rate increases due to rising medical costs, trends, and age. The Office of Insurance
Regulation has approved this rate restructure. The restructured rates will continue to be implemented gradually over the next several years.

Inquiry Support

Product specific toll-free numbers are provided in the rate notification letters. These lines will be staffed by Intermedia, an external vendor that has supported rate increase activities for the Individual Under 65 products for several years and is very familiar with our products, retention practices and all aspects of this initiative.

Rates
Rates will be available on accessBlue by close of business on Wednesday, April 14, 2010.

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Blue Cross Blue Shield of Florida has come forward with their vision of health reform, and no you crazy kids it doesn’t involve corporate malfeasance or shooting everyone that doesn’t buy a Blue Cross policy, but it does involve of course increasing profits while maintaining a certain level of health coverage in Florida.  In other words, they picture it as you would if you owned Blue Cross.

The following post is from an email we received outlining the Blue Cross Blue Shield vision of health reform in Florida and nationwide.  If you have the attention span to sit through it, I applaud you.

Click Here Now For A Comparison Quote

Reform

Introduction The number of uninsured is growing at epidemic proportions. Nearly 50 million Americans — one in six individuals — lack appropriate health coverage and access to care. In Florida, nearly four million people are without health insurance.

Unfortunately, these numbers continue to increase, a fact that should come as no surprise since health care costs have risen more than 70 percent over the past seven years. The increase in the cost of health care and, consequently, the cost of coverage, has far outpaced wage increases for the average American. Absent an employer or government subsidy, health care coverage is simply unaffordable for many Americans.

Vision of Reform
Blue Cross and Blue Shield of Florida’s Vision of Reform Blue Cross and Blue Shield of Florida (BCBSF) believes that the severity of the affordability and uninsured issues require a case for transformational change in today’s health care environment. Our vision for reform includes five critical elements: wellness and prevention; evolution in health care delivery; universal coverage; consistent and equitable funding for safety net programs; and personal responsibility.

BCBSF’s Mission is to advance the health and well-being of Florida’s citizens and to work toward a system where appropriate health care is available to all. But we certainly can’t do it alone. Any change for which we advocate can only be accomplished when all of those involved in health care delivery, financing, utilization and supply coalesce to agree on a realistic platform for reform. Until all parties recognize that the current model is unsustainable, it is unlikely change will occur proactively. And if the health care industry doesn’t come together quickly, a declining economy will drive a political agenda that diminishes the positive impact brought by the private sector in terms of innovation and meaningful competition.

Wellness and Prevention BCBSF envisions a medical delivery system that evolves from an illness model to a wellness model. Today, doctors and other providers are paid to treat the sick with very little financial reward for keeping people healthy. This paradigm must be changed. Incentives for preventive medicine and wellness should be offered to both patients and providers. Steady doses of wellness education should be offered beginning at a very young age and continued through one’s entire educational career.

Overall, our health care financing needs to be realigned to reward both the practitioners and consumers who achieve the best health outcomes. Evolution in Health Care Delivery BCBSF and other payers need to work with our provider partners to implement critical changes in medical delivery.

A system that embraces objective, proven clinical standards as the foundation for reimbursement is the goal. Physicians should be rewarded for adherence to these standards and for the enhanced value that efficient, integrated and clinically appropriate care brings to patients.

Protections from legal liability can be legislated to shield clinicians and eliminate the costs caused by defensive medicine and other consequences of malpractice lawsuits. With the total impact on medical expenditures costing $124 billion each year, removing this cost would pay for virtually any version of comprehensive health care reform. Universal Coverage For the insurance industry and medical community to successfully implement system changes that would bring coverage to all Americans, BCBSF envisions the federal government playing a significant role. For those individuals and businesses that do not obtain coverage voluntarily, an enforceable mandate must be created.

Policy studies consistently find that a voluntary system cannot produce universal participation. Our country’s compassion has created a safe haven of emergency room treatment for all. The cost of this care is being borne by a diminishing number of insured. The fundamental principle of spreading risk can only be achieved when all of those capable of paying for their own or their employees’ coverage are mandated to do so with appropriate incentives. Those who do not have the financial ability should receive a meaningful public subsidy. Consistent and Equitable Funding for Safety Net Programs We believe the best approach for funding these programs will spread the risk nationwide.

Additionally, public subsidies and safety net programs should be equitably funded across the states. Inconsistency in federal and state funding adds to the problem of a disjointed health care system and does not encourage integrated care. Florida has a disproportionate responsibility of caring for seniors in long-term care settings. While an increase in taxes would be necessary, long-term care costs should be part of the Medicare program. Personal Responsibility Finally, BCBSF believes private and public entities, along with the federal government, can create an environment that encourages personal responsibility for each individual. It took only one generation to reduce the number of smokers by half.

We can work together to address and improve conditions that deplete most of our health care dollars; like asthma, diabetes, heart disease and depression. Obesity and diabetes can be significantly addressed through good nutrition and exercise. Can we expect people to take personal responsibility when their neighborhood is unsafe, where there are no sidewalks on which to walk or playgrounds on which to play, and only fast food is available?

When a large percentage of Florida’s adult population is functionally illiterate, how realistic is the expectation that food labels will be read and understood? Clearly, education and resources are the keys to promoting personal responsibility and good health. Let’s work together to put exercise back into our schools, to build and create neighborhoods where children can play in a protected environment and spaces can exist for community markets. How can we eliminate economic and environmental chemical burdens that foster depression and physical illnesses?

We need the commitment to create incentives that promote and pay for early disease intervention and preventive care. BCBSF is not promoting a vision of utopia but rather asking everyone to take a role in building and supporting a long-term view of a healthy Florida and the United States for future generations. As we move forward, BCBSF pledges to continue the dialogue, develop solutions that align with this vision and work with various stakeholders to develop integrated approaches to health care affordability and access.

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Blue Cross Blue Shield Florida Health Insurance National Insurance Coverage Definitions

Ok this is bound to a boring post, but as I get asked this question so many times I feel its time to answer it one health insurance company at a time.  Here is the Blue Cross Blue Shield Plan Coverage Information for people with Blue Cross of Florida (or any Blue Cross from any state) who travel to other states or seek medical attention from out of state or national providers.

Firstly lets discuss the Blue Cross Blue Shield plan in Florida and define them.  Blue Cross Blue Shield of Florida is kind of like a non profit franchise of the Blue Cross Blue Shield Association.  This means that they won the lottery and get to sell health insurance under the Blue Cross name which guarantees you success in the individual health market and thus are like the mob.  But if you have them, they are probably the best insurance company in the state, their network is amazing and they never rescind policies (at least in Florida).  So they will not fight you when they have to pay claims.  But they will raise your premiums!  Of course they can’t target one person or family with an increase so I suppose this is irrelevant except that it speaks to the insanity of our current health insurance industry, and of course the medical field in general.

This article is about getting coverage in other states and seeing out of state providerswith your individual or even group Florida health insurance plan from Blue Cross Blue Shield of Florida and guess what?  They are also amazing in this respect as well!  It seems unfair, and I say it is but they are still the best individual health insurance in Florida should you qualify and I am happy and privileged for the most part to be associated with them.  I would however, make some changes if they ever let me sit on the board!  I have copied their Blue Card national coverage highlights into the post so that you can get their definitions of your coverage but the bottom line is if you get sick and want to go the best doctors in the world then in Florida anyways Blue Cross Blue Shield is your best choice.

blue cross blue shield florida

Overview Of Blue Card Program

The BlueCard Program enables Blue Cross and Blue Shield of Florida (BCBSF) members who travel or live out of the service area (i.e. outside of Florida) to access participating providers of independent Blue Cross and/or Blue Shield organizations and receive all the same benefits of their BCBSF health plan

Purpose

Designed to provide access to the Blue Plan networks nationwide to Blue Plans and their members, facilitate efficient claims processing and customer service, and help Blue Plans maintain strong relationships with their local providers

Program Summary

• The BlueCard program is recognized by the suitcase logo on the member ID card

• Home Plan – where the subscriber’s contract is issued or where the group is headquartered.This Blue Plan holds member eligibility and benefit information

• Host Plan – the Blue Plan in the area where services are rendered.The members’ responsibility will be determined by their benefit contract

• The Home Plan pays an Administrative Expense Allowance and Access Fee to the Host Plan for administration of its members’ claims and access to the Host Plan’s provider networks

Eligibility

All non-Medicare BCBSF members are eligible to take advantage of the program

Product Design

Standard policies and procedures using common formats (ITS software) enable Blue Plans to exchange computerized membership, claims, provider and reimbursement information to support claims processing and customer service

Network

Nearly 90% of U.S. doctors and more than 80% of U.S. hospitals have a contract with a Blue Cross and/or Blue Shield Plan

Product/Claims Administration

• Single network for claims processing and reimbursement

• Provider files the claim to the Local/Host Blue Plan

• The Local/Host Plan prices the claim • The Home Plan verifies benefits and

eligibility • The Local/Host Pan finalizes the

claim with the provider

Member Access

• Toll-free telephone support (800-676-BLUE) during customer service hours of operation

• Provider information accessible through w w w. bc b s f l . c o m

Cost

No additional access fees for international claims • Standard BlueCard fees apply for claims in the United States

florida health insurance from the quote experts

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