In November of last year Empire Blue Cross Blue Shield (BCBS) announced plans to discontinue seven Small Group health insurance plans for its New York market. Empire, the largest Small Group insurer on the East End, said failed negotiations with state regulators in the fall of 2011 forced them unable to adjust their rates based on company-based actuarial calculations. Elimination of these plans was financially necessary to the insurance giant. In its earliest announcement Empire had originally declared that ithese seven plans would end in April 2012, causing outrage in the communities that use their products. While they will still phase out these seven plans, detailed below, Empire revised its earlier declaration and in December said plans will end at their originally-scheduled renewal time, up to one year after the April 2012 date.
20,000 companies, covering an estimated 250,000 workers and their families currently use any of the seven plans being eliminated by Empire. The original decision to end these plans by April 2012 created a hailstorm of criticism from plan-members and the business communities they serve. Had plans ended on April 2012 many people would have been forced to switch carriers or plans mid-enrollment-year and lose potentially large amounts of money already paid into high-deductible plans. People who use these high-deductible plans pay a smaller monthly premium and pay towards this much larger deductible amount before the carrier must begin paying for services on its own. Complaints filed with the State of New York led to talks between Empire and the state Department of Financial Services, prompting the change in end-dates.
Under its revised announcement, persons enrolled in any of the seven discontinued plans will be covered through their plan’s entirety and end at their previously-scheduled renewal dates. Expanding operation of these plans through April 2013 and not April 2012 has seemed to pacify the largely-angered plan-holders. Upon plan expiration, the customer can either purchase a different Empire product, or switch carriers altogether. The seven plans being eliminated are:
- Empire Point of Service (POS)
- Empire PPO Plus
- Empire Prism EPO (Empire’s most popular plan)
- Empire EPO Essential Options 1-9
- Empire EPO Stepped
- Value EPO
- Empire Total Blue PPO with Health Savings Account (HSA) Options 2, 5, 6
The Small Group plans still being offered are:
- Direct HMO Option 12
- HMO Option 12 (Gatekeeper)
- Empire PPO Option 1
- Empire PPO Option 2
- Empire EPO Essential Option 10
- Empire Total Blue (CDHP) Option
Citing unprofitability Empire’s decision to eliminate the seven Small Group plans listed above will make a major dent in its operations: about two-thirds of its business comes from these seven plans.
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