What you need to know about our 2019 ACA plans

We are lowering health care costs for many of our individual ACA customers. Statewide, we are lowering rates by an average of 4.1 percent.

It’s our first rate decrease since we entered the current individual market more than 25 years ago. Many factors allowed us to lower rates – the biggest being new provider arrangements that will reduce health care costs by $120M in 2019.

While most things will remain the same for most people, some members in the Triangle will see changes to their network. We reached an agreement with UNC Health Alliance that will allow us to lower rates by more than $140 a month on average, per person before subsidies.

 We’ve gotten a lot of questions about this and Blue Cross NC will work with customers to make sure they can continue getting the high-quality care they need. 

 Here are some things you need to know:  

 If your answer isn’t here, our customer service professionals are always available to answer additional questions. Please reach out to use using Blue Connect for secure messaging options.  

Will I see a 4.1 percent decrease in my premiums next year?

Not necessarily. The 4.1 percent reduction is an average. This year, rate changes range from a 22 percent reduction to a 9.5 percent increase.

As always, rates vary based on location, age, subsidy amount, and plan.

Will some ACA customers see a rate increase in 2019?

Yes. Although some areas may see a rate increase, all requested county increases are less than 10 percent. 

 

What’s new with Blue Cross NC’s ACA plans for 2019?

If you live outside the Greater Triangle region, not much is changing.

Through new arrangements with regional providers, Blue Cross NC will be reducing pre-subsidy premiums in Charlotte and Gastonia by an average of 16.5 percent. The rate reductions were made possible through collaboration with Blue Cross NC’s provider partners.

Blue Local with Atrium Health and Blue Value with Novant and Caromont will continue to be offered.

The average Blue Value price reduction is $173 a month before subsidies. The average Blue Local with Atrium Health price reduction is $87 a month before subsidies. Benefits will remain similar.

Rates are also being reduced in the Triangle by a pre-subsidy average of $140 a month, due to a new agreement [link to UNC release] with UNC Health Alliance. Benefits will remain similar.

Rates are also being reduced in the Triangle by a pre-subsidy average of $140 a month, due to a new agreement with UNC Health Alliance. Benefits will remain similar.

Beginning in 2019, Blue Cross NC will no longer offer its Blue Local with Duke Health and WakeMed^SM product in the individual market.

Duke Health and WakeMed remain close partners with Blue Cross NC. Both providers are still in-network for other Blue Cross NC products, such as Medicare Advantage, FEP, State Health Plan, and the majority of our Blue Advantage®, Blue Select^SM and group plans.

More information on this transition is available at www.BlueCrossNC.com/ReadyToRenew.

Why are you discontinuing Blue Local plans with Duke Health and WakeMed?

Blue Cross NC’s decision to go with UNC Health Alliance as the provider for its Greater Triangle-region individual ACA plans was the result of a competitive process between the area’s hospital systems. The decision was based on which system could provide our customers with the lowest rates while continuing to offer them access to the highest quality care. 

Blue Value with UNC Health Alliance customers will have access to a statewide, limited network of high-quality, lower-cost providers.

We will work with our current Blue Local with Duke Health and WakeMed customers to make sure they can continue getting high-quality care throughout this transition with as little disruption as possible.

When is Blue Local with Duke and WakeMed going away?  

January 1, 2019.

Blue Local with Duke Health and WakeMed will stay in place through the end of 2018. Blue Local customers should continue seeing their current doctor until the end of the year.

Are Duke Health and WakeMed still in the Blue Cross NC network?

Duke Health and WakeMed remain close partners with Blue Cross NC. Both providers are still in-network for other Blue Cross NC products, such as Medicare Advantage, FEP, State Health Plan, and the majority of Blue Advantage, Blue Select and group plans.

What if I want to continue seeing my Duke Health or WakeMed doctor?

After December 31, 2018, you can continue seeing your Duke Health and WakeMed doctor but they will be considered out-of-network; you will pay out-of-network rates which are much higher than in-network and out-of-network benefits will apply. In order to have the lowest, out-of-pocket costs you will need to transition to a UNC Health Alliance provider. 

If you’d like to begin exploring care options for 2019, you can look up doctors in the Blue Value network here.

You can see a Duke or WakeMed doctor in an emergency situation. Emergency care is always covered as an in-network benefit.

How do I find a new In-Network doctor?

If you’d like to begin exploring care options for 2019, you can look up doctors in the Blue Value network here.

What if I can’t find a doctor who is able to meet my health needs that is available within the network?

If no provider who is able to meet your health needs is reasonably available in-network, you can call the number on the back of your insurance card to request a review of your case. We will work with you to make sure you are able to get the care you need.

How will the Blue Value plans be different from Blue Local plans?

The plans will have lower premiums before subsidies than the current Blue Local plans. 

The benefits will be similar but the network will be different. UNC Health Alliance will be in-network, while Duke Health and WakeMed will be out-of-network.

When can I get my new, less expensive plan?

We will automatically enroll Blue Local customers in Blue Value plans effective January 1, 2019. You don’t have to do anything. You will receive the ID card for this new plan sometime in December 2018. 

Will customers still be able to get premium subsidies from the federal government in 2019?

Yes. Federal tax credits, known as premium subsidies, are still available for customers with household incomes between 100 and 400 percent of the Federal Poverty Level. About 90 percent of Blue Cross NC current customers with ACA plans qualify this year. Subsidies vary by plan and household income. Open enrollment begins on November 1, 2018.

 Will Blue Cross NC continue to offer transitional plans to individuals in 2019?

Yes. Blue Cross NC will continue offering transitional plans in 2019.

The requested rate increase for transitional plans in 2019 is 9.8 percent. These plans were purchased between March 2010, when the ACA was signed, and October 2013 when regulations went into effect. Transitional plans cannot be sold to new customers because they do not meet ACA requirements. Currently, there are 41,500 members with these plans.

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