Employers looking to save a bit more on health insurance will have a few new options for 2021, including narrowed provider-network options from two of the region’s largest health plans.
That’s in addition to several new telehealth options and specialized apps that employers will begin hearing about as the fall enrollment period begins for BlueCross BlueShield of Western New York, Independent Health and Univera Healthcare.
Both BlueCross BlueShield and Independent Health will offer discounts for small groups that opt in to plans with limited provider networks that include only higher-performing physicians and hospitals.
That’s a shift from prior years, when tiered or narrow network plans were offered that limited members to either the Kaleida Health or Catholic Health networks, along with their affiliated physicians.
Company leaders say it’s the next evolution for networks, building on experience with tailored or tiered networks in recent years, including:
Choice Plus offered by Independent Health in partnership with Catholic Medical Partners and Catholic Health
Align offered by BlueCross BlueShield of Western New York through the Optimum Physician Alliance in partnership with Kaleida Health
The Focus product later offered with Catholic Health.
Both Align and Focus will be discontinued at year’s end, with a new tailored network available called Apex. The product focuses on Erie and Niagara counties and includes all 16 hospitals in the two county-area, but only 40% of the primary-care doctors and 90% of specialists in its full network product.
“The goal for this product is really to provide members with the high-quality care and the lowest cost against our full network products,” said Adam Bellomo, director for commercial sales and broker programs at BlueCross BlueShield.
“These physicians provide top quality and efficient care to our members, and they have good outcomes,” he said. “This puts people in control of their own health care, where they’re making a decision to see a doctor in the network, and in return are reaping about 5% premium savings for doing so.”
Apex will be available to small groups only this year, not large companies that are self-insured. Bellomo said the product expands its line of products available, including its broader Point of Service (POS) network product available across the entire eight-county region, as well as the expanded network product that provides access to the national Blue network through the BlueCross Association.
About 85% of members in its overall small group portfolio will also have the option to keep the same plan they have in place now, he said.
Independent Health’s new product is called thRed, and is designed to connect members using the company’s Red Shirt treatment mentality from the health plan to their primary-care provider. The plan is available for small group members who live or work in Erie County. Plans call for offering the product to large groups in the second quarter of 2021.
The product includes a full network of hospitals and all of the region’s specialists and pediatricians, but limits PCPs for adults over 21 to about 100 providers across 20 locations affiliated with General Physician P.C., one of the region’s largest multi-specialty medical practices made up of physicians affiliated with Kaleida Health.
“The product builds on the network and our focus on primary care,” said Nora McGuire, senior vice president for marketing and chief marketing officer.
Independent Health is also continuing its Choice Plus product with Catholic Health and affiliated physicians for small groups and individuals, as well as other products with a full network of providers across the region.
“We have a very extensive product portfolio that continues to be in place in a much improved competitive price position driven largely by our focus on physicians and primary care,” she said. “We’ve seen improvements and decreases in trends that have allowed us to be in an improved price competitively.”
Univera isn’t introducing a narrow network: Pamela Pawenski, vice president for sales, said narrow network products have not produced sustainable cost savings or quality improvements. Instead, the health plan is expanding national network options back into its small group portfolio, something it began offering to large groups in past years.
“There are small groups here who have a smattering of people elsewhere. We want to be a competitive option for them to consider,” she said.
Here’s what else is new for 2021:
Univera is expanding its wellness rewards program, which offers cash rewards at varying levels when members make healthy lifestyle choices. It’s an add-on to a similar program that provides cash back for preventive dental appointments. Pawenski says it’s among Univera’s most popular programs.
When it comes to technology, the company is also offering integrated access to its health savings account (HSA) program through its mobile app to make it easier to pay and track claims, continuing full coverage for telehealth appointments, and it has further customized the Wellframe app to help members with chronic health conditions to make it easier to interact with care managers.
BlueCross BlueShield is expanding its Livongo app to small group members, offering a free diabetes management program that includes glucose meters and unlimited testing supplies, as well as a personalized health coach. Livongo was introduced first among BlueCross employees, expanded to self-funded companies and then to 1,100 Medicare members.
Independent Health’s thRed product also includes a mobile app that provides live chat with physicians as well as enhanced wellness benefits with up to $550 in rewards.
Another new plan called Activate Silver gives members $500 in coverage for health-care services before the deductible kicks in, and if the funds are not used, they’ll roll over to the next year. It’s intended to help soften the impact of high-deductible plans, McGuire said. The company is also eliminating monthly fees tied to health savings accounts.
Source: Biz Journals