Blue Cross and Blue Shield requests rate decrease for first time in 25 years

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ByEd Crump, via
Tuesday, July 31, 2018

North Carolina's largest health insurer says it's cutting some individual premiums for the first time in more than 25 years.

Blue Cross and Blue Shield of North Carolina announced Monday that it requested an overall average rate decrease of 4.1 percent for 2019 Affordable Care Act plans offered to individuals.

About 85 percent of the savings comes from last year's federal income tax cut and Congress suspending a tax on insurers for 2019, the Durham-based company said. Blue Cross didn't describe how much it saved from the tax cut.

The company also will cut costs in 2019 by striking new deals with medical providers in the Charlotte and Raleigh-Durham metro areas.

Blue Cross could have lowered average rates by another 18 percent if Congress and the Trump Administration hadn't eliminated the penalty for people who don't buy health coverage and a subsidy to insurers, the company said. The changes added uncertainty for insurers that also are working to hold down rising health care costs, Chief Executive Officer Patrick Conway said.

Blue Cross has more than 475,000 ACA customers and has been the only insurer offering the subsidized coverage in all 100 North Carolina counties.

What does this mean?

The Blue Local with Duke Health and WakeMed health plan will not be offered next year. Customers with those plans will be moved to a new ACA health plan for 2019: Blue Value with UNC Health Alliance.

The Durham-based insurer says the new plan will have similar benefits to the current plan, including the same deductible.

When will the change be made?

The Blue Local with Duke Health and WakeMed plan will stay in effect through December 31, 2018. So, no changes are needed at this point. You should keep using your health plan like normal for the rest of the year.

What about Duke Health and WakeMed?

Duke Health and WakeMed will not be in the Blue Value with UNC Health Alliance network. That means you will pay out-of-network rates - which are much higher than in-network rates - if you see a Duke Health or WakeMed doctor after December 31, 2018. Blue Cross NC has about 50,000 customers residing in 12 counties currently enrolled in the product.

What happens now?

Rate notices will arrive in the mail by Oct. 1. It will have details on your 2019 Blue Value with UNC Health Alliance plan - including your new monthly premium. Rates will not be available until these notices go out.

More information here.

The Associated Press contributed to this report.