And Blue Choice is Out in Sc

Oct 5, 2016

  1. pbbaseball

    pbbaseball Guru

    Likes Received:
    Nothing major but will confuse customers, leading to more calls

    BlueChoice HealthPlan to Exit Federal Exchange for 2017 BlueChoice HealthPlan will not offer any health plans for 2017 on the federally facilitated marketplace (FFM), also known as the “exchange” or Health Insurance Marketplace ( This change impacts members who enrolled in Blue OptionSM products through the FFM, as well as members who purchased a gold level Blue Option plan off exchange. BlueChoice® will continue to offer silver and bronze Blue Option products off exchange.

    Both BlueCross BlueShield of South Carolina and BlueChoice HealthPlan have participated on the exchange since its inception. After an exhaustive internal analysis, however, a decision was made to offer health plans on the exchange under a one-company approach. Selling exchange products exclusively through our BlueCross line of business will allow us to achieve financial and operational efficiencies and reduce redundancies. Most importantly, it will allow us to continue to provide access to health care for people in this market — especially since many insurance companies have since exited or have announced plans to exit it.

    BlueCross and BlueChoice are working under the guidance of CMS and the S.C. Department of Insurance to transition Blue Option exchange members to a comparable BlueCross BlueEssentialsSM plan for 2017. *These BlueChoice members will receive a letter explaining that they will be auto-enrolled into a similar BlueEssentials plan and what they need to do to make sure they will have coverage for 2017. *Of course, these members may choose to shop from all of the plans available to them and make their own selection if they decide the plan mapped to them does not meet their needs.

    As you know, the BlueEssentials plans that BlueCross offers are very similar to BlueChoice’s Blue Option plans, since the Affordable Care Act mandates a core set of essential health benefits. The BlueEssentials network also includes the same South Carolina providers as the Blue Option network — so patients will not need to select new doctors or facilities when they switch from a Blue Option plan to a BlueEssentials plan.

    In addition, since Aetna and United have announced that they will exit the exchange for 2017, their 2016 ACA exchange plans have also been mapped to comparable 2017 BlueEssentials plans. This was done to make sure South Carolinians do not experience any gaps in coverage during the transition from 2016 coverage to 2017 coverage under different carriers.