Market Overview

Blue Cross NC, UNC Health Alliance Agreement Lowers Triangle ACA Rates by More Than 21 Percent

Share:

Plans will cost $140 less per month on average before subsidies

New agreement means $200 million reduction in healthcare costs for
2019 in Triangle

Statewide, Blue Cross NC is lowering ACA rates by an average of 4.1
percent

Blue Cross and Blue Shield of North Carolina (Blue Cross NC) and UNC
Health Care's
UNC Health Alliance announced today a partnership that
reduces premium costs for Affordable Care Act (ACA) customers in the
Triangle by more than $1,680 a year on average, before subsidies. The
North Carolina Department of Insurance (NCDOI) today approved an average
rate decrease of more than 21 percent for these customers.

This press release features multimedia. View the full release here:
https://www.businesswire.com/news/home/20180822005418/en/

"Our agreement with UNC Health Alliance allows us to offer similar
plans, but at a significantly lower cost," said Patrick Conway,
President and CEO of Blue Cross NC
. "What makes this possible is
that UNC agreed to partner with us on an arrangement where we're both
responsible for the quality and total cost of care. We will work with
our current Blue Local customers to find in-network providers, and make
sure they are getting the care they need throughout this transition."

"On behalf of the UNC Health Care physicians, nurses, specialists and
thousands of other co-workers, I am very pleased Blue Cross NC selected
our health care system as the provider of choice for its Blue Value
coverage in the Triangle," said UNC Health Care CEO William Roper, MD.

"We believe our hospitals, from the UNC Medical Center in Chapel Hill to
UNC REX Healthcare in Raleigh, and our facilities in Chatham and
Johnston Counties are well positioned to meet the health care needs of
Blue Cross NC members across the Greater Triangle," Roper
explained. "Spanning from our industry-leading primary care physicians
and Level 1 trauma center to our oncology and heart and vascular
providers, UNC is a clinical leader with a complete breadth of services.

"We look forward to serving thousands of patients and entire families
expected to take advantage of ‘Blue Value' coverage beginning in
January, after open enrollment in November."

The agreement between UNC Health Alliance and Blue Cross NC will reduce
rates for Triangle customers by a pre-subsidy average of $140 a month.
Benefits will remain similar. Blue Cross NC insures 90,000 individual
ACA customers in the 10-county region where Blue Value with UNC Health
Alliance will be offered.

Pre-subsidy premiums will be less, but some customers will need to
change providers in order to take full advantage of the cost reduction.
Through Blue Cross NC's Blue Value Plan, UNC Health Alliance will be the
in-network provider for Blue Cross NC's ACA plans in the Triangle. Blue
Value with UNC Health Alliance will be available in Wake, Johnston,
Franklin, Lee, Chatham, Alamance, Orange, Durham, Caswell and Person
Counties.

Blue Value with UNC Health Alliance customers will have access to an
extensive network of high-quality providers in the Greater Triangle
region. In Wake and Durham Counties alone, UNC Health Alliance has more
than 1,600 providers, including 300 primary care physicians and more
than 1,000 specialists.

UNC Health Alliance is UNC Health Care's physician-led clinically
integrated network that includes independent and UNC Health Care
providers, sharing a common goal of delivering high quality, cost
effective care. Clinical integration brings together the different parts
of care for the patient – primary care, specialists, urgent care,
telemedicine and six hospital campuses in the Greater Triangle – to
ensure patients receive coordinated care across a wide variety of care
settings.

Blue Cross NC will no longer offer its Blue Local product with Duke
Health and WakeMed. Blue Cross NC has about 50,000 customers residing in
12 counties currently enrolled in the product.

Customers in Granville and Vance Counties with Blue Local will have
access to Blue Advantage and Blue Select plans. These plans have a
broader network that includes UNC Health Alliance, Duke Health, WakeMed
and multiple other providers. While premiums for these two plans may be
higher than what Blue Local currently costs, subsidies are available for
those who qualify.

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 customers with the lowest rates,
while continuing to offer them access to the highest quality care.

Duke and WakeMed are still in-network for other Blue Cross NC products,
including the majority of group plans, Blue Advantage, Blue Select,
Medicare Advantage, FEP and State Health Plan. Blue Cross NC plans to
still partner closely with Duke and WakeMed to care for people in NC and
improve our health system.

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

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

More information on UNC Health Alliance is available at: www.UNChealthcare.org/Health-Alliance.

Non-Triangle Rates and Plans

Statewide, NCDOI approved a 4.1 percent rate decrease for Blue Cross NC
ACA plans. The reduction marks the first rate decrease in the history of
Blue Cross NC since entering the current individual market more than 25
years ago. Across all regions, rates range from a 22 percent reduction
to a 9.5 percent increase.

During the first three years of the ACA, Blue Cross NC lost more than
$450 million dollars on the plans. Despite these losses, the insurer
remained committed to offering coverage in all 100 of North Carolina's
counties. Those losses, however, necessitated rate increases. Now, for
the first time since entering the ACA marketplace in 2014, Blue Cross NC
is able to reduce rates by an average of 4.1 percent. Statewide, the
rate decrease means a $120 million reduction in health care costs for
2019. Blue Cross NC is proud to serve over 475,000 ACA customers and
expects to once again be the only ACA insurer in all 100 counties.

As always, rates vary based on location, age, subsidy amount, and plan.
Federal tax credits known as premium subsides 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. Individual premiums will be available in October. Open
enrollment begins on November 1, 2018.

Through new arrangements with regional providers, Blue Cross NC will be
reducing pre-subsidy premiums in Charlotte and Gastonia by 16.5 percent.
Blue Local with Atrium Health and Blue Value with Novant and Caromont
will continue to be offered.

The average monthly price reduction before subsidies is $173 for Blue
Value with Novant and Caromont, and $87 for Blue Local with Atrium
Health. Benefits will remain similar. Blue Cross NC insures 110,000
individual ACA customers in the Charlotte and Gastonia region. Blue
Cross NC insures around 110,000 individual ACA customers in the
Charlotte and Gastonia region.

The Triangle, Charlotte and Gastonia regions account for roughly 40
percent of Blue Cross NC's individual, under-65 ACA members.

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

Plans available in these regions may include broad-network Blue
Advantage and Blue Select.

Transitional Plans

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.

View Comments and Join the Discussion!