September 25, 2015

In an announcement made to Illinois health insurance agents recently, Blue Cross Blue Shield of Illinois, the state's largest and most influential health insurance carrier announced that it will no longer be offering large-network PPO coverage to those with Bronze, Silver, Gold or Platinum health plans, effective January 1st 2016.

And while this decision is reportedly not expected to impact those covered under an employer-provided group plan, it will have a very different impact on individuals, families and couples who purchase medical insurance outside the workplace.     

The details are early and a bit sketchy, but here's what we know:

  • Plans are being cancelled to compensate for extreme losses that were incurred by the carrier, mostly as a result of increased claims and unexpected, related costs.
  • Those affected by this decision include non-employer provided "metallic" health insurance policies purchased after January 1st of 2014.  Therefore, if you purchased a Bronze, Silver, Gold or Platinum plan outside of work, your plan may be cancelled as of 2016.
  • Cancellation of metallic plans will not affect transitional or grandfathered health insurance policies.
  • The move only affects individual and family plans currently within the large-network PPO.  Those who have a Blue Cross Blue Shield Choice PPO or Precision HMO will not be affected.
  • The decision is not expected to affect those who are currently in a company-provided group plan, regardless of whether they have a PPO or HMO.

Will You Be Affected, and What Can You Do?

It is safe to assume that this decision will cause more than its fair share of confusion among scores of Illinois residents, at a time when many were just becoming familiar with how the new system of health care reform works.  Additionally, there has been great speculation over potential rate increases of 20-40% on individual plans, only adding more fuel to the flames for those who have seen their budgets stretched thin simply to comply with all the new mandates. 

If you get your health insurance coverage from work, there will likely be no change in your coverage or choice of hospital networks and specialists.  If you're an individual, a couple, or a head of household who purchased a metallic plan at the onset of the Affordable Care Act passing, it could have an impact on where you go to get treatment, and whether or not the carrier will honor claims or allow you to continue seeing your primary care physician.

Free Health Insurance Consultations & Assistance

Our independent Lisle health insurance agency offers free consultations, and can help you in determining whether or not you're affected and how to go about making any adjustments that are needed.  We're located in the heart of the Naperville/Lisle business district and offer convenient office hours. 

To speak with one of our licensed Illinois health insurance agents, call Premier today at 800-369-0287 to learn more or schedule your free consultation.  You can also write to us through our secure contact form.