Updates Archive

Individual and Family Plans

BCBSIL Meets Affordable Care Act’s (ACA) 2018 Medical Loss Ratio (MLR) Standards

Aug. 5, 2019

What is the ACA’s MLR?

Generally, the ACA’s MLR is the percentage of insurance premium dollars that a health insurer spends on health care services and expenses reported as activities to improve health care quality.

The ACA set MLR standards for health insurers. The MLR standard for the large group market is 85%. The MLR standard for individual and small group markets is 80%.

If an insurer’s MLR doesn’t meet or exceed the ACA’s MLR standard in a certain market segment of a state, the insurer may provide MLR rebates in that market.

2018 MLR update

Blue Cross and Blue Shield of Illinois (BCBSIL) met or exceeded the ACA’s MLR standards in the individual, small group and large group markets of Illinois in 2018. As a result, no MLR rebates will be provided in Illinois for 2018.

We're proud of our track record of managing costs, collaborating with providers and other health care professionals, and business innovations.

Texas Judge Rules Individual Mandate Unconstitutional. Nothing Changes for Our Members.

Dec. 16, 2018

You may be aware that a federal judge in Texas ruled that the individual mandate was unconstitutional, and that the entire Affordable Care Act was invalid. For now, nothing changes; current and 2019 coverage remains in place for our members and employers.

We expect this decision to be appealed, and for the litigation process to continue for a period of time. We are currently reviewing the decision and will keep you updated on any next steps.

Meanwhile, Blue Cross and Blue Shield of Illinois continues to work with state and federal regulators and legislators to ensure a stable and affordable health insurance market that is accessible to all Americans regardless of health status.

CMS Resumes Risk Adjustment Payments

Aug. 6, 2018

BCBSIL is pleased the Centers for Medicare and Medicaid Services (CMS) announced it will resume risk adjustment payments to health insurers. These transfers between insurance carriers are designed to keep costs down and make sure all consumers regardless of health status have access to health insurance and receive the care they need.

CMS Suspends Risk Adjustment Payments

Jul. 16, 2018

On July 7, the Centers for Medicare and Medicaid Services (CMS) announced it will suspend risk adjustment payments under the Affordable Care Act (ACA). BCBSIL is concerned with this decision. Risk adjustment payments are transfers between insurance carriers. They are meant to keep costs down and make sure all consumers have access to health insurance and get the care they need, no matter if they’re healthy or not. There is no immediate impact to our members. We will continue to review what this may mean for our members and will post more information here.

Proposed Short-Term Health Plan Policy

Mar. 1, 2018

On Feb. 20, the Departments of Health and Human Services, Labor, and the Treasury proposed a new rule on short-term health insurance plans. For now, nothing changes. The federal government still needs to gather and review feedback from the public. Once we know what the final proposal is, we’ll let you know how it may impact you.

Developments on the Tax Reform Bill

Dec. 04, 2017

The Senate passed the tax reform bill on December 2. The differences between the Senate version of the tax bill and the one passed by the House must be settled before it's signed into law.

Nothing will change for now. We encourage customers to keep shopping for or renew their coverage during this open enrollment period which ends December 15. There's only one open enrollment period each year so, customers need to purchase by December 15 to make sure they have coverage in 2018.

Illinoisans Could Qualify for Lower Monthly Payments on 2018 Individual Health Plans

Dec. 01, 2017

Many Illinoisans reviewing options for an individual health insurance plan may not be aware that financial assistance is available to help lower the cost of their monthly payment. In some cases, this financial assistance may cover the full premium cost. That means for those who qualify, the monthly cost for health coverage could be as low as $0 (for the 2018 coverage year).

We are committed to helping you find the best fit for your health care needs and budget. To learn more about how to protect your health and finances, and save on monthly premium costs, you can:

  • Call 855-636-8702 available every day from 8 a.m. – 10 p.m. CT
  • Contact your independent, authorized BCBSIL agent
  • Visit MyChoiceBCBSIL.com to use our premium tax credit estimator and review your options

Open Enrollment for Individual Health Plans is Here

Nov. 01, 2017

For more than 80 years, Blue Cross and Blue Shield of Illinois (BCBSIL) has been committed to providing access to quality, cost-effective coverage to as many people as possible, and we’re once again ready to help our members choose the individual coverage that best meets their needs and budgets. BCBSIL is the only insurer offering retail products statewide in all 102 Illinois counties, with plan options both on and off the exchange. It’s important to note that this year the open enrollment period is shorter, from Nov. 1 – Dec. 15, 2017, and we have many ways to help consumers shop for a plan during this time:

  • BCBSIL Product Specialist – available every day from 8 a.m. - 10 p.m. Central Time at 855-813-1465

Our business starts and ends with our members, and BCBSIL is ready to serve as a go-to resource for customers for help reviewing all their choices and finding the best fit for their health care needs.

Understanding the Impact of Recent White House Action on Health Insurance

Oct. 25, 2017

Recent executive action, along with the announcement to stop funding of cost-sharing reduction payments (CSRs), has once again put a spotlight on health care.

BCBSIL accounted for the uncertainty around the federal government’s funding of the member’s CSR benefit in our 2018 rates. The decision to stop the CSR payments has no impact our market participation. BCBSIL is proud to once again offer a variety of health plan options for 2018 – and is the only carrier offering retail products statewide in all 102 Illinois counties

It's important to note that the Administration's decision on CSRs isn’t related to the Advanced Premium Tax Credit (APTC).The APTC is federal aid available to people who earn less than 400 percent of the Federal Poverty Level. It can lower the monthly premium for Marketplace (on-exchange) plans and is paid by the federal government directly to insurers.

Recent Notice about Updates to Our Individual Health Plan Options

Oct. 02, 2017

Blue Cross and Blue Shield of Illinois (BCBSIL) is proud to again offer a variety of health plan options for individuals and families in every county of Illinois in 2018. For 2018, we’ve simplified our health plan options to make them easier for you to review and select the coverage that best meets your needs.

While our plans will have fewer options at each metallic level, we’ve worked to make sure you get the same quality of benefits you expect from BCBSIL. There won’t be any major changes to our provider networks.

You may have received a legally-required notice informing you that you’ll need to select a new individual plan for 2018. There’s nothing you need to do right now. To help make the transition as seamless as possible we’ve taken the step of identifying a recommended plan that is similar to your current coverage. You will be automatically enrolled in this similar plan, or you can select any plan from our 2018 offering during the open enrollment period, which runs from Nov. 01, through Dec. 15, 2017.

Details on all 2018 plan options will be included in an enrollment package each member will get in the mail before open enrollment. We understand you may have questions, and we’re committed to helping you find the plan that best meets your needs. We have increased the number of sales and customer service representatives during open enrollment to offer support throughout the enrollment process.

You can reach a Customer Advocate at the number listed on the back of your BCBSIL member ID card Monday – Friday, 8 a.m. – 8 p.m. (Central Time), 8 a.m. – 6 p.m. (Central Time) on Saturdays and 10 a.m. – 6 p.m. (Central Time) on Sundays. You can also check this webpage for further updates.

2018 Individual Market Participation Update

Sept. 28, 2017

Blue Cross and Blue Shield of Illinois is proud to announce that we will continue to offer consumers health insurance options both on and off the individual marketplace in 2018. Specific plan, network and benefit information will be available closer to the open enrollment period that begins on Nov. 1, 2017.

We remain committed to working with lawmakers, regulators, providers and the entire health care system to ensure a stable, sustainable individual marketplace and to improve the quality and cost of care for all our members.

Health Care is Complicated, Understanding Individual Insurance Rates

Aug. 01, 2017

Blue Cross and Blue Shield of Illinois has filed proposed rates and products in the individual marketplace with the Illinois Department of Insurance in the hopes of continuing to offer quality, affordable coverage to Illinoisans in 2018.

On August 1, the federal government released the rates from insurers across the country who submitted 2018 products in the individual insurance market. While this may be the subject of conversation and media attention, it’s important to keep a few things in mind:

  • Rates should be viewed in context, or include any premium assistance for those who may receive subsidies. Actual out-of-pocket costs will differ based on the financial assistance consumers receive from the government to offset their total monthly premium cost.
  • There is still a lot of uncertainty on the rules and regulations of the individual market for 2018. Our 2018 product pricing reflects that uncertainty and the associated risks that exist within this marketplace. We will continue to work with legislators, regulators and other stakeholders toward getting the necessary certainty around issues like the continued funding of cost-sharing reductions (“CSRs”) and mechanisms that encourage broad and continuous coverage.
  • Our rates also account for keeping pace with escalating health care costs and the growing use of that care. It is important to note that while we have submitted rates, our level of participation and pricing has not yet been finalized. If we receive regulatory certainty within an acceptable time frame we will review and, where appropriate, adjust our rates if we are able.

Please continue to visit this page for updates to our 2018 products and services in the individual marketplace, as well as through employer and Medicare coverage.

Back to top

Medicare and Medicaid

Navigating Medicare Annual Election Period

Oct. 16, 2017

The Medicare Annual Election Period (AEP) is now under way, and Blue Cross and Blue Shield of Illinois (BCBSIL) is proud to again offer a variety of health coverage options centered around optimized networks, flexibility and affordability.

During AEP, which runs from Oct. 15 through Dec. 7, Medicare-eligible customers can sign up for a plan or make changes to their current coverage. We know that choosing a health care plan can be hard. That’s why BCBSIL is committed to helping you understand your options and pick the best coverage for your unique needs.

Plan benefit and network information for 2018 BCBSIL Medicare plans is now available at www.bcbsil.com/medicare. We also have dedicated Medicare experts ready by phone at 1-877-213-1821, every day from 8 a.m. – 8 p.m. to answer questions and offer personalized enrollment help. Or, you can find a licensed, approved BCBSIL agent in your area at www.bcbsil.com/medicareagents.

Back to top

Employer Based Plans

BCBSIL Meets Affordable Care Act's (ACA) 2018 Medical Loss Ratio (MLR) Standards

Aug. 05, 2019

What Is the ACA’s MLR?

In general, the ACA’s MLR is the percentage of insurance premium dollars that a health insurer spends on health care services and expenses reported as activities to improve health care quality.

The ACA set MLR standards for health insurers. The MLR standard for the large group market is 85%. The MLR standard for individual and small group markets is 80%.

If an insurer’s MLR doesn’t meet or exceed the ACA’s MLR standard in a certain market segment of a state, the insurer may provide MLR rebates in that market.

2018 MLR Update

Blue Cross and Blue Shield of Illinois (BCBSIL) met or exceeded the ACA's MLR standards in the individual, small group and large group markets of Illinois in 2018. As a result, no MLR rebates will be provided in Illinois for 2018.

We're proud of our track record of managing costs, collaborating with providers and other health care professionals, and business innovations.

Update for Our Small Business Customers

Oct. 03, 2017

As we're preparing to sell 2018 plans and service our clients, small group employers who currently offer BCBSIL coverage to their employees through the Small Business Health Options Program (SHOP) will receive notifications that Blue Cross and Blue Shield of Illinois (BCBSIL) will not participate on the SHOP exchange, effective Jan. 1, 2018. However, it's important to know that members currently enrolled in a SHOP plan will have coverage through the full term of the existing contract.

We’re also sending letters to employers and members to let them know that certain off-exchange small group plans as well as other group plans are being discontinued. Federal regulations require that small group plans must be discontinued if they are significantly modified.

We will continue to serve the Small Group Market with a range of robust plans off-exchange that enable employers in Illinois to continue offering quality, cost-effective coverage from BCBSIL.

Back to top