Preparing to Serve Our Members In 2018
A Message from Our President
Our business remains in the spotlight and it’s because we matter in the lives of those we serve every day. As the debate on health care continues, one thing remains constant: our commitment to expanding access to cost-effective health coverage to our members through a variety of product options.
While we may not be able to offer each product option across the state, we are pleased to offer at least one product in all of Oklahoma’s 77 counties. To do this, we must be able to cover the costs for our member’s current health care needs with effective, quality health coverage, in addition to saving for future needs.
Speaking of the future, the next few months will be full of activity. This is the time of year we enter our peak period in preparing to renew, sell and implement health insurance plans for employers, Medicare beneficiaries, and individual insurance customers throughout the state. It’s a period full of activity and it can be difficult to track and understand it all.
Because we are a community leader and the only carrier still offering coverage on the health insurance exchange in Oklahoma, it’s inevitable that people are paying attention to our activities. While the spotlight may focus on the specific actions we take in the market, many of which are routine required regulatory filings or contract negotiations, it’s important to not lose sight of the important things we are doing to make the health care system work better for our members:
- We’re refreshing our product offerings with new solutions to help existing and prospective members manage their health and wellness. Each year, we submit our products and rates to appropriate regulatory agencies, and we communicate immediate and potential changes to our members so they have enough time to understand their coverage options and what might change for them.
- We’re preparing our operations to sell those products and take care of our members. At least 65 percent of our business is effective as of Jan. 1 each year, and we’re focused on preparing ourselves for this peak period of activity. We are also investing in technology and operational models that will create a more personalized experience based on unique customer needs.
- We’re advocating on behalf of consumers by negotiating contracts with doctors, hospitals and pharmacies that focus on outcomes and quality medical practices. No other insurer contracts with more providers in our state, so we’re also putting important data directly in the hands of doctors to help them make the best possible treatment and decisions.
- We’re advocating at the federal and state level for the market ingredients necessary to stabilize premiums for the long term and create choice and innovation in our markets.
As we navigate all of the unique moving parts and routine business cycles, we will continue to do everything in our power to stand with our members and our communities. This commitment is what makes us Blue Cross and Blue Shield of Oklahoma, and it is why our company has weathered change and been committed to Oklahomans for more than 76 years.
President, Blue Cross and Blue Shield of Oklahoma
Aug. 01, 2017
Health Care is Complicated, Understanding Individual Insurance Rates
Blue Cross and Blue Shield of Oklahoma has filed proposed rates and products in the individual marketplace with the Oklahoma Department of Insurance in the hopes of continuing to offer quality, affordable coverage to Oklahomans 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:
- Rate submission and review is an annual process and necessary to participate in the individual marketplace.
- 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. If we want to control premiums, then we must focus on the cost of care and the amount of care being used.
It is important to note that while we have submitted rates, our level of participation 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 time allows.
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.