In August, we were notified of a change in Healthcare providers and administrators. As part of this, the states of Idaho, Montana, North Dakota, Oregon, South Dakota, Washington and Wyoming will be changing the administrator of the United Health Care (UHC) PPO plan to High Mark Blue Cross Blue Shield (BCBS) (see Q-164). 

All other states, as well as those on the high deductible health plan (HDHP) will continue to be administered by UHC. 

Naturally our concern was how disruptive this change would be to our members. In September the Health and Wellness Advisory Committee (HWAC) met with CenturyLink management to discuss our concerns.  

Following this meeting, we met with the CenturyLink Benefits group to review the data provided by an independent third party to accurately gauge how big a disruption this would cause to our members and retirees.  

The third party examined the 2010 claims submitted to UHC and compared them to BCBS to determine how each claim would have been paid under the new administrator. In every state but North Dakota, BCBS paid more times in network than UHC. In North Dakota UHC paid 99.7% to BCBS 99.5%. 

We also did some random audits and found that in the vast majority of cases, the physician is in both the UHC and BC networks and/or there are other options readily available in the those instances where the employee's health care provider in not a member of the BC network.  

The change will be effective January 1, 2012. 

Below are the most asked questions we’ve been receiving. Should you have any other questions or concerns, please contact either of us.  

Frequently Asked Questions: 

Q.        Will my premiums, out of pocket costs, or plan design change because of this plan? 

A.        No, plan design is bargained for and locked in for the term of the contract.  Addendum 10 of our contract allows them to change administrators after a review by and discussion with, the Union.  

Q.        In my area we have another Blue Cross/Blue Shield (BCBS) franchise not Highmark will they still accept our coverage? 

A.        Yes, regardless of the type of BCBS in your area they will take our coverage. 

Q.        Is it guaranteed that my doctor will take BCBS? 

A.        No, while the disruption numbers indicate that in most cases our provider numbers will increase, we do expect there to be a few cases of doctors that do not except the new coverage. This should be the rare exception not the rule.  

Q.        Because of this change do I have to do anything during annual enrollment? 

A.        If you wish to maintain the same plan design you have now, the answer is no. You will automatically be transferred to Highmark BCBS effective 1/1/2012.  

Q.        Will anything change around my Prescription drug coverage? 

A.        No.  

RWR:vk opeiu5/ afl-cio

c:    District 7 Staff