Sept. 3, 2015

Changes Slated for Oklahoma Retail Market in 2016

The retail health insurance market has evolved significantly since the opening of the Health Insurance Marketplace in 2014. These changes require Blue Cross and Blue Shield of Oklahoma (BCBSOK) to make adjustments in 2016 that will allow us to continue offering sustainable health insurance options to Oklahomans across the state.

Beginning Jan. 1, 2016, Blue Cross and Blue Shield of Oklahoma (BCBSOK) will no longer offer individual health insurance plans, including Blue Options^SM that utilize the Blue Choice^® PPO network. We will continue to offer individual health insurance products, both on and off the Marketplace, through our Blue Preferred PPO network in all 77 counties across the state. In addition, the Blue Advantage^SM PPO network will be available to individuals in 52 counties, including the major metro areas.

It is important to note that the above discontinuance does not impact the options available to our employer group customers and members. The Blue Choice PPO network will continue to be available to employer groups across Oklahoma.

In addition, individual PPO members enrolled in plans in place prior to March 23, 2010 (grandfathered plans), and BCBSOK members enrolled in Medicare Supplement or Medicare Advantage plans will not be impacted by these changes in 2016. Almost 80 percent of our Individual PPO members are in plans that are not being discontinued.

These changes to our individual health insurance marketplace products will become effective Jan. 1, 2016. There will be no change to 2015 coverage. Individual health insurance members enrolled in the Blue Choice PPO or Blue Options PPO products can continue to use their existing coverage through the end of 2015 as long as they continue to pay their monthly premiums on time.

To ensure there is no gap in coverage for our members currently enrolled in the individual health insurance plans that will not be offered in 2016, we will automatically transition impacted members to a comparable plan, effective Jan. 1, 2016. This includes members enrolled in Blue Cross and Blue Shield multi-state plans that use the Blue Choice PPO network.

It is important to make sure doctors and hospitals are in a member’s network when referring them for additional medical services. By staying in-network, members may reduce or even avoid additional out-of-pocket expenses.

We are committed to working with our providers to minimize the impact of this change to our members’ ongoing care. There will be training opportunities this fall to learn more about these changes. Watch Blue Review for more information.

If you have questions, you can call your BCBSOK provider representative. BCBSOK members can call the toll-free Customer Service number listed on the back of their ID card.