PROVIDENCE – Blue Cross & Blue Shield of Rhode Island has opened up its Direct Pay plans to COBRA-eligible people, saying it wants to provide lower-cost insurance options for people who have lost their jobs in the economic downturn.
Blue Cross is the only insurer in the state offering such coverage for families and individuals. But its Direct Pay plans usually are open only to people who are not eligible for insurance through any employer or a government program.
Year-round, people can enroll if they can pass a health screening or meet a narrow set of parameters. During open enrollment – currently scheduled for May 15 through June 15 – they are guaranteed coverage at a higher, “basic” rate regardless of their health.
Now, Blue Cross spokesman Christopher J. Medici said, COBRA-eligible individuals and families will be able to get guaranteed coverage anytime.
The flip side is that – unlike COBRA coverage, which under the federal stimulus plan is currently subsidized by the government through employers at 65 percent (READ MORE) – premiums for the newly available individual plans will have to be paid entirely by the subscribers.
For many people, however, Blue Cross officials say that may still be a better deal: For a 35-year-old man, for example, the “preferred” premium for a HealthMate Coast-to-Coast plan with a $400 deductible would be $267.29, while “basic” coverage at any age up to 65 would be $660.47; health savings account-eligible plan with a $3,000 deductible would be $172.83, or $425.46 for basic.
That means any man eligible for the “preferred” rates whose pre-subsidy COBRA premiums would be $494 or more might find Blue Cross more affordable, and then would have to weigh the difference in the coverage that money would by.
Blue Cross also offers subsidies to lower-income Direct Pay subscribers through a $11 million program called AccessBlue, funded by the company, that currently helps more than 20 percent of individual-plan subscribers. Separately, Blue Cross offers individual dental insurance plans.
President and CEO James E. Purcell noted in a statement that – given the state’s unemployment rate, which as of January had risen to 10.3 percent (READ MORE) – “an increasing number of our fellow Rhode Islanders are having more difficulty than ever before accessing proper health care.”
With this policy change, he added, Blue Cross can offer “options which may be less expensive than the cost of COBRA coverage.”
Currently, about 14,000 people are covered by BCBSRI individual plans. Medici said he did not know how many more had become eligible through the new policy, and he said that although Blue Cross expects to see an increase, it won’t speculate on how big that increase might be.
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In a joint statement, both Lt. Gov. Elizabeth H. Roberts and state Sen. Joshua Miller, D-Cranston, praised Blue Cross for its move.
“I’ve heard from many of my constituents regarding the lack of options for people who had been forced to pick up COBRA,” Miller said. “I am pleased that BCBSRI has taken steps to make another alternative available that may be more affordable.”
The federally mandated COBRA subsidy – enacted as part of the American Recovery and Reinvestment Act of 2009(ARRA) – only applies to people losing their jobs between September 2008 and December 2009. The subsidy is good for no more than nine months, although coverage under the federal COBRA (U.S. Consolidated Omnibus Budget Reconciliation Act of 1986) health-benefits law can last for up to 18 months, unless a person becomes eligible for another employer-sponsored plan.
Blue Cross & Blue Shield of Rhode Island, based in Providence, covers more than 670,000 members. BCBSRI is an independent licensee of the Blue Cross and Blue Shield Association. For additional information about Direct Pay plans, call BCBSRI – at (401) 459-5000 or (800) 639-2227 for current members; or (401) 351-2583 or (800) 505-2583 for non-members – or visit www.bcbsri.com.
Millions of Americans who lost their jobs prior to September 1, 2008 could not afford Cobra. Millions more elected Cobra but have now depleted their resources and can not continue on. Still millions more with pre-existing conditions who rely on cobra to bridge the 18 month gap between their former employers insurance and their state’s high risk insurance pools are struggling to pay their premiums every month to prevent being locked out of insurance permanently.
Please join us in asking Congress and the Obama administration to eliminate the arbitrary September 1, 2008 cut-off date and 9 month limitation of assistance by signing our petition at http://www.ipetitions.com/petition/cobrareform and telling your friends about our efforts.
For more information please see our website at http://cobrareform.weebly.com.