Scott Fraser, Blue Cross spokesman.
Blue Cross Blue Shield of Rhode Island is giving Medicare beneficiaries until Jan. 31 to sign up for its BlueCHiP for Medicare program. After that, with a few exceptions, the company’s “open enrollment” policy will be cut off, at least for now.
BlueCHiP, which is short for Coordinated Health Partners Inc., is a Blue Cross product that has both a commercial and a Medicare component. BlueCHiP for Medicare – Blue Cross’s Medicare + Choice program – had 31,300 members as of Nov. 30, 1999; the commercial BlueCHiP product had 52,000 members as of the same date.
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The move is part of Blue Cross’s efforts to stem the program’s losses. As of Nov. 30, 1999, losses in the program have totaled $14.4 million, said spokesman Scott Fraser. But he noted that the losses have been diminishing, and that the company overall will have positive numbers at the end of the year.
For example, losses for BlueCHiP totaled $23 million at the end of 1998. And the company expects to break even or make a slight gain with BlueCHiP by the end of 2000, he said.
In cutting off its open enrollment program for Medicare beneficiaries, Blue Cross is making its policies consistent with that of its Plan 65 program, its supplemental Medicare program, Fraser said.
But Fraser added that Blue Cross will review the BlueCHiP program’s financial performance at the end of March, which is the end of the first quarter. If enough progress has been made in turning the program around, the company may return to its open enrollment policy, he said.
”The plan is to have this be a very temporary measure,” he said. “We would love to go back to a situation where we have open enrollment.”
When Blue Cross introduced BlueCHiP in 1996, large numbers of people signed up for it, which led to a large number of claims. The company has since had to hike its rates to compensate, he said. The program has gotten an influx of Medicare beneficiaries that have been dumped by Harvard Pilgrim Health Care of New England, which, along with Tufts Health Plan, has pulled out of Rhode Island.
“We’re trying to be cautious,” he said, adding that the decision to cut off the open enrollment period gives Blue Cross a “way to control our enrollment growth, to continue to allow us to provide the benefit. BlueCHiP has grown very rapidly.”
For example, the BlueCHiP program had just 42,000 commercial members and 25,000 Medicare members as of Dec. 31, 1998.
The ‘open enrollment’ cut off has a few exceptions. People who turn 65 who “age into” the program will still be eligible to join. Medicare beneficiaries who are new to Rhode Island will be eligible. Those who have retired or left their group coverage will remain eligible. Those Medicare beneficiaries who have been dropped by Harvard Pilgrim, Tufts Health Plan, or the Medicare beneficiaries who live in Newport County who were dropped by United HealthCare will still be eligible. These people will have 63 days from the date that their coverage ends to sign up for the BlueCHiP for Medicare program, Fraser said.
Blue Cross has placed a legal notice explaining these changes in the Providence Journal. For Medicare beneficiaries thinking of signing up for BlueCHiP, “the time is now, before the end of January,” Fraser said.
Robert Marshall, of the state Department of Health, noted that United HealthCare has already taken the same action. “I think this is a routine procedure; United has already done this,” he said.
In order to execute its plan, Blue Cross had to notify the Health Care Financing Administration, the federal agency that administers Medicare and Medicaid. Michael Scott, a managed care specialist for the administration’s regional office in Massachusetts, said managed care plans are allowed to close enrollment at any time they wish, as long as they give the public 30 days notice.
Right now, many managed care plans have open enrollment for their Medicare programs, which allows Medicare beneficiaries to jump in and out of the program, Scott said.
Whether or not Blue Cross decides to go back to an open enrollment program, however, it will accept new members throughout the month of November – the month designated as Medicare’s annual election period, in which those who are eligible to receive Medicare benefits can elect to do so. But there is a chance that the BlueCHiP program could be open to new enrollees by then anyway, Fraser said.
