Blue Cross Health Insurance Companies Must Now Compete...Second BlueBid Explained

Blue Cross Health Insurance Companies Must Now Compete...Second BlueBid Explained

Blue Cross is not one company. It's actually 36 separate companies that are connected to each other via the Blue Cross Blue Shield Association.

Each Blue Cross company has a geographic monopoly for the employers in their geographic area. Meaning historically each Blue Cross plan would never compete with another for an employer's business.

Until now.

Employer clients of Blue Cross plans did not like Blue Cross's anti-competitive behavior and filed a class action lawsuit stating Blue Cross was in violation of the Sherman Antitrust Act.

Employers and Blue Cross reached a settlement whereby Blue Cross must pay $2.67 Billion in damages and must now compete across state lines for large, self-funded employer clients in a process called 'Second BlueBid.'

In Second BlueBid, a self-funded employer with greater than 5,000 employees can request a second competitive bid from a second Blue Cross plan.

Historically, some employers have had difficulty with poor service and data restriction by their Blue Cross carrier, but if they wanted to continue to use the Blue Cross Network, they had no other choice in plan administrators.

Today with Second BlueBid, large employers have a second choice in Blue Cross plans... a real win for employers and employees in America.

Sources:

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[robmal]

Can you make a video on how providers bill the BCBS insurance? Do they go directly to BCBS, or must they go to the specific provider? Please show from the start. I want to understand more why sometimes they take the local BCBS, and not the out-of-state since they are supposed to share the same network.

[Healthperformance]

Noncompetitive market conditions like this inhibit supply and demand. Competitive markets are the only way to control the rise in healthcare costs.

[hungcapitalll]

You're content is the best man. My ears literally inhale everything you say

[Peace-ynfu]

Love your videos and your ability to communicate so effectively. Thank you!

[ev]

Huge fan of your content! It’s helped me deeply understand the healthcare industry in all aspects. The hospitals, insurance carriers, PBMs, reimbursement models, etc. The writing on the white board was intimidating at first, but your explanations simplify it all so well! As a consultant who just started working with health insurance carriers, I take with me and apply all that I have learned from your videos!

[ferndog]

I was on a Marketplace plan. I was having hard time finding an in-network doctor. I then decided spend a little more to sign up with BCBS Illinois- budget preferred choice. The less expensive BCBS plans are just catastrophic plans. The list of in-network Doctors on the website is wrong. When doctors elect not to accept budget-BCBS Illinois plans, BCBS won't update the list. It's on the patient to demand that the doctors' office staffer to call- wait on hold for ten minutes - & verify the particular sub plan has the doctor in network. I have gotten referred to two doctors by BCBS Illinois customer service, only to show up & being told the doctor is not in-network. Same thing happen to my friend in her search for a orthopedic surgeon. Marketplace plans would be the similar service but cost less. I'm abandoning BCBS Illinois & going back to Marketplace .

[ravitrivedi]

Can u make video on change healthcare cyber attack

[thomasaquinas]

I learn so much from your videos. It may not be a high priority to you, but I think you can reach a larger audience if you get better audio. Everything else in your content (whiteboard, delivery, expertise) is top notch!

[mrfkeys]

This sounds great, but unfortunate that only 0.04% of U.S. Companies employ over 5, 000 employees.

[liberoAquila]

Highmark also owns a hospital system AHN.

[abigailnobel]

Yes, who says only the bigs deserve good service? Bring it down to 5 employees!

[Robert.Blodgett]

You do a great job. Please keep these videos coming.

[hunterrodriguez]

Is there not already enough competition with blue cross and the other insurance providers? If an employer isn’t happy with blue cross, cant they threaten to go with one of the other big guys?

[johnm.]

Anti-trust is what BlueCross does best. Here in Florida, if you want to be able to sell Florida Blue individual plans, they forbid you from being appointed with any other insurance company that offers individual health. So agents must choose if they want to be able to offer Florida Blue plans or all the other insurance company's plans except for Florida Blue. You can still assist clients on the Marketplace, but if you not appointed with the carrier they chose, you're out of the loop, and working pro bono. Never mind that CMS requires that all marketplace plans be offered equally. I can't speak for other Blue Cross entities, but Florida Blue is unquestionably the most agent/broker hostile organization in America.

[azppmd]

Please use the lav microphone you have.