Alabama Baptists insured through the Southern Baptist Convention’s Annuity Board (AB) will have Blue Cross Blue Shield (BCBS) options.
Many current and future participants in the AB medical insurance program can choose a plan offering a BCBS PPO network including those in BCBS of Alabama, according to Kim Walthall, AB department head of insurance operations. The new coverage under the name AB Health Maintenance Choice (HMC) becomes effective Jan. 1, 2004.
Walthall said people in many states where there is a BCBS and where the AB offers its services are eligible to participate in this plan.
The new option resulted from an agreement negotiated between the AB and Highmark Blue Cross Blue Shield, an entity based in Pennsylvania.
Worldwide access to BCBS networks will be made available through a product called BlueCard Doctors and Hospital Finder, a trademark of BCBS, according to Jeff Wall, AB vendor support/team leader in the department of insurance operations.
He said this means all doctors, hospitals and other health care providers included under each state’s various plans within its networks are accessible through the card.
“It is a tremendous benefit to those who use it,” said Jim Swedenburg, coordinator of annuity and insurance services with the Alabama Baptist State Board of Missions.
“In the previous plan — an HMO with a different entity —people had a difficult time finding doctors and hospitals in the network,” Swedenburg said.
“We call it an HMO look-alike plan but it has no deductible for individuals or families, when they use network health care providers,” said Weldon Doherty, AB regional director of insurance marketing.
When a patient pays his or her co-pay of $20 per doctor’s office visit or $30 per specialist’s visit, 100 percent of all other charges are paid, Doherty explained.
He said it differs from an HMO in that if a patient uses an out-of-network health care provider, this insurance does pay something less than it does for in-network care, whereas most HMO’s out-of-network services are not covered at all.
“In Alabama, BCBS has such extensive networks that there should be no problem in finding ample physicians and hospitals that are in the network,” Doherty said.
Claims decisions will be made by the AB, which originates and offers the HMC plan, Swedenburg said.
The role of Alabama’s BCBS is to be the entity whose network of providers is used when Alabamians are treated in Alabama, he added.
Because of the AB’s agreement with Highmark, when Alabamians are treated in other states, they have a greater likelihood of being treated by a doctor who is part of the BCBS provider’s network in that state.
Networking benefits
According to an AB press release, its medical plan participants are benefited the most when using network providers. This is because health care providers who participate in the networks agree to provide services at a significantly discounted price. And the medical plans pay a higher coinsurance percentage for care received.
Doug Day, AB executive officer of benefit services, said the amount discounted off regular prices by in-network providers can be 30–40 percent or more.
Walthall said that for about a year the AB has offered one network of health care providers with a choice of several plans within that network.
The plans currently offered are all through the Principal Financial Group, so the addition of Blue Cross expands the AB’s medical insurance choices to two provider networks for Alabamians. The Principal group is expected to continue alongside the BCBS option.
Though the HMC plan costs as much as 50 percent more than some of the other plans the AB offers, a much larger network of providers is the substantial benefit, Swedenburg said.
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