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Highmark BCBS Restricting Some Plans

Highmark Blue Cross Blue Shield recently announced that they are offering a new health plan which requires subscribers to pay higher deductibles and co-pays if they go to UPMC Hamot and some of their doctors. The plan is called Highmark’s Choice Blue and it will be available as of July 1. This comes soon after UPMC Health Plan started their Inside Advantage plan which increases the costs for members who attend any Erie or Crawford county acute care hospital other than Hamot according to David Bruce’s article on GoErie.com.

David Dausey, chairman of Mercyhurst University’s public health department sees this as the next hit in the battle between Highmark and UPMC. There has been some debate between the two companies since March 2011 when UPMC stopped negotiating a new provider’s contract with the health insurance company. Lisa Koshan, Highmark’s director of client management in Erie downplayed the battle by pointing out that this will provide lower premiums for members which is what they are ultimately asking for.

Choice Blue premiums will be about 3-18% less when compared to similar Highmark plans. Inside Advantage premiums are 15-22% less than similar UPMC plans according to Ki Kim, UPMC Health Plan’s sales manager for Erie. Kim also pointed out that restrictive plans are getting more popular with smaller businesses who cannot afford the top notch plans for their employees. They have already signed 20-25 groups and are planning on more enrollment throughout the year.

Written by Sam Tabes

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