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State: Insurance Plan Delay Appears To Only Affect Blue Cross Blue Shield

5:43 PM, Oct 30, 2013   |    comments
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WINSTON-SALEM, N.C. -- Roughly 600 retired Winston-Salem employees have been notified they will not have their Blue Cross Blue Shield Medicare Advantage Plan next year.

According to the city's human resource director, Carmen Caruth, the letters were sent out this week.

Caruth says Blue Cross Blue Shield informed the city a delay in getting approval from the North Carolina Department of Insurance will make it unlikely to have the plan ready "within an acceptable timeframe" to offer coverage for a Jan. 1, 2014 effective date.

Frank Dorn, a retired Winston-Salem police officer, says he was upset when he read the letter.

"I went to a meeting about a week ago and they couldn't give us any information. They said 'we don't know what we're going to do yet.' Then, a week later we get the letter," he said. "Now, we're going to have to go ahead and find another plan. Don't know what it's going to entail, I don't know if I'm going to have the same primary care physician, I don't know if I'm going to be able to deal with the drug store I dealt with for the past 40 years." 

Caruth says the city is now working with other providers to match the current plan.

She went on to say, this has nothing to do with the Affordable Care Act but rather a state law that changed this year requiring providers to get approval of their Medicare Advantage Plans from both Medicare and the Department of Insurance.

Previously, providers only needed approval from Medicare.

The city is currently reviewing proposals from two other providers and Caruth says, city reitrees will be notified by Monday, Nov. 11, about details going forward.  

"It's just a whole new ball game that retirees have to go through. The anxiety factor and the unknown of what's coming down the road - probably increase premiums? We just don't know," Dorn added.

WFMY News 2 reached out to Blue Cross, a spokesperson says the company has offered Winston-Salem a comparable plan.

The representative confirmed other retirees in North Carolina, in the network, are affected by the delay but the company refused to say how many.

According to the Department of Insurance (DOI), this appears to just be a Blue Cross Blue Shield issue. The assistant director of public information told WFMY News 2 that the company filed the papers Tuesday and they are working to get it approved so Blue Cross can offer the plans before the deadline.

DOI also clarified that the filing they've received from Blue Cross only affects the supplemental prescription drug part of the Medicare Advantage Plan.

The city of Greensboro, High Point and Burlington say they have not been affected and their retirees will see no changes in their insurance in 2014.

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