Preparing to Serve Our Members In 2018
A Message from Our President
Our business remains in the spotlight. It's because we matter in the lives of those we serve every day. As the debate on health care continues in Washington, D.C., one thing is constant: our commitment to expanding access to affordable health insurance through a variety of product choices.
While we may not be able to offer all of our products in each county we serve, our goal is to be in each county with a product offering. To do that, we must be able to cover costs for the health care needs of our members with effective, quality health coverage while saving a little for their future needs.
The next few months will be full of activity. At this time each year, we enter our peak period of preparing to sell, renew and implement health insurance products for employers, retail customers, and government program enrollees, in addition to supporting year-round enrollments. It's a period full of activity, and it can be hard to follow and understand it all.
We are a leader and, in some cases, one of the few carriers still offering coverage in certain markets, so it's likely that people will notice our activities. While the spotlight may focus on the specific actions we take in the market, many of which are routine required regulatory filings or contract negotiations, let's not lose sight of all the things we are doing to make the health care system work better for our members:
- We're refreshing our product offerings with new solutions to help existing and prospective members manage their health and wellness. We submit our products and rates to appropriate regulatory agencies each year, and we communicate immediate and potential changes to our customers so they have enough time to understand their coverage options and what might change for them.
- We're readying our operations to sell those products and take care of our members. At least 65% of our business is effective as of Jan. 1 each year, and we’re focused on preparing ourselves for this peak period of activity. We are also investing in technology and operational models that will create a more personalized experience based on unique customer needs.
- We're advocating for consumers by negotiating contracts with doctors, hospitals and pharmacies. that focus on value-based care. We're also putting important data directly in the hands of doctors to help them make proper treatment and business decisions. Blue Cross and Blue Shield of New Mexico has multiple networks of providers to help meet our member’s health care needs.
- We're advocating at the federal and state level for those market factors needed to stabilize premiums for the long term and create choice and innovation in our markets.
As we navigate all of these moving parts and routine business cycles, we will continue to do everything in our power to stand with our members and our communities. This commitment is what makes us Blue Cross and Blue Shield of New Mexico, and it is why our company has weathered change for more than 75 years.
President, Blue Cross and Blue Shield of New Mexico
Health Care is Complicated, Understanding Individual Insurance Rates
Blue Cross and Blue Shield of New Mexico has filed proposed rates and products in the individual marketplace with the Office of the Superintendent of Insurance in the hopes of continuing to offer quality, affordable coverage to New Mexicans in 2018.
On August 1, the federal government released the rates from insurers across the country who submitted 2018 products in the individual insurance market. While this may be the subject of conversation and media attention, it’s important to keep a few things in mind:
- Rate submission and review is an annual process and necessary to participate in the individual marketplace.
- Rates should be viewed in context, or include, any premium assistance for those who may receive subsidies. Actual out-of-pocket costs will differ based on the financial assistance consumers receive from the government to offset their total monthly premium cost.
- There is still a lot of uncertainty on the rules and regulations of the individual market for 2018. Our 2018 product pricing reflects that uncertainty and the associated risks that exist within this marketplace. We will continue to work with legislators, regulators and other stakeholders toward getting the necessary certainty around issues like the continued funding of cost-sharing reductions ("CSRs") and mechanisms that encourage broad and continuous coverage.
- Our rates also account for keeping pace with escalating health care costs. and the growing use of that care. If we want to control premiums, then we must focus on the cost of care and the amount of care being used.
It is important to note that while we have submitted rates, our level of participation has not yet been finalized. If we receive regulatory certainty within an acceptable time frame we will review and, where appropriate, adjust our rates if time allows.
Please continue to visit this page for updates to our 2018 products and services in the individual marketplace, as well as through employer and Medicare coverage.