Highmark Blue Shield’s Tiered Benefit Design to Expand in Pennsylvania

Camp Hill, Pa. (Aug. 16, 2013) — After rolling out a tiered benefit in July in nine counties in north central Pennsylvania, Highmark Blue Shield is now expanding the benefit to 21 counties in central and eastern Pennsylvania beginning on January 1, 2014.

Called Community Blue Premier Flex, it will now be offered to group customers in the following 21 counties: Adams, Berks, Centre, Columbia, Cumberland, Dauphin, Franklin, Fulton, Juniata, Lancaster, Lebanon, Lehigh, Mifflin, Montour, Northampton, Northumberland, Perry, Schuylkill, Snyder, Union and York.

With Community Blue Premier Flex, all area providers that participate in Premier Blue Shield are in-network. Community Blue Premier Flex includes two levels of in-network benefits — Enhanced Value Benefits level and Standard Value Benefits level. At both benefits levels, members receive high quality care.

Community Blue Premier Flex members receive Enhanced Value Benefits, or pay less, if they choose an in-network hospital or doctor that provides care at a lower cost. When they receive care from other in-network providers, members are covered at the Standard Value Benefits level or have higher cost sharing. Hospitals in the region are listed on our member websites along with the level of benefit coverage.

“In the short time since we have introduced this benefit design in north central Pennsylvania, we are pleased with the customer response and are excited about the rollout for the entire region,” said Steven Nelson, Highmark Health Services senior vice president of product, marketing and strategy. “We estimate that employers can save up to 20 percent on their premium costs depending on the group’s current utilization.”

Highmark Blue Shield has a number of transparency tools on its member website where members can compare estimated costs among providers for many common procedures.


Leave a Reply

Your email address will not be published.

This site uses Akismet to reduce spam. Learn how your comment data is processed.