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Blue Cross Launches New Power Select HMO Plan and Medical Network; New Product and Physician Network Offers More Affordable Coverage.


Business Editors/Health/Medical Writers

THOUSAND OAKS Thousand Oaks, residential city (1990 pop. 104,352), Ventura co., S Calif., in a farm area; inc. 1964. Avocados, citrus, vegetables, strawberries, and nursery products are grown. , Calif.--(BUSINESS WIRE)--Nov. 19, 2003

Blue Cross of California (Blue Cross) today announced the introduction of a new and competitively priced HMO HMO health maintenance organization.

HMO
n.
A corporation that is financed by insurance premiums and has member physicians and professional staff who provide curative and preventive medicine within certain financial,
 plan now being offered to large employers throughout California. Customers choosing this plan can benefit from premium savings that will average 15 percent lower (statewide) than its current HMO product on the market.

The "Power Select HMO" from Blue Cross is both a new HMO product and a new physician network design concept being offered to employers with more than 51 employees throughout 22 counties in the state. Blue Cross selected participating counties based on population and availability of the most cost effective medical groups. Altogether, the new network will have more than 5,400 primary care physicians and 8,400 specialty physicians who can refer to more than 400 hospitals. The significant premium cost savings passed along to members will be achieved by contracting with medical groups displaying: financial stability, administrative efficiency, accessibility for new membership and cost efficiencies involving physician, hospital and pharmacy charges. According to according to
prep.
1. As stated or indicated by; on the authority of: according to historians.

2. In keeping with: according to instructions.

3.
 Larry Rehhaut, general manager of key accounts for Blue Cross, "We took a two-step approach in designating a network and developing a comprehensive HMO benefit design with the intention of bringing a more affordable insurance product to California employers who are concerned with managing their costs."

Numerous mid-sized employers still believe current coverage options are not affordable or that the current health care environment is too expensive or cost prohibitive pro·hib·i·tive   also pro·hib·i·to·ry
adj.
1. Prohibiting; forbidding: took prohibitive measures.

2.
. Blue Cross intends to target these employers with its Power Select HMO product and introduce its cost-savings approach to the small group and individual market in the future in order to reach an even broader audience of under or uninsured populations. At a glance, the Power Select HMO plan provides the following benefits:

    --  Three medical coverage options that offer three different
        levels of cost sharing:
        --  Option A is a $15/$30 Primary/Specialist office visit
            copay with 100% inpatient medical coverage
        --  Option B is a $20/$30 Primary/Specialist office visit
            copay with $100 per day hospital copay
        --  Option C is a $20/$30 Primary/Specialist office visit
            copay with 80% inpatient medical coverage

    --  A three-tier pharmacy benefit ($10 generic/$25 brand
        formulary/$40 brand non-formulary) with a $100 annual brand
        deductible, which is waived if there is no generic equivalent
        available.

    --  An array of preventive and low or no-cost health care services
        including:
        --  DirectAccess (allows self referral to participating
            allergists, dermatologists and ENTs)
        --  WellWoman, a program that allows self-referral to
            participating OB-GYNs
        --  Baby Connection, a free risk assessment and pregnancy
            support program for expecting mothers
        --  HealthyExtensions program provides discounts to an array
            of independent, health-related vendors and practioners
            such as vitamin supplements, health clubs, nutritionists
            and massage therapists


"Power Select HMO is uniquely designed to address employer and employee affordability concerns in this current environment of industry-wide medical cost increases," said Mike Higgins Michael S. Higgins (born February 17, 1967 in Grand Island, Nebraska) is an American professional basketball player.

A 6'9" power forward from the University of Northern Colorado, Higgins played two seasons (1989-1991) in the National Basketball Association as a member of
, senior vice president of Large Group services for Blue Cross. "Our company has always been innovative in providing products that respond to marketplace needs. We think that Power Select HMO is an affordable, viable alternative that will be effective at reducing the number of uninsured people in the state and attracting more employers to offer health benefits to their employees."

Counties Offering Power Select HMO include:

Alameda                Sacramento
Contra Costa           San Bernardino
Fresno                 San Diego
Imperial               San Francisco
Kern                   San Joaquin
Los Angeles            San Mateo
Merced                 Santa Clara
Nevada                 Santa Cruz
Orange                 Stanislaus
Placer                 Tulare
Riverside              Yolo


Blue Cross of California and its California affiliates, with more than 7 million medical members, is an operating subsidiary An operating subsidiary is a business term frequently used within the United States railroad industry. In the case of a railroad, it refers to a company that is a subsidiary but operates with its own identity and rolling stock.  of WellPoint Health Networks Inc., one of the nation's largest publicly traded health care companies. WellPoint serves the health care needs of more than 14 million medical members and more than 44 million specialty members nationally. WellPoint offers a broad spectrum of quality network-based health products including open access PPO PPO
abbr.
preferred provider organization


PPO Managed care Preferred provider organization, see there Infectious disease Pleuropneumonia-like organism, see there
, POS (1) See point of sale and packet over SONET.

(2) "Parent over shoulder." See digispeak.

POS - point of sale
 and hybrid products, HMO and specialty products. Specialty products include pharmacy benefit management A Pharmacy Benefit Manager (PBM) is a third party administrator of prescription drug programs. They are primarily responsible for processing and paying prescription drug claims. , dental, utilization management Utilization management is the evaluation of the appropriateness, medical need and efficiency of health care services procedures and facilities according to established criteria or guidelines and under the provisions of an applicable health benefits plan. , vision, mental health, life and disability insurance, long term care insurance, flexible spending accounts flexible spending account,
n an employee reimbursement account primarily funded with employee-designated salary reductions. Funds are reimbursed to the employee for health care (medical and/or dental), dependent care, and/or legal expenses and are
, COBRA cobra, name for African and Asian snakes of the family Elapidae that are equipped with inflatable neck hoods. The family also includes the African mambas, the Asian kraits, the New World coral snakes and a large number of Australian snakes.  administration, and Medicare supplements. Blue Cross of California may be found on the web at www.bluecrossca.com. Blue Cross of California is an independent licensee licensee n. a person given a license by government or under private agreement. (See: license, licensor)


LICENSEE. One to whom a license has been given. 1 M. Q. & S. 699 n.
 of the Blue Cross Association.
COPYRIGHT 2003 Business Wire
No portion of this article can be reproduced without the express written permission from the copyright holder.
Copyright 2003, Gale Group. All rights reserved. Gale Group is a Thomson Corporation Company.

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Publication:Business Wire
Date:Nov 19, 2003
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