Bupa’s international health insurance business, Bupa Global, is pleased to announce the appointment of Sheldon Kenton to the role of Global Commercial Director.

In this newly created role, Sheldon will report to Robert Lang, Managing Director for Bupa Global, and serve as a member of Bupa Global Executive Team. The role will focus on the growth of Bupa Global’s corporate sales and health benefits business, which provides products and services in over 190 countries, as well as the further development of its institutional distribution partnerships around the world.

Sheldon joins Bupa Global later this year following a long tenure with Cigna Corporation, most recently as Chief Commercial Officer for Cigna Global Health Benefits (CGHB) North America.

Sheldon’s appointment builds on the momentum created by Bupa Global’s significant investment in its international private medical insurance (IPMI) business and commitment to globally-minded and globally-mobile customers. This commitment was demonstrated in 2013 by Bupa’s considerable (49%) investment in a US-based specialist health insurance and services company, and in 2014 when Bupa Global began a strategic global partnership with the Blue Cross Blue Shield Association, a national federation of 36 independent, community-based and locally operated Blue Cross and Blue Shield companies that collectively provide healthcare coverage for more than 106 million members. 

This partnership created the largest combined healthcare provider network ever formed in the IPMI market. Sheldon’s appointment complements several recent senior industry hires to Bupa Global that strengthen the commercial and clinical teams. These include: Lorna Friedman from Mercer Health & Benefits; Mary Trometer and Nic Brown from Aetna International; Justin Howcroft from Friends Provident International; and Stephen Killian from United Healthcare Global.

Commenting on this appointment, Robert Lang, Managing Director, Bupa Global, said “We are delighted to have Sheldon join our team later this year. He will be instrumental in ensuring Bupa Global’s corporate and health benefits customers access the full scope of Bupa’s significant global presence in the UK, Australia, Spain, Poland, New Zealand and Chile, as well as Saudi Arabia, Hong Kong, India and Thailand.”

Thirty-one million people with health coverage in the United States were underinsured in 2014, according to a new Commonwealth Fund report. The share of working-age adults who had health insurance all year but were underinsured was statistically unchanged since 2010, after nearly doubling, from 12 percent to 22 percent, between 2003 and 2010. People are considered underinsured if they have had health insurance for a full year, but have high deductibles or out-of-pocket expenses relative to their income.

The study, The Problem of Underinsurance and How Rising Deductibles Will Make It Worse, is based on The Commonwealth Fund’s Biennial Health Insurance survey, which interviewed people 19-64 years old between July and December 2014. It could not separately assess the effects of the Affordable Care Act on underinsurance because people insured all year in the survey had coverage that began prior to the law’s major insurance expansions going into effect.

According to the report, the financial consequences of being underinsured are significant. Half (51%) of those who were underinsured had problems paying medical bills or were paying off medical debt over time. More than one-third either had trouble paying or couldn’t pay their medical bills (38%) and one-third had medical debt they were paying off over time (34%). More than one-fifth were contacted by a collection agency over unpaid medical bills (23%) or said they had to change their way of life in order to pay their medical bills (22%).

“The financial and health insecurity that comes from being underinsured is substantial and puts people’s health and well-being at risk,” said Commonwealth Fund President David Blumenthal, M.D. “If health insurance costs continue to be shifted to consumers at the rates we have seen over the past ten years, the problem will likely grow.” Underinsured adults who had difficulties paying their medical bills reported the following consequences:

• Forty-four percent received a lower credit rating.
• Forty-seven percent used all of their savings.
• Thirty-four percent took on credit card debt.
• Nine percent took out a mortgage against their home or a loan.
• Seven percent declared bankruptcy.

In addition to financial strain, people who were underinsured also skipped needed health care—44 percent either didn’t go to the doctor when they were sick; did not fill a prescription; skipped a physician–recommended medical test or follow-up visit; or didn’t see a specialist when their doctor told them to do so.

Who Is Underinsured?

People with health insurance through their jobs are increasingly underinsured as employers, particularly firms with 100 or fewer employees, are sharing more of their health care costs with employees, especially in the form of higher deductibles. While people buying coverage on their own are still more likely to be underinsured than those with employer coverage (37% vs. 20%), the share of people with employer insurance who are underinsured has doubled since 2003, when it was 10 percent.

According to the report, underinsured rates were higher among those working in small firms with health benefits through their jobs—27 percent were underinsured compared to 14 percent in firms with 100 or more workers. Adults under age 65 who are disabled and covered by Medicare were underinsured at the highest rate of any group in the survey (42%). 

People with health problems were more likely to be underinsured. Thirty percent of people in poor health or who had a chronic health problem or disability were underinsured, compared with 16 percent of those who were healthier.

Rising Deductibles Contribute to the Underinsured Rate

Over the past 10 years, deductibles have contributed to underinsured rates in two ways: more people than ever before have plans with deductibles, and those deductibles are taking up larger shares of people’s incomes. According to the report, in 2003, 40 percent of people with private health insurance had no deductible, while in 2014 just 25 percent didn’t have one. In 2014, 14 million people had deductibles that were 5 percent or more of their income, while only 4 million had deductibles that high in 2003. The impact has been substantial. While many people were underinsured because they had high out-of-pocket costs and high deductibles, 7 million people were underinsured due to deductibles alone in 2014.

When looking at high deductibles by type of insurance, the report found that 11 percent of people with employer plans and 24 percent with individual market plans had high deductibles in 2014, up from 2 percent and 7 percent respectively in 2003. People in small firms with insurance through their jobs were more likely to have a high deductible than those in larger firms (20% vs. 8%).

“People with health insurance should be able to get the health care they need without depleting their savings accounts or worrying about potential bankruptcy,” said Sara Collins, vice president for Health Care Coverage and Access at The Commonwealth Fund and the report’s lead author. “Changing the way we design health insurance benefits to keep rising deductibles in check could help keep health care affordable.”

Additional Report Findings

• Underinsured rates in the four largest states. In the four largest states, the underinsured rate varied from 19 percent in California and 22 percent in New York to 29 percent in Florida and 31 percent in Texas.
• Slight decline in underinsured rate among low-income people. Forty-two percent of people who were insured all year and had incomes below 200 percent of the federal poverty level ($22,980 for an individual, $47,100 for a family of four) were underinsured in 2014, compared with 49 percent in 2010.
• Health insurance problems among the underinsured. Thirty-six percent of underinsured adults reported expensive medical bills under their current health plans that were not covered by insurance; 37 percent said their doctor had charged them more than the insurance would pay and they had to pay the difference; 25 percent said their health plan denied payment for medical care they had received; and 20 percent said a doctor’s office told them they did not accept their insurance.

Moving Forward

Even among families with health insurance, the report demonstrates how the growing share of health care costs that families must pay themselves has a substantial impact on their ability to afford the care they need. Changes in health insurance design that keep deductibles from rapidly increasing could help consumers. In addition, policies that eliminate gaps in health plans could alleviate the unexpected costs many families face—for example, when they are unknowingly treated by out-of-network physicians in in-network hospitals. Finally, system-wide efforts to lower the underlying rate of medical cost growth and share any resulting savings with consumers are needed.

With a growing number of Americans retiring abroad, a poll released by Clements Worldwide indicates that international political instability and terrorism top the list of worries among would-be expatriates.

The survey by Clements, a global insurance provider with 68 years’ experience covering individuals living and working outside of their country of citizenship, also found strong concern but lack of information about the availability of appropriate health care insurance overseas. Asked to choose the risks of overseas living they feared most, 92 percent of respondents selected political or economic upheaval, while 86 percent picked terrorism. Eighty-nine percent expressed concern about a health crisis, while 79 percent said they were concerned about a natural disaster. When asked which factor they were “extremely concerned about,” the largest share, 18 percent, chose terrorism and 15 percent political upheaval.

“Americans appear to be forgoing retirement abroad due to fears of terrorism and potential political upheaval,” said Sergio Sanchez, chief marketing officer at Clements Worldwide. “And that’s unfortunate because our international claims data show that such risks, and the costs associated with them, pale in comparison to those created by insufficient health care coverage, or by having the wrong auto or personal accident insurance while abroad.”

In all, 24 percent of 1,179 people over age 50, and with household income over $100,000, said they are considering expatriate life within the next 15 years. Respondents planning to retire outside of the United States were somehow less worried about the more commonplace threats of traffic or personal accidents, with just one percent saying they were “extremely concerned” about such mishaps.

Europe was the top destination considered by 59 percent, followed by the Caribbean (40 percent) and Central and South America (32 percent). Less than nine percent of those likely to relocate are considering a new life in Asia, while fewer than three percent are looking at Africa and less than two percent at the Middle East, suggesting concern about instability in those regions.

“Risks vary based on location,” said Mr. Sanchez. “Those considering a move abroad should begin with the basics, such as comprehensive international health and automobile coverage. Then they should consider factors specific to their destination, such as personal property insurance for theft or vandalism and political violence insurance including coverage for emergency evacuation. Regardless of nationality, it’s critical for would-be retirees, and even currently employed professionals planning to or already living outside their home country, to reach out to a specialized international insurance broker who is familiar with their needs and the regulations that affect expatriates around the world. Having the wrong coverage can be as harmful as having no coverage.”

For instance, while access to affordable health care was the second biggest relocation concern among those planning to live abroad -- at 68 percent, second only to the cost of living (72 percent) -- a majority of respondents were not clear about what their health coverage needs abroad would be, or if expatriate coverage with access to U.S. medical facilities would be available.

Respondents were also unclear as to whether they will have to become a citizen of their destination country to receive health coverage. Nearly half were unsure about this, while 22 percent said that is the case.

“Finding a suitable international health policy should not stand in the way of expatriate retirement planning,” said Mr. Sanchez. “At Clements we offer programs like GlobalCare® for individuals and organizations that include unsurpassed benefits in hard currency, allow access to western-style facilities worldwide including coverage for doctor visits in the US, and Englishlanguage support. Designed to meet the healthcare needs of expats, contractors, and travelers, Clements' core plans automatically include the benefit of emergency medical evacuation at no extra cost.”

The survey was conducted online from March 19 to March 23.

Anthem Blue Cross and Blue Shield in Colorado (Anthem) announced the expansion of its new lower cost mountain health plan, created in partnership with a community hospital in Eagle County and the region’s leading health care provider, to large and small group employers.

Anthem in January began selling a new health plan created in collaboration with Vail Valley Medical Center in Eagle County and Centura Health -- which includes St. Anthony Summit Medical Center, Mercy Regional Medical Center and a network of about 75 providers in Summit, La Plata and Montezuma counties – to individuals purchasing insurance on and off the Colorado health exchange marketplace. The expansion now allows small and large employers in Eagle, Summit, La Plata and Montezuma counties to purchase Anthem’s Mountain Enhanced HMO plan effective July 1.

Mountain Enhanced is exclusive to the Centura Health network and Vail Valley Medical Center, and brings together three organizations committed to finding ways to enhance the availability of, and accessibility to, quality health care services across the full continuum of need at reduced costs. This plan helps to keep health care local, giving residents the ability to receive care from physicians and providers in the communities where they live and work, while addressing the high health insurance premiums in Colorado’s mountain communities.

“Anthem is very pleased with the reception Mountain Enhanced has received from individual consumers, which is why we’re excited to expand it to an even broader market as part of our commitment to ensure that high quality, high value health care remains accessible and affordable throughout Colorado,” said Mike Ramseier, president and general manager, Anthem Blue Cross and Blue Shield in Colorado.

“We continue to find ways to expand our partnership to support accessible health care solutions for our mountain communities,” said Gary Campbell, president and CEO, Centura Health. “By expanding this plan, we are helping to improve their access to high-value care, at an affordable cost in their own community.”

Mountain Enhanced Blue will include Anthem’s unique benefits such as its 24/7 nurse line and 360 degree health and wellness programs like Condition Care, which helps members with complex medical conditions receive help following their doctor’s care plan.

“As Eagle County’s nonprofit community hospital, we are committed to finding viable initiatives to address rising health insurance premiums,” says VVMC President and CEO Doris Kirchner. “Mountain Enhanced is a good option for businesses to provide quality healthcare close to home and at a reduced premium.”

SOURCE: https://ipmimagazine.com/medical-health-insurance/en/health-medical-travel-expatriate-insurance-product-news/item/3442-anthem-expands-affordable-mountain-health-plan-to-small-and-large-employers

UnitedHealth Group (NYSE: UNH) reported first quarter results, highlighted by accelerating growth, consistent execution and strong operating performance in businesses across the Company.

“We are working to create more effective and more modern approaches to accessing and delivering health care. We are gratified with the market response to our efforts, providing us opportunities to serve more people, in more ways,” said Stephen J. Hemsley, chief executive officer of UnitedHealth Group.

The Company expects 2015 revenues of approximately $143 billion, an increase of $2 billion from the previous outlook, due to stronger business growth in the first quarter. Earnings are now expected to be in a range of $6.15 to $6.30 per share, an increase from the prior outlook of $6.00 to $6.25 per share, despite absorbing approximately $0.10 per share from the proposed combination with Catamaran Corporation, including transaction costs and the effect of moderated share repurchase activity. Management expects the combination to contribute $0.30 per share to UnitedHealth Group’s 2016 earnings. Reflecting the increased outlook for revenues and earnings, the Company is raising its projection for 2015 cash flows from operations to a range of $8.2 billion to $8.4 billion.

UnitedHealth Group’s first quarter 2015 revenues of $35.8 billion grew 13 percent or more than $4 billion yearover-year. Revenue growth was broad-based, with both UnitedHealthcare and Optum revenues growing by double digit percentages.

• First quarter earnings from operations were $2.6 billion and net earnings of $1.46 per share increased 33 percent year-over-year. With strengthened overall operating performance compared to the first quarter of 2014, the net margin of 4.0 percent expanded 50 basis points year-over-year.

• First quarter 2015 cash flows from operations of $2.3 billion were 1.6 times net earnings and grew 61 percent year-over-year due to growth in risk-based products and the expansion in overall earnings.

• The consolidated medical care ratio decreased 140 basis points year-over-year to 81.1 percent in the first quarter of 2015. Prior year medical reserve development was $140 million, compared to $220 million in the first quarter of 2014.

• The first quarter 2015 operating cost ratio of 16.6 percent increased 20 basis points year-over-year due to higher growth in services businesses.

• The first quarter 2015 tax rate of 43.3 percent increased 130 basis points year-over-year due to higher levels of nondeductible ACA fees. • First quarter 2015 days sales outstanding of 13 days increased 1 day year-over-year, due to higher growth in government programs. Days claims payable was flat year-over-year at 47 days.

• The Company’s balance sheet remained strong, with a debt to total capital ratio of 36.6 percent at March 31, 2015. UnitedHealth Group repurchased $900 million in stock in the first quarter, acquiring more than 8 million shares, and grew dividend payments to shareholders by 29 percent year-over-year to $357 million.

UnitedHealthcare provides health care benefits, serving individuals and employers ranging from sole proprietorships to large, multi-site and national and international organizations; delivers health and well-being benefits to Medicare beneficiaries and retirees; manages health care benefit programs on behalf of state Medicaid and community programs; and serves the nation’s military service members, retirees and their families through the TRICARE program.

UnitedHealthcare’s first quarter 2015 revenues of $32.6 billion grew $3.4 billion or 12 percent year-over-year. The number of people served across the U.S. benefits markets grew 1.6 million year-over-year, all organically, with balanced growth across commercial, Medicare and Medicaid offerings. In the first quarter of 2015, UnitedHealthcare grew to serve more than 1 million additional people domestically.

• First quarter 2015 earnings from operations for UnitedHealthcare increased $494 million over the first quarter of 2014. Improved performance in managing health care costs across all businesses and improved operational performance combined to advance UnitedHealthcare’s first quarter operating margin to 5.8 percent. Page 4 of 7 UnitedHealthcare Employer & Individual

• UnitedHealthcare Employer & Individual served 680,000 more people in the first quarter and 320,000 more people year-over-year. First quarter growth was led by the positive market response to the Company’s individual public exchange products and favorable annual renewal activity and new business awards serving employer customers.

• First quarter revenues of $11.4 billion grew 4 percent year-over-year reflecting growth in the number of people served, price increases for medical cost trends and a continuing market shift to lower price point products, including public exchange offerings. UnitedHealthcare Medicare & Retirement

• First quarter 2015 UnitedHealthcare Medicare & Retirement revenues of $12.8 billion grew $1.3 billion or 11 percent year-over-year due to consistent growth in services to seniors. - In Medicare Advantage, UnitedHealthcare grew to serve 220,000 more seniors, a 7 percent year-overyear increase, including 200,000 more in first quarter 2015. - Medicare Supplement products grew 8 percent to serve 305,000 more people year-over-year, including 180,000 in the first quarter. - UnitedHealthcare’s stand-alone Medicare Part D prescription drug plan participation remained largely unchanged, contracting year-over-year by 40,000 people. UnitedHealthcare Community & State

• First quarter 2015 UnitedHealthcare Community & State revenues of $6.9 billion grew $1.7 billion or 33 percent year-over-year, due to strong overall growth and an increasing mix of higher acuity members, such as those served through long-term care programs.

• In the past year UnitedHealthcare grew its Medicaid services by 750,000 people or 17 percent to serve more than 5 million people. Strong first quarter growth of 160,000 people was fully offset by a previously scheduled membership reduction of 175,000 people in one market, where an additional offering was introduced by the state. UnitedHealthcare Global

• UnitedHealthcare Global’s first quarter 2015 revenues of $1.5 billion decreased 7 percent or $107 million year-over-year. Using first quarter 2015 exchange rates for both periods, revenues grew 12 percent yearover-year. The number of people served declined 495,000 year-over-year as a result of strengthened pricing and underwriting disciplines in response to regulatory actions causing use of the health care system to rise.

Optum is a health services business serving the broad health care marketplace, including payers, care providers, employers, governments, life sciences companies and consumers. Using advanced data analytics and technology, Optum’s people help improve overall health system performance: optimizing care quality, reducing costs and improving the consumer experience and care provider performance.

Optum’s revenues for the first quarter of 2015 grew 15 percent or $1.6 billion year-over-year to $12.8 billion as each reporting segment advanced revenues by a double-digit percentage. Optum’s first quarter 2015 earnings from operations of $742 million grew 14 percent or $92 million year-over-year. Absent $42 million in acquisition costs from the proposed Catamaran combination, first quarter operating earnings growth would have exceeded 20 percent and the operating margin of 5.8 percent would have been 6.1 percent, up 30 basis points year-over-year.

OptumHealth revenues of $3.3 billion grew 27 percent year-over-year due to growth in the number of patients served across its OptumCare health care delivery businesses, as well as business expansion in population health management services for third party payers. - OptumInsight revenues grew to $1.4 billion in the first quarter of 2015, advancing 11 percent year-overyear, driven by expansion and growth in care provider revenue management services. OptumInsight’s quarter end revenue backlog was $9.1 billion, with growth in external backlog accelerating to 24 percent year-over-year.

OptumRx revenues grew 11 percent year-over-year as first quarter script volumes increased 5 percent to nearly 150 million adjusted scripts. Management expects the Catamaran combination to enhance OptumRx’s offerings and generate substantial value for clients and individuals.

In the most recent International Private Medical Insurance Magazine Executive Round Table business forum, we speak with leading C-Level Executives about the major differences between international and local health insurance plans.

As expatriate hot spots around the world continue to mandate health insurance cover for expat employees, under various visa and employment laws, questions from the business community continue to be raised. Issues focus around how new laws will help and assist expatriates and what levels of cover they may expect from local health insurance plans.

Four of 10 adults in Florida and Texas reported they had trouble paying their medical bills or were paying off medical debt over time in 2014, compared to one of four in California and three of 10 in New York, according to a new Commonwealth Fund report comparing health care coverage in the nation’s four largest states.

The study, based on findings from the Commonwealth Fund 2014 Biennial Health Insurance Survey of working-age adults, also found higher proportions of people in Florida and Texas had trouble getting needed health care because of the cost than in California and New York. More than four of 10 in Florida (43%) and Texas (43%) said they did not see a doctor when sick, did not fill a prescription, skipped a test, treatment, or follow-up visit, or did not get needed specialist care in the past 12 months for cost reasons, compared to three of 10 in California (31%) and New York (30%). The differences in bill problems, debt, and cost-related access problems remained even when taking into account demographic variations across the states.

According to Health Care Coverage and Access in the Nation’s Four Largest States—Results from the Commonwealth Fund Biennial Health Insurance Survey, 2014, by Commonwealth Fund researchers Petra Rasmussen, Sara Collins, Michelle Doty, and Sophie Beutel, the differences among the states may be attributable to state health insurance policies before and after the Affordable Care Act (ACA) took effect. For example, California and New York both expanded eligibility for Medicaid years before the ACA was implemented, making coverage available to more people than in many states, and then expanded it fully under the law. Texas and Florida, meanwhile, have not. As a result, uninsured rates for residents with low incomes are lower in California and New York than in Florida and Texas.

“Policy decisions states have made are likely having an effect on the number of their residents who have health insurance,” said Sara Collins, Vice President for Health Care Coverage and Access at The Commonwealth Fund. “Fully expanding Medicaid would help reduce the high uninsured rates in Florida and Texas and help improve people’s ability to afford the care they need.” The report found significant differences among the four states in rates of health insurance coverage, delays in care because of cost, and problems paying medical bills:

• Texas had the highest uninsured rate among working-age adults (30%), followed by Florida (21%), California (17%), and New York (12%). These differences were not explained by variations in the demographic composition of these states’ populations.
• Adults with low incomes ($11,490 for an individual or $23,550 for a family of four) had higher uninsured rates in Florida (33%) and Texas (51%) than in California (23%) and New York (13%).
• Of the four states, New York has the lowest uninsured rate for young adults ages 19 to 34—14 percent. Rates for this group are 34 percent in Texas, 26 percent in Florida, and 23 percent in California.
• Even for people with insurance, affording health care was more of a problem for Floridians and Texans. Thirty-six percent of insured adults in Texas and 39 percent in Florida reported at least one problem getting needed care in the past 12 months because of the cost, compared to 28 percent in California and 27 percent in New York.
• About three of 10 adults in Florida (29%) and one of four in Texas (26%) reported having a medical problem but not going to a doctor or clinic for cost reasons, compared to 18 percent in New York and California.
• One-fifth of adults in Texas (21%) and 17 percent in Florida reported being contacted by a collection agency for unpaid medical bills in past year, compared to 9 percent in California and 11 percent in New York.

Moving Forward

Despite significant declines in uninsured rates following implementation of the Affordable Care Act, millions of people lack access to affordable health insurance in states that have not yet expanded their Medicaid programs, the authors note.

“The bottom line is that states’ health policy decisions are a factor in whether or not millions of people have health insurance coverage,” said Commonwealth Fund President David Blumenthal, M.D. “If states don’t take the necessary steps to help their residents obtain insurance, we may see ever-widening disparities between states in their residents’ coverage and the financial protection it provides.”

Blue Cross and Blue Shield of Texas (BCBSTX), partnering with more than 40 community organizations, last year improved the health and wellness of more than 2.9 million children in the communities it serves through its Healthy Kids, Healthy Families^® initiative. In the four years since its inception, the initiative has served more than 9 million children in Texas.

Additionally, the company had more than 1,600 employees volunteer nearly 30,000 hours to community organizations statewide. As a result of this volunteer time, BCBSTX's matching dollar program generated an additional $88,000, which was donated to non-profit organizations across the state.

Blue Cross and Blue Shield of Texas' just-released Social Responsibility Report, which can be found online at www.bcbstx2014srr.com, demonstrates how the company made significant gains in the number of children impacted through its Healthy Kids, Healthy Families initiative by targeting its community investments in the areas of nutrition, physical activity, disease prevention and management, and supporting safe environments.

"We align our community investments with our business objectives and partner with organizations that allow us to address the most pressing health needs in our local communities," said Dr. Dan McCoy, chief medical officer, BCBSTX. "These investments work hard to decrease the incidence of illness and growing chronic trends such as diabetes and childhood obesity."

In an effort to help create a healthier Texas, BCBSTX committed to a gift of $5 million to support the implementation of Project Blue Zones Fort Worth, collaborating with leadership from the City of Fort Worth Chamber of Commerce and Texas Health Resources. Blue Zones are areas where people live measurably longer, happier lives with lower rates of chronic disease and a higher quality of life. The research behind Blue Zones, coupled with an eight-year worldwide longevity study, has been used to develop lifestyle management tools and programs that help transform communities. The collaborative approach to Blue Zones engages the business community, government entities, nonprofits, schools, media and citizens in a unifying campaign that drives permanent changes to encourage individuals to choose healthy options.

Another one of BCBSTX's most significant social investments was the decision to offer health insurance through the Affordable Care Act (ACA) in every community it serves. During this time of historic expansion of access to health care, the company enabled more than 4.4 million health care services to our retail members, including mammograms and wellness visits, to many individuals receiving health care coverage for the first time.

As in past years, the 2014 report was produced digitally, reducing environmental impact and enabling a more dynamic presentation of community partnerships through videos and social media integration. Readers can instantly share and comment on a specific page of the report through Facebook, LinkedIn and Twitter or email the entire report to family, friends and colleagues.

Blue Cross and Blue Shield of Minnesota and its family of companies (Blue Cross) today announced audited financial results for 2014. Blue Cross closed out the year with net income of $61.5 million, reflecting positive investment portfolio performance that offset slight operational losses. The organization reported a net operating loss of $8.2 million on full-year revenues of $10.1 billion, for a negative operating margin of one-tenth of one percent (0.1%).

Blue Cross reported more than $9.1 billion paid in medical claims for the year, representing 90 cents of every premium dollar collected going directly to cover health care costs. Additionally, Blue Cross paid more than $205 million in taxes, assessments and surcharges for the year. Overall year-end 2014 enrollment of 2.6 million members represents a slight decrease from year-end 2013.

“Our operating performance for 2014 was favorable to projections, amounting to a near break-even year for the organization,” said Michael Guyette, president and CEO of Blue Cross and Blue Shield of Minnesota. “We knew 2014 would be a challenging year, as the market continued to go through significant transition related to health reform. We continue to engage with multiple stakeholders in order to explore ways of bringing additional cost and coverage stability for both the short- and long-term.”

During 2014, Blue Cross celebrated several successes in communities across the state. Among them:

•     Collaborated with Allina, Entira, Minnesota Community Health Network (MCHN), Northern Health Alliance and Sanford Health in support of innovations that promote advancements in health care affordability and quality.
•     Opened the company’s first health insurance retail store, where Minnesotans can receive health plan information, service and claims support.
•     Raised more than $1 million in employee donations through the annual Community Giving Campaign to benefit more than 700 nonprofits statewide.
•      Supported efforts of Minnesota communities to enhance access to health coverage and improve health, including:

o    Southern Prairie Community Care, an Accountable Community for Health, focused on improving the health of residents of 12 southwestern Minnesota counties.
o    Access to coverage grants, helping low-income Minnesotans enroll in insurance.
o    Act on Alzheimer’s, helping foster dementia-friendly communities.
o    Increasing access to various dental care programs in Mankato, Bemidji, Duluth and Rochester.

Audited results include the consolidated financial statements for businesses operating under Aware Integrated Inc. (AII), a non-profit corporation and parent organization. AII serves as the holding company for all affiliates and subsidiaries, including the following regulated businesses associated with Blue Cross:

Blue Cross and Blue Shield of Minnesota — A nonprofit health insurance company and independent licensee of the Blue Cross and Blue Shield Association.

Blue Plus — A nonprofit health maintenance organization (HMO) that offers health plans and contracted provider networks throughout Minnesota to individuals and local, state and national groups.

SelectAccount — A third-party administrator of medical spending accounts included in consumer-directed health plans throughout the country.

Blue Cross provides all information, reports and audited details as required by the State of Minnesota for both commercial and public program products. Detailed financial statements for the organization’s regulated businesses are filed with the Minnesota Department of Commerce. A consolidated earnings statement for 2014 results is available at https://www.bluecrossmn.com/2014Results.

Blue Cross and Blue Shield of Minnesota, with headquarters in the St. Paul suburb of Eagan, was chartered in 1933 as Minnesota’s first health plan and continues to carry out its charter mission today as a health company: to promote a wider, more economical and timely availability of health services for the people of Minnesota. Blue Cross is a not-for-profit, taxable organization. Blue Cross and Blue Shield of Minnesota is an independent licensee of the Blue Cross and Blue Shield Association, headquartered in Chicago. Go to bluecrossmn.com to learn more about Blue Cross and Blue Shield of Minnesota.