The Legislature’s money panels agreed Friday to a series of changes in the state’s $1.1 billion annual contract with Blue Cross Blue Shield of Louisiana to administer state government’s health insurance program.
Three changes in the pact will increase the firm’s responsibilities but won’t add to contract costs, Group Benefits Chief Executive Officer Susan West assured state legislators at a joint meeting of the House Appropriations Committee and the Senate Finance Committee.
Blue Cross Blue Shield has a three-year contract for $1.1 billion per year to be Group Benefits third-party administrator. The contract expires Dec. 31. A request for proposal for a new administrator went out March 13. The new contract takes effect Jan. 1.
Group Benefits provides insurance for about 230,000 state employees, teachers, retirees and their dependents.
Under the changes, Blue Cross Blue Shield will administer the new Pelican HRA (health reimbursement arrangement) insurance plan — an option added with a recent Jindal administration revamp of Group Benefits offerings, West said. It’s an account employers use to reimburse employee health care expenses.
The company also will assume responsibility for determining insurance coverage eligibility of dependents over age 26, West said.
The firm also will take over third-party collection efforts for accident-related claims expenses as it does for other clients, she said. “We believe their staff is fully equipped to perform this function for Group Benefits,” she said.
Group Benefits’ third-party administrator is responsible for all aspects of claims administration, disease and case management and wellness initiatives as well as delivering members access to a broad and discounted local and national network of providers, handling provider billings including audits and fraud prevention and provider relations activities.
In addition, Blue Cross Blue Shield performs customer service duties related to claims and benefit questions as well as population health data, prior authorization requirements and a medical review process.