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Highmark Blue Cross Blue Shield introduces new, lower-cost plan option in western Pennsylvania

Highmark Blue Cross Blue Shield

PITTSBURGH (June 10, 2015) — On the heels of its first tiered-benefit plan offering in western Pennsylvania, Highmark Blue Cross Blue Shield is introducing a three-tiered plan that provides an even greater level of cost savings, while still giving members the power to choose the care, place and price that is right for them in their community. Connect Blue, a Community Blue plan, is a three-tier EPO product built on the Community Blue network that preserves quality and choice while helping to control health care costs.

Beginning on July 1, this product will be available to large group clients whose headquarters are located in one of the following western Pennsylvania counties: Allegheny, Beaver, Butler, Erie, Mercer, Washington and Westmoreland.

"Connect Blue is yet another way we're partnering with our clients and members to help control health care costs," said Tony Benevento, Highmark senior vice president of Pennsylvania markets. "Last year we introduced Community Blue Flex, which features Enhanced and Standard Value benefit levels to provide two levels of in-network care. With Connect Blue, we've added a third tier that provides even greater member savings and preserves members' access to high-quality physicians in the Community Blue network."

That new third tier is known as the Preferred Value level of benefits. Members choosing services from providers and facilities at this tier will have the lowest level of cost-sharing, which includes the member's deductible, copay and coinsurance (the percentage of the cost of care for which the member is responsible). Cost-sharing is higher at the Enhanced Value level of benefits and highest at the Standard Value level of benefits, both of which are still in network. There is no out-of-network coverage with Connect Blue, except for situations as emergencies and consent decree provisions.

Connect Blue's Preferred Value tier features all Allegheny Health Network (AHN) hospitals, which includes Allegheny General, Allegheny Valley, Canonsburg, Forbes, Jefferson, Saint Vincent and West Penn Hospitals. Also in the Preferred Value tier are St. Clair Hospital, Sharon Regional Health System, Washington Hospital, Children's Hospital of Pittsburgh of UPMC, Western Psychiatric Institute and Clinic, as well AHN's joint ventures with the UPMC for the Cancer Institute in Erie and independent providers throughout the region.

All Community Blue network hospitals and providers (except UPMC Hamot and Horizon) outside the counties where the product is available, services provided through the BlueCard program and AHN joint ventures with UPMC in other locations fall under the Enhanced Value level of benefits. All facilities that are a part of the Consent Decree, as well as UPMC Hamot and Horizon, are covered at the Standard Value level of benefits.

"Tiered benefit plans like Connect Blue are one of the health insurance industry's best tools to help members reduce their health care costs," Benevento said. "This product not only enables our members to choose doctors and facilities close to where they live, but also at a cost that best meets their health care budget."

In addition to increased cost savings, another advantage of this health plan offering is an outpatient surgery benefit, which means that when outpatient surgery is performed in a non-hospital setting, such as an ambulatory surgery center, the copay is waived for services from providers participating at the Preferred Value level of benefits.

About Highmark Blue Cross Blue Shield

Highmark Blue Cross Blue Shield serves approximately 3.2 million members through the company's health care benefits business and employs more than 4,000 people in western Pennsylvania. Highmark Blue Cross Blue Shield is an independent licensee of the Blue Cross and Blue Shield Association, an association of independent Blue Cross and Blue Shield companies. For more information, visit
For more information, contact:
Aaron Billger
Highmark Blue Cross Blue Shield