The following are the most popular products and plan design elements chosen by employer
groups with Blue Cross Blue Shield of Illinois.
The most popular PPO plan design elements:
- $500 individual/$1500 family deductible (in-network)
- $1,000 individual/$2,000 family out-of-pocket expense limit (in-network)
- 80%/60% in and out-of network coinsurance
- $20 office visit copay
- $15 generic, $30 formulary, $50 non-formulary prescription drug copay
The participation in most of these PPO plan categories has decreased somewhat since 2006, as high deductible, more affordable consumer-directed health plans (CDHPs) have become more commonly available.
The most popular HMO plan design elements:
- $0 inpatient care hospital copay
- $20 office visit copay
- $15 generic, $30 formulary, $50 non-formulary prescription drug copay
From 2006 to 2008, there has been a drop in member participation in both the PPO and HMO plans, while membership in CDHPs has increased. Of the groups that offer the CDHP option, subscriber enrollment in CDHPs is highest within the 2-50 market segment, whereas enrollment in PPO plans remains the highest in the 51-99 and 100+ market segments.
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