Capital Blue Cross (CBC):
Q. Why are our health plans now going to be managed by Eliance Health Solutions?
A. Health-related costs—including insurance, illness, workplace injuries and disability—are among the largest expenses for individuals today, as well as for the businesses that employ them. LG Health launched Eliance Health Solutions in 2016 to help businesses in our community better manage their employees’ health and wellness needs. As the largest employer in Lancaster County, LG Health will benefit from the cost savings offered by Eliance, as will our employees.
Q. Why didn’t Eliance take over in January, when our 2018 benefits became effective?
A. In an ideal situation, the timing of this transition would have aligned with open enrollment; however because of the size of LG Health, this process required more time. We did not want employees to have to wait until 2019 to experience the health benefits and cost savings that this change represents, which is why we are making the transition in April 2018.
Q. If the switch to Eliance will bring cost savings, why did copays increase for Tier 2 providers?
A. Effective January 1, 2018, copays for Tier 2 providers and facilities (formerly called Preferred Providers) increased as follows:
Primary Care visits—$20 to $30
Specialty Provider visits—$35 to $50
Urgent Care visits—$35 to $50
These increases have no relation to the transition to Eliance Health Solutions, but were made in response to the rising cost of health insurance. By modifying cost-sharing for non-LGHP/Penn Medicine providers and facilities, we were able to offer employees health plans with no increase in medical or dental premiums, no increase in copays for Tier 1 providers and facilities, and no increase in deductibles, co-insurance or maximum out-of-pocket limits for 2018.
Q. After April 1, will I need to call Eliance Health Solutions if I have a question or claim issue?
A. No. Trustmark will continue to handle claims processing and member services. You may continue to reach Trustmark through the mobile app, by visiting mytrustmarkbenefits.com, or calling 1-877-848-9997.
Q. Aside from carrying my new Eliance-branded member ID card after April 1, are there other changes I will need to make for my health benefits?
A. No. The transition to Eliance Health Solutions is a behind-the-scenes process. On April 1, please begin using the permanent member ID card with the Eliance logo on it wherever you use your health insurance. You will need to present your new member ID card to your providers, so they have the updated card on file and can submit claims on your behalf. Other than that, the transition will be seamless.
Q. Will the provider networks change on April 1, 2018?
A. No. Employees will have access to the same two tiers of providers as before. To simplify communications, we are now calling the two networks Tier 1 (previously called Top Tier Providers) and Tier 2 (previously called Preferred Providers). Our Tier 1 network includes all of the providers and facilities of LG Health, Penn Medicine and Children’s Hospital of Philadelphia.
Q. Can I search the Find a Provider page on the Eliance Health Solutions website to find a doctor?
A. No. The Find a Provider feature on the Eliance Health Solutions website is for their other clients in the community. As Eliance’s largest client, LG Health has a custom provider network that includes not only all LG Health Physicians practices, but the employed physicians of Penn Medicine and Children’s Hospital of Philadelphia. Please visit LGHealthBenefits.com for a complete list of Tier 1 and Tier 2 providers. Note: our benefits team is working on improvements to make provider searches easier and more convenient for our employees. Our benefits team is working on improvements to make provider searches easier and more convenient for employees.
Q. Why should I choose Tier 1 providers and facilities?
A. As the largest employer in Lancaster County, when LG Health employees receive care within the Penn Medicine LG Health physician network, it keeps us all healthy. When we utilize Tier 1 providers and facilities, we can better contain costs, which helps us to avoid substantial increases in premiums, deductibles and other expenses year to year. The primary care physicians and specialists in our Tier 1 network follow national guidelines for evidence-based care, which means you and your family can participate in our most convenient, cost-effective provider network and never have to compromise on quality. Finally, because our Tier 1 providers and facilities use a shared electronic medical record, it is easy and convenient to see a specialist, schedule screenings and other tests, and manage your health—with all of your providers collaborating seamlessly.