WellPoint subsidiary drops coverage in Illinois, Texas

UniCare says it couldn't get enough market share. Members can opt for comparable insurance with Blues plans in both states.

By Emily Berry — Posted Nov. 13, 2009

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Indianapolis-based WellPoint is sending about 400,000 of its non-Blue membership to BlueCross BlueShield-affiliated plans owned by another company, citing an inability to win enough market share to serve those members efficiently.

The members belong to WellPoint's national UniCare subsidiary but are not in one of the 14 states in which it owns Blues plans. The company reported 33.9 million members before the announcement.

"In markets where we are Blue, we see the advantage of our scale; we see the advantage of our market depth. And that was a challenge for us in Illinois and Texas," said WellPoint President and CEO Angela Braly.

Affected UniCare members can opt to move to Blues plans, which in both states are owned by Health Care Service Corp.

HCSC, based in Chicago, has about 4.4 million members in Illinois and 7.2 million in Texas, said company spokesman Ross Blackstone. HCSC also owns the Blues plans in Oklahoma and New Mexico. Members who move are guaranteed comparable coverage without consideration of preexisting conditions.

The move will include only commercial membership in the two states; customers with Medicare plans and other products sold by UniCare will not be affected.

Physicians in Illinois and Texas who serve UniCare members should send claims to UniCare through the end of the year, then to the Blues after members switch at the beginning of 2010, Blackstone said.

After the switch, reimbursement rates will be under the Blues' fee schedule. Any doctors who are in UniCare's network but not the Blues' will be considered out-of-network and reimbursed accordingly, Blackstone said.

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