Like I said in a previous post, Regence of Oregon's enforced switching of individual health insurance policies to their new "Evolve" plans is bad news for members.
Benefits are reduced considerably, while premiums are rising for many families, since each child now has to be on a separate policy. The Evolve plans' individual premiums for my wife and myself would only be a bit higher, but we were seriously disturbed by the benefit reductions.
For example, the Regence Evolve Core plan only covers a maximum of $1,000 a year for prescription drugs. We're pretty sure that our current "Blue Selections" plans have no limit. My wife, Laurel, noticed that the Regence Evolve Plus plan has a prescription drug benefit that covered a maximum of $4,500 a year, albeit with a $500 a year deductible.
However, the letter she got from Regence informing her of the changeover to Evolve plans said that she'd be switched to the Evolve Core plan, as this most closely matched her current policy.
Download Regence of Oregon new plan comparison
When she phoned Regence to ask about getting the Evolve Plus plan, at first she was told that this wasn't possible since Plus had greater benefits. Thus she'd need to fill out an application for an entirely new policy, which would be subject to underwriting and almost certainly rejected because of her pre-existing conditions.
Laurel argued with the Regence employee, saying, entirely accurately, that the switch to either Evolve plan amounted to a reduction in benefits from what her current Blue Selections plan offers. So how could moving to Evolve Plus be viewed as a benefit increase?
She didn't get anywhere with that argument. Reason and logic don't get much respect in the health insurance industry. Nor does the adage, "the customer is always right."
Overhearing Laurel's conversation -- her side of it, at least -- I could tell that it wasn't going anywhere productive. The Regence employee was stonewalling her request to be switched to the Evolve Plus plan, whose only redeeming quality was that it was somewhat less crappy than the Evolve Core plan Regence intended to move her to.
Then I had a good idea.
I picked up the "Important Notice of Benefit Plan Replacement" that had come in the mail from Regence. I dropped it in Laurel's lap while she was still on the phone with the Regence employee. I pointed at a section and whispered "read that to her."
Download Regence Evolve letter
What if I want a plan other than the one that was chosen for me? We've enclosed a plan summary comparison so can compare your current coverage with all our new plans. If you find another plan that's better for you and the deductible amount is the same as or more than the plan we chose for you, complete the enclosed Plan Change Reguest Form and return it by June 1, 2010.
The woman Laurel was talking to asked her to wait on the line while she consulted a supervisor. A few minutes later she told Laurel that Regence would stand behind what was said in the letter, even though it supposedly wasn't accurate.
So anyone who is being switched to the Evolve Core plan can choose the Evolve Plus plan instead. No complicated application required. All you need to do is check a few boxes and make sure you're requesting an Evolve Plus plan with the same or larger deductible as you have now.
The enforced switchover to the reduced benefit Evolve plans still sucks, for reasons I cited before. But the Evolve Plus plan sucks less than the Evolve Core plan, especially for people who have substantial prescription drug expenses.