Just as Congress works to pass health reform that would give insurance companies tax dollars to help consumers pay for coverage, the nation's largest medical insurer said it would exit the Texas and Illinois market, leaving behind more than 400,000 customers.

WellPoint Inc., which operates locally as UniCare, said it will exit Texas and Illinois, where it has about 400,000 members, in an effort to focus on its other U.S. operations. WellPoint said the subsidiary is profitable, but "there are competitive pressures in Illinois and Texas that have made it increasingly difficult for UniCare to offer quality products that are competitively priced."

The health bill "is a moving target, and this decision is a strategic one that was made independent of any health reform legislation," WellPoint spokesman Tony Felts said. "It is a small plan competing against much larger plans and, therefore, it was increasingly difficult for us to compete in that market."

WellPoint said its Illinois UniCare customers would be guaranteed coverage if they transition to Health Care Service Corp., parent of Blue Cross and Blue Shield of Illinois, the state's largest insurer, with more than 7 million members.

WellPoint also plans to reduce its 680-person UniCare work force in Chicago next year, but could not say how many would be let go.

Some other disadvantages is that the customers most likely will be paying more for their health insurance unless they do their part in shopping around for an alternative plan.   Customers should always shop the plans when they either move, transfer or make any changes in their families health coverage.

There is no guarantee that UniCare members will get medical coverage at the same price after the transition. Customers will have until Dec. 1 to decide whether to accept the Blue Cross coverage -- a proposition that worries some UniCare subscribers.

"I am a UniCare customer and I've been turned down for coverage by Blue Cross Blue Shield of Illinois before, so I'm concerned that Blue Cross will use this as an opportunity to deny coverage based on pre-existing conditions," said Ray Valek, 52, of La Grange, a writer and public relations consultant who has coverage for himself, his wife and his two daughters.

Illinois Department of Insurance Director Michael McRaith said his office took steps to address concerns, approving language in letters outlining UniCare member protections from being denied coverage. UniCare members in Illinois must choose Blue Cross under terms of its agreement to offer "replacement coverage."

"UniCare policyholders will be able to enroll in Blue Cross and pre-existing conditions will not be applied," McRaith said. "The law requires they be offered ... similar, if not identical, coverage."

There may be price differences that could cost Illinois UniCare members more should they choose Blue Cross, the state and the health plans said. They could not say what these price increases might be.

"We know these groups and individuals have a choice to accept our offer," said Pat Hemingway Hall, chief executive of Chicago-based Health Care Service. "Our goal is to make the transition as seamless as possible for UniCare policyholders. We want to earn and keep their business."

Customers should call a licensed insurance expert to learn some of the key differences about the different plans that carriers are offering. 
 

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