Rochester’s Excellus BlueCross BlueShield on Friday reported a 43 percent decline in net income for 2020. The health plan also reported its top three executives’ salaries, which totaled nearly $6 million last year.
In fiscal 2020, the health plan reported $6.2 billion in premium revenue, with net income of $97.2 million, a $73.6 million decline from $170.8 million in 2019. The full-year results amount to a net income of $68.40 per member for the entire year, down from $113.87 per member in 2019.
“No one has ever faced a year like 2020,” Booth said in a statement. “The COVID-19 crisis required a strong and comprehensive response to assure our members were able to receive the care they needed and to help assure the health care system itself would survive. The pandemic devastated the economy and sickened tens of thousands of upstate residents.”
Booth noted that the organization took concrete steps to help members, provider partners, employer groups and brokers cope with the challenges created by COVID-19.
“We also reached out to local community organizations with financial support and resources to help them address real community needs,” he added.
During 2020, Excellus BCBS addressed the community needs resulting from the COVID-19 pandemic through financial support including:
• $102 million to pay for increased telemedicine coverage and increased provider reimbursement rates;
• More than $40 million in cash advances to providers approved beyond the normal $192 million in advances;
• $1 million in grants to hospitals for COVID-19 testing supplies and personal protective equipment;
• $250,000 in grants to hospitals for COVID-19 testing machines;
• $1.5 million in grants and sponsorships for locally-based health-related initiatives;
• $51 million to cover the cost of suspending prior authorization reviews, clinical editing programs and claim filing requirements;
• $3 million to cover the mandated increase in reimbursement for COVID-19 hospital admissions;
• $600,000 in grants to community-based food banks and pantries;
• $50,000 to support local domestic violence prevention organizations;
• $30,000 in grants to local diaper banks;
• $17.6 million in medical premium refund credits to large employers;
• $3.4 million in dental premium refund credits to employers; and
• $200,000 in grants for “return-to-work” kits for employers.
Total membership in the health plan grew by more than 13,000 during 2020, the fourth consecutive year membership has grown. Excellus BCBS has a total membership of 1.5 million. More than 95 percent of the Upstate New York population has some form of health coverage by private insurance or government-sponsored programs according to the latest reported figures from the U.S. Census Bureau.
Last year, Excellus BCBS’ rate increase request for 2021 in the individual market was 87 percent lower than the state average of all insurers and its rate increase request for small groups was 61 percent lower than the state average, the nonprofit organization noted.
“For the past four years, the health plan’s rate adjustments in the individual and group markets were far below the state average requests by other health plans,” Booth said.
Last year, Booth earned $3.26 million, while Chief Administrative Officer and General Counsel Stephen Sloan earned $1.41 million. The health plan’s Chief Financial Officer Christopher Gorecki’s salary was $1.1 million in 2020, according to the report. Booth is slated to retire on May 1. He will be succeeded by James Reed, regional president in the Central New York market.
Excellus BCBS paid $530.5 million in federal and state taxes in 2020, including $112 million for the federal tax to pay for the Affordable Care Act. The company’s reserves were $1.2 billion at the end of 2020, or the equivalent of 70 days of claims and expenses.
“The health plan spent more than $5 billion, or an average of $14.2 million every day, covering the health care cost for our 1.5 million members,” Gorecki said.
The federal government’s latest quality ratings have awarded the Medicare Advantage programs from Excellus BCBS with some of the highest ratings in the state, officials said. Medicare awarded the organization with 4.5 stars out of a possible 5-star rating for its Medicare Blue Choice HMO plans and its Medicare PPO plans. For the fifth year in a row, the Medicare Part D prescription drug plan from Excellus BCBS received a 5-star rating, the highest rating possible.
“This continues to be a well-run health plan and the company’s performance reflects that,” said Marianne Gaige, chairwoman of the health plan’s board of directors. “As a taxpaying nonprofit, our business helped our communities through the pandemic and assured members of access to coverage. We continued to offer competitively priced health plans and those products were recognized for their high quality. We also achieved a financially responsible margin to assure the company continues as a major partner for health care providers and a major employer in upstate New York.”
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