Humana contemplating pullout of some markets next year

[MichaelB]

I agree with what you say, but I'm not as confident as you are about the long term scenario.BCBS has no individual plans in MN in 2017. They have been my insurer of choice for almost 40 years.I still have my group small business plan, but will have 2017 income that would get me some assistance with premiums. So even the off exchange third are being affected by this. I can either stay with the small business deductible premium or go the ACA route and switch carriers, that is until I don't have one to choose from. What I can't do is change anything and still be BCBS, at any cost. They don't want me.

I would go with the national pool which makes area cherry picking impossible but I don't get to decided how it works.

The only thing I know about this is what I read, most of which is linked here. No doubt the decision by BCBS Minnesota is tough - I feel bad for people there in their individual PPO network. They are not a national insurer - BCBS is mostly separate state businesses with a common link and reciprocation agreements. The MN Bluecard network still works for people in other states.

This leads me to conclude that they would continue if they could, and they can't get the authorization to increase the price to where they need it.

 

[explanade]

It'll be interesting to see if some of these insurers go back to the exchanges at some point.

 

[MBSC]

BCBS has no individual plans in MN in 2017.

While BCBS-MN will no longer offer its PPO products on the individual market in 2017 its subsidiary will continue to offer the Blue Plus HMO products on the individual market.

Blue Cross and Blue Shield of Minnesota, has decided to stop selling health plans to individuals and families in Minnesota starting next year. The insurance carrier will continue to sell a more limited offering on the individual market through its Blue Plus HMO.

Although Blue Cross Blue Shield is leaving the individual market, its much smaller subsidiary, Blue Plus, will continue to offer plans on the individual market, according to the company statement.

Reference: https://www.mprnews.org/story/2016/06/24/blue-cross-blue-shield-individual-insurance-market

Minnesota’s largest health insurer is minimizing its individual plan offerings, so much so that all family and individual preferred provider organization, or PPO, plans no longer will be in effect after Dec. 31. Restricting its presence in the individual market solely to Blue Plus HMO.

“They are not exiting the individual market entirely,” Ed Haislmaier, a senior research fellow at The Heritage Foundation, told The Daily Signal, but simply shifting to narrow network plans that reimburse only for specific doctors and hospitals.

Because the Blue Plus HMO plan restricts members to coverage solely at certain health care providers, issues could arise in rural communities where covered care is not offered in the immediate area.

Reference: Blue Cross of Minnesota Diminishes Under Obamacare

 

[ivinsfan]

While BCBS-MN will no longer offer its PPO products on the individual market in 2017 its subsidiary will continue to offer the Blue Plus HMO products on the individual market.

Reference: https://www.mprnews.org/story/2016/06/24/blue-cross-blue-shield-individual-insurance-market
Reference: Blue Cross of Minnesota Diminishes Under Obamacare

Correct, I am in a very rural county and this HMO won't work for me... which is why I stated I have to stay in my off subsidy group plan .Blue Plus is a BCBS spin-off correct? This info might help someone else.

 

[ShokWaveRider]

We use the HMO here is Florida, it worked so far for us this year. We only had to buy extra when we left the country for a week.

 

[Texas Proud]

One of the things that I read was that almost all of the insurers are making big money on the expanded Medicaid... they are not leaving that market...


So, it is very easy for the Fed gvmt to say.... if you want our Medicaid business you have to offer plans in the market... that would then make a number of them change their mind on what to do...

 

[GTFan]

The lack of exchange plans means they can buy insurance on the open market.

Anyone can buy open market, ACA-compliant plans today. We had two of them with Humana last year and they were the exact same cost/bennies as their ACA plans.

But the real question is what happens with subsidies, cost-sharing etc. when there are no exchange plans in a county? Sucks to be you?

We're going to get there soon if pressure is not exerted on these insurance companies, and/or the gov't. steps in to fix the issues preventing one or more of them from offering plans. As long as the ACA is the law of the land steps need to be taken to preserve the markets.

Heard an interview on NPR with a Georgia health policy guy about the ACA yesterday (wrt Aetna pullout here), he said that the government is counting on penalties to increase signups for 2017 and encourage insurers to stay in. Maybe that will happen if coupled with premium increases and more risk-sharing by the gov't. But sticks usually don't work as well as carrots, and right now it costs way more carrots for policies than it does to avoid the IRS stick.

 

[Mulligan]

The "stick" is actually a pillow.... The masses will figure out the enforcement of the penalty is confiscating any refund you may have had coming or a mean nasty little letter no more dangerous than the pillow itself. This in realty are the punishments; if you say, "Go pound sand, I am not paying".
http://www.forbes.com/sites/kellyph...opting-out-of-the-obamacare-tax/#3e9a02e94424



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[NW-Bound]

Anyone can buy open market, ACA-compliant plans today. We had two of them with Humana last year and they were the exact same cost/bennies as their ACA plans.

But the real question is what happens with subsidies, cost-sharing etc. when there are no exchange plans in a county? Sucks to be you?

We're going to get there soon if pressure is not exerted on these insurance companies, and/or the gov't. steps in to fix the issues preventing one or more of them from offering plans. As long as the ACA is the law of the land steps need to be taken to preserve the markets...

I think the law requires insurers to charge the same premiums if the same plans are offered inside and outside the exchange. They can offer some plans exclusively outside the exchange with different benefits (and premiums). However, I understand that they have to keep all their clients in a single risk pool.

It looks like my insurer United Healthcare is getting out of individual health insurance all together. They will operate only group insurance plans such as those offered by employers.

 

[audreyh1]

We got a notice from Humana in September, and another this week notifying us that our insurance plan will not be available in 2017. They didn't offer any alternative options from Humana - just general information about where to go look for insurance. So clearly they've pulled out of the TX individual insurance market.

It looks like BCBS HMO will be our best option, and unfortunately no more options that are HSA compatible.

Last year I really panicked when BCBS dropped their PPO plans and planned to switched us to the only available HMO options. I hadn't foreseen such a move by a major insurance co in TX. This year my reaction is more sanguine. I mean - it's completely out of my hands. We just have to buy what we can and hope for the best. DH is at least only 3.5 years away from Medicare. Me - I've 8 years to go.

 

[GTFan]

I got the same notice last week but I'm not sure if it means that Humana won't offer plans here, it might be that they're canceling current plans in favor of new ones. I believe they are still offering ACA coverage in the ATL next year (with a huge 67.5% rate increase) but we'll see in a few weeks.

Fortunately we'll still have a few other providers here including Kaiser, which is not going anywhere as far as I can tell. But if more people have to shift to them and they incur losses as a result, who knows.