Join Early Retirement Today
Reply
 
Thread Tools Search this Thread Display Modes
United Health may stop offering ACA Exchange plans
Old 11-19-2015, 03:13 PM   #1
Thinks s/he gets paid by the post
 
Join Date: May 2008
Posts: 3,423
United Health may stop offering ACA Exchange plans

UnitedHealth suggests Obamacare is being gamed - MarketWatch

And even suggested that people are gaming the plans by enrolling for special enrollment periods and then submitting claims:

Quote:
In a profit warning that sent its stock down as much as 7% Thursday, UnitedHealth Group Inc. said that not enough people are signing up under the exchanges set up by Obamacare and that it was considering withdrawing from them.

But there was another factor behind the lowered outlook from the nation’s biggest health insurer: people signing up after the open-enrollment period that have higher claims. Or, less charitably—people are gaming Obamacare.

In UnitedHealth’s UNH, -0.25% words: “We have identified higher levels of individuals coming in and out of the exchange system to use medical services.”

This isn’t supposed to happen. There are so-called special enrollment periods, meant to be 60 days following certain life events—marriage, birth of a child, or a loss of health coverage.

Other special periods include moving, gaining citizenship, gaining or losing a dependent, having a change in income or household status that impacts eligibility for tax credits or cost-sharing reductions, and leaving jail.

A spokesman for UnitedHealth acknowledged the issue but didn’t provide more details on how this was occurring or what medical services these out-of-enrollment users sought.
However, some are skeptical that UNH is being victimized by people enrolling just before they use medical services:

Quote:
Cynthia Cox, associate director of health reform and private insurance for the Kaiser Family Foundation, said other insurers haven’t voiced these concerns. She says that it could be the group who takes advantage of special enrollment are more likely to want medical coverage.

“The penalty is the stick that motivates people,” Cox said. “If you don’t sign up for coverage in a short window, not only do you have to pay a penalty, you wouldn’t be able to sign up for another year.”

“Because special enrollment provides an exception to the latter part of the stick, it could be people that want to sign up want that coverage.”

Cox also pointed out that UnitedHealth, after skipping the exchanges the first year, was one of the lowest-cost providers, meaning that it was more susceptible to being pressured on profitability.
It seems insurers stop offering plans on the exchanges but they still try to get people to sign up for plans outside the exchanges. Presumably these are still ACA-compliant but not eligible for subsidies?
__________________

__________________
explanade is offline   Reply With Quote Reply
Join the #1 Early Retirement and Financial Independence Forum Today - It's Totally Free!

Are you planning to be financially independent as early as possible so you can live life on your own terms? Discuss successful investing strategies, asset allocation models, tax strategies and other related topics in our online forum community. Our members range from young folks just starting their journey to financial independence, military retirees and even multimillionaires. No matter where you fit in you'll find that Early-Retirement.org is a great community to join. Best of all it's totally FREE!

You are currently viewing our boards as a guest so you have limited access to our community. Please take the time to register and you will gain a lot of great new features including; the ability to participate in discussions, network with our members, see fewer ads, upload photographs, create a retirement blog, send private messages and so much, much more!

Old 11-19-2015, 03:21 PM   #2
Thinks s/he gets paid by the post
 
Join Date: Feb 2014
Posts: 1,050
UHC has the highest priced plans, by a wide margin, every time I look.
Something doesn't add up with this story.
__________________

__________________
jim584672 is offline   Reply With Quote Reply
Old 11-19-2015, 04:09 PM   #3
Give me a museum and I'll fill it. (Picasso)
Give me a forum ...
Mulligan's Avatar
 
Join Date: May 2009
Posts: 7,380
I must say, I am a bit worried long term. I have read several articles on how people newly introduced to ACA plans have discovered they can afford the insurance but cant afford to use it, and are considering dropping it.
If a significant amount of people find out there is a dozen ways to exempt out of avoiding penalty or just realize they don't even have to pay it. A death spiral could begin.
And I struggle to find a way that government will find a consensus to fix anything on this program if it heads down that path.


Sent from my iPad using Tapatalk
__________________
Mulligan is offline   Reply With Quote Reply
Old 11-19-2015, 04:49 PM   #4
Moderator
MichaelB's Avatar
 
Join Date: Jan 2008
Location: Rocky Inlets
Posts: 24,465
UHC is going to stop offering individual plans on the exchanges? First it would need to start offering them. UHC is not an important insurer on many major individual health care exchanges around the country, and individual policies are not a significant source of revenue for them (I estimate less than 5%).
__________________
MichaelB is offline   Reply With Quote Reply
Old 11-19-2015, 05:02 PM   #5
Give me a museum and I'll fill it. (Picasso)
Give me a forum ...
Mulligan's Avatar
 
Join Date: May 2009
Posts: 7,380
Quote:
Originally Posted by MichaelB View Post
UHC is going to stop offering individual plans on the exchanges? First it would need to start offering them. UHC is not an important insurer on many major individual health care exchanges around the country, and individual policies are not a significant source of revenue for them (I estimate less than 5%).

From news report I heard this morning they are just considering it.


Sent from my iPad using Tapatalk
__________________
Mulligan is offline   Reply With Quote Reply
Old 11-19-2015, 05:05 PM   #6
Give me a museum and I'll fill it. (Picasso)
Give me a forum ...
brewer12345's Avatar
 
Join Date: Mar 2003
Posts: 16,391
If they open access to insurance at non ridiculous premiums goes away, I will be signing up for a cube job again.
__________________
"There are three kinds of men. The one that learns by reading. The few who learn by observation. The rest have to pee on the electric fence for themselves."



- Will Rogers
brewer12345 is offline   Reply With Quote Reply
Old 11-19-2015, 07:04 PM   #7
Thinks s/he gets paid by the post
 
Join Date: Feb 2014
Posts: 1,050
I see this story being touted as "The biggest U.S. health insurer is considering pulling out of Obamacare..." with the implication that UHC is a huge Obamacare insurer. It is an intentional misrepresentation, I mean lie, with the aim to show why the ACA must be repealed. Totally political agenda here.
__________________
jim584672 is offline   Reply With Quote Reply
Old 11-19-2015, 07:07 PM   #8
Thinks s/he gets paid by the post
 
Join Date: May 2008
Posts: 3,423
Well I saw an alert from the CNBC app. on my phone that the market as a whole was down because all health care was down:

"Stocks close mildly lower, health care lags."

So UNH was down a lot and dragged down the rest of the sector? Probably the UNH news was an excuse for profit taking.
__________________
explanade is offline   Reply With Quote Reply
Old 11-19-2015, 07:11 PM   #9
Moderator
ziggy29's Avatar
 
Join Date: Oct 2005
Location: Texas
Posts: 15,612
As far as cost, it's interesting. I'm dealing with sorting through FEHB open enrollment, and several of the lower cost plans with decent but not the best PPO networks actually are through UHC even though the plans aren't *branded* UHC. For example, for postal workers in Texas the GEHA HDHP and the APWU consumer-directed plans are both administered by UHC, and both are among the lower cost plans. Their networks aren't as robust as, say, Blue Cross Standard but they cost a hell of a lot less, too, and they aren't bad.

Not sure why UHC would feel singled out in terms of being "gamed" in the Marketplace arena, though. Others have cut back or eliminated PPO offerings but haven't cried about bailing out completely.

UHC isn't even a really huge player in the Marketplace anyway, at least in a lot of markets.
__________________
"Hey, for every ten dollars, that's another hour that I have to be in the work place. That's an hour of my life. And my life is a very finite thing. I have only 'x' number of hours left before I'm dead. So how do I want to use these hours of my life? Do I want to use them just spending it on more crap and more stuff, or do I want to start getting a handle on it and using my life more intelligently?" -- Joe Dominguez (1938 - 1997)

RIP to Reemy, my avatar dog (2003 - 9/16/2017)
ziggy29 is offline   Reply With Quote Reply
Old 11-19-2015, 07:21 PM   #10
Recycles dryer sheets
 
Join Date: Nov 2015
Posts: 189
UHC most likely doesn't want to fool with the small amount of business that these plans generate for them since they are a group health insuror and probably don't really want to write individual health policies. If they are losing money on that line of business then there is even more reason to dump them. They are not an eleemosynary institution. so they will do what is best for their stockholders and avoid the reporting and compliance issues they most likely have with Marketplace business.
__________________
rdy2go is offline   Reply With Quote Reply
Old 11-19-2015, 07:32 PM   #11
Moderator
ziggy29's Avatar
 
Join Date: Oct 2005
Location: Texas
Posts: 15,612
Quote:
Originally Posted by rdy2go View Post
UHC most likely doesn't want to fool with the small amount of business that these plans generate for them since they are a group health insuror and probably don't really want to write individual health policies. If they are losing money on that line of business then there is even more reason to dump them. They are not an eleemosynary institution. so they will do what is best for their stockholders and avoid the reporting and compliance issues they most likely have with Marketplace business.
Yeah, it's certainly not a core line of business for them, so if they don't think they can make it work, they hit the eject button. Still the reduction in competition is a bit unsettling.
__________________
"Hey, for every ten dollars, that's another hour that I have to be in the work place. That's an hour of my life. And my life is a very finite thing. I have only 'x' number of hours left before I'm dead. So how do I want to use these hours of my life? Do I want to use them just spending it on more crap and more stuff, or do I want to start getting a handle on it and using my life more intelligently?" -- Joe Dominguez (1938 - 1997)

RIP to Reemy, my avatar dog (2003 - 9/16/2017)
ziggy29 is offline   Reply With Quote Reply
Old 11-19-2015, 07:59 PM   #12
Recycles dryer sheets
 
Join Date: Nov 2015
Posts: 189
It will get worse with Anthem and CIGNA merging and Aetna and Humana going together. They will have more market clout to squeeze the doctors fees and more political power to buy their congressional support. I don't want to make this political, but I believe the administration would like to force the country into a single payer system and the largest surviving health insurors will get paid to administer that system.
__________________
rdy2go is offline   Reply With Quote Reply
Old 11-19-2015, 08:39 PM   #13
Moderator
ziggy29's Avatar
 
Join Date: Oct 2005
Location: Texas
Posts: 15,612
Quote:
Originally Posted by rdy2go View Post
It will get worse with Anthem and CIGNA merging and Aetna and Humana going together. They will have more market clout to squeeze the doctors fees and more political power to buy their congressional support. I don't want to make this political, but I believe the administration would like to force the country into a single payer system and the largest surviving health insurors will get paid to administer that system.
Look, the politics could go either way. Yes, there are concerns about how the ACA will mature. And it's easy to spin...err, interpret news to either say we need to return to pre-ACA status quo or go to single payer or some such. Both sides have their agenda and their spin. But we play the hand we are being dealt now. I share concern about mergers and reduced competition. But for now it's all speculation.

I don't think it's helpful to get into the political what-might-be; that will just derail a thread that is relevant to many of us.
__________________
"Hey, for every ten dollars, that's another hour that I have to be in the work place. That's an hour of my life. And my life is a very finite thing. I have only 'x' number of hours left before I'm dead. So how do I want to use these hours of my life? Do I want to use them just spending it on more crap and more stuff, or do I want to start getting a handle on it and using my life more intelligently?" -- Joe Dominguez (1938 - 1997)

RIP to Reemy, my avatar dog (2003 - 9/16/2017)
ziggy29 is offline   Reply With Quote Reply
Old 11-19-2015, 08:46 PM   #14
Thinks s/he gets paid by the post
zinger1457's Avatar
 
Join Date: Jul 2007
Posts: 1,452
For next year I only have two providers to choose from in ACA, United Healthcare and BCBS, and BCBS dropped all their PPO plans next year. If United Healthcare leaves it's going to be very slim pickings.
__________________
zinger1457 is offline   Reply With Quote Reply
Old 11-19-2015, 09:46 PM   #15
Give me a museum and I'll fill it. (Picasso)
Give me a forum ...
audreyh1's Avatar
 
Join Date: Jan 2006
Location: Rio Grande Valley
Posts: 16,476
7 of the 22 plans available to me (no subsidy) are from UnitedHealthcare according to the eHealth site.

Does that mean UnitedHealthcare is pulling these plans now?

Why would UnitedHealthcare talk about dropping ACA offerings during open enrollment?
__________________
Well, I thought I was retired. But it seems that now I'm working as a travel agent instead!
audreyh1 is online now   Reply With Quote Reply
Old 11-20-2015, 04:50 AM   #16
Thinks s/he gets paid by the post
 
Join Date: May 2008
Posts: 3,423
Another article, with an analyst alleging $2.5 billion in losses in ACA products and allegations of people signing up for a few months to get benefits and then dropping out without paying penalties.

UnitedHealth move a 'wake-up call' for the White House: Analyst

What benefits can you get in 3 or 4 months? Maybe if you sign on for a plan with very low deductibles but the premiums for those plans would be very high.

It wouldn't make sense to enroll for only 3-4 months for say a Bronze plan, which has $5000 in deductibles? Only benefit you get without meeting the deductible would be preventive care, the annual physical exam?

It would be cheaper to pay out of pocket for that versus paying. 3 months of deductibles, unless you're like 23 years old or something.
__________________
explanade is offline   Reply With Quote Reply
Old 11-20-2015, 06:27 AM   #17
Thinks s/he gets paid by the post
 
Join Date: Mar 2011
Posts: 3,705
Quote:
Originally Posted by MichaelB View Post
UHC is going to stop offering individual plans on the exchanges? First it would need to start offering them. UHC is not an important insurer on many major individual health care exchanges around the country, and individual policies are not a significant source of revenue for them (I estimate less than 5%).
The free market has a nice way of filtering out the noise, half-truths and emotion. Time will tell whether UHC is the canary in the coal mine or just another distraction.
__________________
Living well is the best revenge!
Retired @ 52 in 2005
marko is online now   Reply With Quote Reply
Old 11-20-2015, 06:46 AM   #18
Moderator
MichaelB's Avatar
 
Join Date: Jan 2008
Location: Rocky Inlets
Posts: 24,465
Quote:
Originally Posted by audreyh1 View Post
7 of the 22 plans available to me (no subsidy) are from UnitedHealthcare according to the eHealth site.

Does that mean UnitedHealthcare is pulling these plans now?

Why would UnitedHealthcare talk about dropping ACA offerings during open enrollment?
No, 2016 plans are in the exchange and cannot be withdrawn. Any change would have to be effective in 2017 or later.

Quote:
Originally Posted by explanade View Post
Another article, with an analyst alleging $2.5 billion in losses in ACA products and allegations of people signing up for a few months to get benefits and then dropping out without paying penalties.

UnitedHealth move a 'wake-up call' for the White House: Analyst
Here's a different credible source reporting the insurers have done well in 2015 with their ACA compliant individuals policies. It breaks down the detail into on and off exchange plans, which sheds some insight into why insurers may be cutting back on some policies.

Comparing Individual Health Coverage On and Off the Affordable Care Act’s Insurance Exchanges - The Commonwealth Fund

There is no announcement of this change at the UHC website. edit to add:
Another link, this time to the NYT, with additional information. The one detail the Times adds is that "Risk Corridor" payments are being made at a rate lower than requested by the insurers, this may be a motive for UHC.

http://www.nytimes.com/2015/11/20/bu...ales.html?_r=0

UHC does not break out detail of individual policies in its financial statements, so there is no way to know what is causing the challenges in profitability. No reason for us to be any less skeptical here than with any other media or financial indistry claim.
__________________
MichaelB is offline   Reply With Quote Reply
Old 11-20-2015, 07:24 AM   #19
Give me a museum and I'll fill it. (Picasso)
Give me a forum ...
easysurfer's Avatar
 
Join Date: Jun 2008
Posts: 7,891
Quote:
Originally Posted by zinger1457 View Post
For next year I only have two providers to choose from in ACA, United Healthcare and BCBS, and BCBS dropped all their PPO plans next year. If United Healthcare leaves it's going to be very slim pickings.
Already slim pickings for me as my doc is not in UHC's network.

I think PPO plans on the individual market are going away like free pillows and snacks on an airline flight.
__________________
Have you ever seen a headstone with these words
"If only I had spent more time at work" ... from "Busy Man" sung by Billy Ray Cyrus
easysurfer is online now   Reply With Quote Reply
Old 11-20-2015, 07:26 AM   #20
Full time employment: Posting here.
 
Join Date: Jan 2014
Posts: 662
Quote:
Originally Posted by audreyh1 View Post
7 of the 22 plans available to me (no subsidy) are from UnitedHealthcare according to the eHealth site.
Those not eligible for subsidies can purchase off-exchange plans. UHC will still offer off-exchange plans if they decide to exit the 2017 exchanges.

Quote:
Originally Posted by audreyh1 View Post
Does that mean UnitedHealthcare is pulling these plans now?
No, it was a conference call where management said they will spend the first half of 2016 "evaluating" their participation/non-participation on the 2017 exchanges. UHC has 550,000 on-exchange policyholders, or about 5% of the market.

Quote:
Originally Posted by audreyh1 View Post
Why would UnitedHealthcare talk about dropping ACA offerings during open enrollment?
It was a conference call due to a change in earnings expectations. Securities and Exchange (SEC) regulations for public companies with shareholders requires companies to disclose information impacting earnings in a timely manner.

Quote:
Originally Posted by MichaelB View Post
No, 2016 plans are in the exchange and cannot be withdrawn. Any change would have to be effective in 2017 or later.

There is no announcement of this change at the UHC website.
Correct. There is no change at this time. They are only evaluating their future participation.
__________________

__________________
MBSC is offline   Reply With Quote Reply
Reply


Currently Active Users Viewing This Thread: 1 (0 members and 1 guests)
 
Thread Tools Search this Thread
Search this Thread:

Advanced Search
Display Modes

Posting Rules
You may not post new threads
You may not post replies
You may not post attachments
You may not edit your posts

BB code is On
Smilies are On
[IMG] code is On
HTML code is Off
Trackbacks are Off
Pingbacks are Off
Refbacks are Off


Similar Threads
Thread Thread Starter Forum Replies Last Post
ACA Exchange Dental Plans for 2015 FUEGO Health and Early Retirement 6 11-15-2014 09:53 PM
Stop Stop Scrounging for Income and Sell Some Stocks clifp FIRE and Money 88 12-27-2013 08:17 AM
United Healthcare Stops Offering Insurance to Children dgoldenz FIRE Related Public Policy 30 05-06-2010 09:50 AM

 

 
All times are GMT -6. The time now is 07:37 PM.
 
Powered by vBulletin® Version 3.8.8 Beta 1
Copyright ©2000 - 2017, vBulletin Solutions, Inc.