Florida Blue making a profit in the marketplace

[audreyh1]

Sorry if I touched a nerve. No idea how it is controversial. I intentionally don't keep up with the goings on with the current health insurance goings on.

I think it's just that it's too early to feel confident about guaranteed issue (and no price penalty) for pre-existing conditions.

Current law may say that, but current law could change. So, personally, I don't feel like it's a sure thing.

 

[Hdhead]

We moved to FL this year after retirement. Still maintain a home in WI also all our doctors are in WI. Went with a Blue Select bronze HSA plan with national coverage. We are 63/61. $1400 month before subsidy, $6350 deductible per person. Very pricey in my opinion.

 

[MBSC]

Florida Blue has confirmed its participation in the 2018 individual market.

Florida Blue, the state’s largest health insurer, will remain in the individual market for 2018 and offer plans this fall in all 67 counties on the Affordable Care Act's marketplace platform.

The company did not say what premium increases it will seek when it notifies the state of its intentions later this month. But Pizzo said the company will base its premium price requests on the assumption that the administration will leave in place what are known as cost-sharing reduction (or CSR) payments to insurers. Without them, Florida Blue estimates that premiums for individual market plans would jump about another 20%.

Reference: https://www.usatoday.com/story/mone...remain-individual-insurance-market/388073001/

 

[simple girl]

Thank you for the update!!!

 

[GTFan]

The CSR subsidies are still the biggest elephant in the room. Lots of uncertainty and market chaos until that gets resolved.

 

[pb4uski]

But Pizzo said the company will base its premium price requests on the assumption that the administration will leave in place what are known as cost-sharing reduction (or CSR) payments to insurers. Without them, Florida Blue estimates that premiums for individual market plans would jump about another 20%.

Why would that be? As I understand it, what Florida Blue pays for claims will be the same whether cost sharing reductions are paid to insurers or not... in other words, if cost sharing reductions are not in place then customers would end up paying more for deductibles. I don't have CSR but I just don't understand why the lack of CSR would cause a change in premiums (other than perhaps less people will buy insurance if there is no CSR).

 

[MichaelB]

Why would that be? As I understand it, what Florida Blue pays for claims will be the same whether cost sharing reductions are paid to insurers or not... in other words, if cost sharing reductions are not in place then customers would end up paying more for deductibles. I don't have CSR but I just don't understand why the lack of CSR would cause a change in premiums (other than perhaps less people will buy insurance if there is no CSR).

The way it is phrased, the CSR is acting like a subsidy, and if it is removed, the premium would need to increase as an offset. The logic is convoluted (but so is everything else when it comes to health care and insurance).

 

[Blue Collar Guy]

Im sure if i move to Florida the rates will skyrocket. Now that im retired im a hypochondriac. I got to 1 doctor and the next thing i know im going for 3 tests , multi authorizations, mri, cat scans, blood tests. Im crying about the co-pays. Imagine what the premiums would be to pay these bills.

 

[MBSC]

Why would that be? As I understand it, what Florida Blue pays for claims will be the same whether cost sharing reductions are paid to insurers or not... in other words, if cost sharing reductions are not in place then customers would end up paying more for deductibles.

Federal regulations would still require the insurer to reduce the enrollee's portion of cost sharing but the remaining portion would no longer be gov't funded. It becomes an "unfunded mandate" where the insurer has to find another way to cover the cost sharing...by raising premiums.

The regulations do not go away just because the funding goes away.

 

[pb4uski]

So what they pay for claims would go up because they are not getting paid by the government. Got it.