November 1 is the first day of open enrollment for ACA plans. Affordable Care Act updates for 2017 are significant. Julie McPeak serves as the State of Tennessee’s Commissioner of Commerce and Insurance. On August 23, 2016, Ms. McPeak announced that she was approving significant rate hikes in the Affordable Care Act’s insurance exchange. McPeak told The Tennessean that the exchange market in Tennessee was very near collapse.
“I would characterize the exchange market in Tennessee as very near collapse…and that all of our efforts are really focused on making sure we have as many writers (carriers) in the areas as possible, knowing that might be one. — I’m doing everything I can to prevent a situation where that turns to zero.” – Julie McPeak in interview with The Tennessean’s Holly Fletcher. 08/25/2016.
Earlier in the year, UnitedHealthcare announced that they were dropping out of the exchange in Tennessee. Noting this effect on the State, McPeak allowed Cigna, Humana and BlueCross-BlueShield of Tennessee to refile their respective rates. Rate hikes varied from 44% up to 62% increases.
On Monday, September 26, BCBS announced that it was dropping ACA plans in three major Tennessee geographic regions; Memphis, Nashville, and East Tennessee including Knoxville. A total of 29 counties in all, affecting over 100,000 participants, would not have BCBST Plans made available for 2017.
“Because of many challenges, we have made the difficult but necessary decision to end coverage in three regions for 2017 – the Memphis, Nashville, and Knoxville regions…we’re disappointed in this development…” — BlueCross-BlueShield
In a letter to affected customers, BCBST stated the “Individual/Marketplace plan members had more health needs than we (BCBS) anticipated and a result, there is a significant gap between what we charge and what we pay out for medical care. We’ve lost almost $500 million on ACA plans since 2014. Other potential issues with the law could make the cost gap even worse in the future….Even though BlueCross won’t offer Individual/Marketplace health plans in your area, you may still have options for coverage next year. You can visit www.healthcare.gov or contact a licensed insurance broker for help making the right choice for your needs.” — Scott Pierce, Chief Operating Officer; BCBS
Nancy Amons with Nashville’s local NBC affiliate WSMV, reported on September 26, that in areas where BCBS continues offering coverage, four plan types will be offered: on Bronze, two Silver and one Gold, all featuring Network S. Network E will no longer be available in any region of Tennessee, according to Amons’s report.
HealthTN will be offering solutions for the Affordable Care Act clients in 2017. Due to significant rate increases and carriers pulling out of some areas, changes in plans and coverage is inevitable for many. And deductibles and out of pocket cost continues to increase and shift more risk and costs to the consumer.
Every customer and situation are different. While you do not have to qualify for coverage under ACA, your health history and past utilization of health insurance benefits will be key factors in which product or coverage is best suited to you. Always remember to consider value over price when choosing your health insurance benefits.
HealthTN will offer a Minimum Essential Coverage (MEC) plan that is ACA compliant and members will avoid the penalty for not having health insurance coverage. Pairing this MEC plan with other additional benefit plans may save our customers valuable dollars.