Aetna CEO: Health Insurers Face Extinction

[AllenChicago]

If they don't have a bank account (checking, savings) they probably don't have a credit card either.

Oh well.

Homeless Jerry could get a $500 credit limit Master Card from __rch___ Bank with a 40% interest rate. Instant online approval and card number sent to e-mail address. Jerry buys an ObamaCare policy this month, gets his hip replacement next month and some therapy during the 60 day grace period before the policy lapses.

Over the past 5 years, there's been a rapidly growing number of professional "system gamers", for some reason.

 

[somarco]

gets his hip replacement next month and some therapy during the 60 day grace period before the policy lapses.

90 day grace period.

Suh-weet!

 

[AllenChicago]

90 day grace period.

Suh-weet!

Homeless Jerry will have full Platinum coverage for 120 days after his first month's premium payment?!?! Oh my! That gives him time to get a full physical, some medical marijuana and new teeth as well.
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All of this will add greatly to the costs.

1. Can HHS, CMS, IRS, etc. keep pumping out rules and mandates that add expenses to Exchange insurers after these Marketplaces go "live" on October 1st?

2. Can an Exchange insurer increase the new business premiums AS NEEDED, AT ANY TIME, after purchasing starts on October 1st?

If the answer to question #1 is YES, I hope the answer to #2 is YES also, or else agents can kiss commissions good-bye, followed a few months later by the public kissing their health insurance good-bye.

 

[xrac]

Homeless Jerry will have full Platinum coverage for 120 days after his first month's premium payment?!?! Oh my! That gives him time to get a full physical, some medical marijuana and new teeth as well.
- - - - - - - - - - - - - - - - - -


1. Can HHS, CMS, IRS, etc. keep pumping out rules and mandates that add expenses to Exchange insurers after these Marketplaces go "live" on October 1st?

2. Can an Exchange insurer increase the new business premiums AS NEEDED, AT ANY TIME, after purchasing starts on October 1st?

If the answer to question #1 is YES, I hope the answer to #2 is YES also, or else agents can kiss commissions good-bye, followed a few months later by the public kissing their health insurance good-bye.

The people who drew up this legislation (1)either have no clue how these things work or (2)have plotted the demise of our healthcare system. Unfortunately, I think it is number two aided and abetted by lawmakers too lazy and too out of touch who didn't even read what they were making into law.

 

[kahlestyle]

1. Can HHS, CMS, IRS, etc. keep pumping out rules and mandates that add expenses to Exchange insurers after these Marketplaces go "live" on October 1st?

2. Can an Exchange insurer increase the new business premiums AS NEEDED, AT ANY TIME, after purchasing starts on October 1st?


1 yes but with much political difficulty
2 no

 

[somarco]

On a state by state basis, carriers can raise rates as needed. New rules under Obamacare prevent carriers from having different rates for new biz vs existing. No more sucker rates for new biz while clobbering existing block.

I would not be surprised to see a mid 2014 adjustment by some carriers or possibly 3rd quarter.

If carriers are getting killed on loss ratio some could withdraw from the exchange.

 

[harbinger]

Are you sure individual exchange business carriers can change rates in the middle of the year?

I thought they were pretty much stuck with those rates until 1/1/2015 with their options being to either exit the market or eat losses until the 2015 rates take effect (and hope they noticed the bad experience early enough in 2014 for it to impact 2015 pricing, since they'll only have 1-2 months of post 2014 data by the time 2015 rate filings are due).

 

[russelltw]

Not sure about the rate changes, but I know the federal government will be subsidizing the losses on the book of business until 2018. When 2018 arrives, we will see who know what they were doing and who did not. That's about when I expect commissions to go down the drain...

 

[somarco]

The Obamacare reinsurance is pro-rated with more $$ flowing to carriers that write the lions share. Carriers like Blue will get more reinsurance $$ just because and more or less irrespective of their loss ratio.

Reinsurance typically does not pay out until 90 - 180 days after closing the plan year which means 2nd or 3rd quarter 2015.

Carriers that are monitoring and trending their block will know long before then if they need an adjustment or not.

I really don't expect carriers, other than possibly BX, to be particularly aggressive in their pricing.

The higher priced carriers on the exchange and those who only write off-exchange will benefit more than the ones that go all out.

In GA only BX will offer statewide plans. The others have staked out zips and counties where they will operate and screw the rest of the state.

 

[AllenChicago]

The Obamacare reinsurance is pro-rated with more $$ flowing to carriers that write the lions share. Carriers like Blue will get more reinsurance $$ just because and more or less irrespective of their loss ratio.

Reinsurance typically does not pay out until 90 - 180 days after closing the plan year which means 2nd or 3rd quarter 2015.

Carriers that are monitoring and trending their block will know long before then if they need an adjustment or not.

I really don't expect carriers, other than possibly BX, to be particularly aggressive in their pricing.

The higher priced carriers on the exchange and those who only write off-exchange will benefit more than the ones that go all out.

In GA only BX will offer statewide plans. The others have staked out zips and counties where they will operate and screw the rest of the state.

The government funded start-up cooperatives will have aggressive pricing, but the physician reimbursement will be pitiful and the network size even pitifuller. I think there are 24 cooperatives being designed for 24 states.

The Illinois Coop, Land of Lincoln Health Cooperative appears to be having trouble paying it's website hosting bill. Ref: Migration Information Bodes well for their success at paying millions $$$ in claims doesn't it?
-ac