Buying and Selling Across State Lines

[somarco]

Hard to believe there are still politico's talking about increasing competition by allowing carriers to sell health insurance across state lines.

Georgia has been there, done that.

Still waiting on more competitors ..............


In Georgia, the interstate sale of health insurance has already had a five-year tryout.

The state Legislature in 2011 passed a bill letting insurers sell any policies in Georgia that they offer in other states. The legislation was hailed by supporters and business groups as a way to skirt the state’s required benefit coverages – such as screenings for cervical, prostate and colorectal cancer, along with mammograms – and thus lower the sticker price of insurance.

The law is still in effect. But since it was passed, no health insurer has taken advantage of it.

Interstate health insurance sales had tryout in Georgia | Georgia Health News

 

[AllenChicago]

As many times as Insurance Executives have been to Capitol Hill the past 6 years, you'd think that politicians would know that the "across state lines" theory for lowering prices, is a red herring fallacy.

 

[somarco]

It's possible no one thought to ask. Or if they did, the CEO's may not have known the answer.

The assumption that C level execs understand their industry if faulty thinking. Having spent the first 18 years or so working on the carrier side I can tell you most of them have no idea what happens at the street level.

 

[BeeSelective]

How about the in state networks Of in state companies. Doctors accepting plans is already a big issue. What good is a plan when you can't go to your own doc?

 

[LGilmore]

How about the in state networks Of in state companies. Doctors accepting plans is already a big issue. What good is a plan when you can't go to your own doc?

In my state this year, networks are the big deal. In the old days like 2016, you could go out of network and still have coverage, just not as good as your in network. For 2017, for individual and small group, there is no out of network feature on 90% of the plans. Choosing to go out of network means you foot the bill entirely and it doesn't count towards your max.

Personally think people will have a cow over this because most will find out after the fact. People as a group do not check ahead on their healthcare visits. Sure everybody can give me an example of somebody, but over the years I am used to seeing plan booklets looking as new at the end of the year as they were when I handed them out.

If you think about it, networks are about the only place insurance carriers can play. The max cap is federally set, the 10 essentials are federally set so about the only place they can play is with the networks.

I am seeing very small networks being offered as a way to reduce premium. The big thing will be getting people to check their network before they go as we are also seeing doctors and hospitals drop in and out. The idea that the doctor/hospital contract is 12 months anymore is subject to debate.

 

[RayNY]

How about the in state networks Of in state companies. Doctors accepting plans is already a big issue. What good is a plan when you can't go to your own doc?

The whole idea is that a company can simply file their product in any state, comply with those laws, and sell in any state.

So, argument's sake, Empire BCBS, an NY company with a NYC metro area network, can file their product in Oklahoma.

NY has GI, pre-ex prohibition, forced community rating, no age bands, no smoker surcharge, mental health parity, and prior rate approval with a DFS that regularly slashes requests (among other mandates). OK doesn't.

Empire could file a plan that complies with OK laws, and since it avoids the numerous NY mandates, it can be cheaper. Empire can then sell that plan in NY even though it doesn't comply with a list of NY regulations, so long as it complies with OK's laws.

 

[somarco]

Filing is one thing. Gaining approval is time consuming and costly.

Probably a dozen years ago a carrier VP told me the cost of filing new rates and plans in GA (where they are already admitted and writing business) cost around $1M and took almost 2 yrs for approval.

 

[RayNY]

Filing costs are high, but they're high whether you're filing in your own state or another. You wouldn't have to file twice. Approvals take a while, but most states are doing it in <6 months (since you have to file new experience/rates/plans every year).

If GA is really that slow and expensive, it's yet another reason to file in another state, is it not?

 

[GreenSky]

I just re-read the Constitution and can't see where the federal weenies have any say over health insurance.

Of course, Medicare, SS, Drug enforcement, etc. are all unconstitutional so why would a little thing like law stop them?

Rick

 

[LGilmore]

I think you need to review pricing so you have a better understanding of premiums. The assumption of buying your health insurance in OK and then using it in NY as a NY resident and the OK company still pricing their premium for OK claim costs doesn't jive with any insurance product sold in America.

You're thinking the OK company is willing to sell (at a loss) to have product in NY. NOPE NOPE NOPE.

Name any successful insurance product that is sold at a loss by any insurance company that is still open?