Healthspan Going Out of Business on 3/31/2016 in Cleveland, OH: Will Healthcare.gov Allow Switching

Jan 3, 2016

  1. OldGeorge1950
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    A family member has been a Healthspan customer for the last couple of years.
    It was always signed up and purchased via Healthcare.gov website.

    Healthspan bought Kaiser in Cleveland a few years ago, but everything
    continued to run pretty much like how Kaiser operated. Same out-patient
    clinics and same doctors.

    She renewed the same Healthspan plan for 2016, again, using Healthcare.gov
    website. (signed up again 12/15/2015)

    Yesterday, she received a notice from Healthspan saying that they're going
    out of business in Cleveland as of March 31, 2016. Existing customers will
    have to use different doctors and hospitals on a different network. No detailed
    info on how that's supposed to work.

    In this type of situation where the health insurance has decided to stop
    doing business in a major city, will Healthcare.gov allow her to switch to a
    different health insurance company now?

    Thanks!
     
  2. KennyWest
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    Re: Healthspan Going Out of Business on 3/31/2016 in Cleveland, OH: Will Healthcare.gov Allow Switching to Another Compa

    If the carrier cancels the plan then yes, that would qualify them for SEP.
     
  3. CHUMPS FROM OXFORD
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    Re: Healthspan Going Out of Business on 3/31/2016 in Cleveland, OH: Will Healthcare.gov Allow Switching to Another Compa

    Actually, they notified brokers about three weeks ago about this change. They are not going out of business (yet) and there should still be some providers available.

    But I would not be shocked if they get out of the individual market and focus on their other core markets.
     
    Last edited: Jan 3, 2016
  4. OldGeorge1950
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    Re: Healthspan Going Out of Business on 3/31/2016 in Cleveland, OH: Will Healthcare.gov Allow Switching to Another Compa

    She live pretty close to the current Healthplan building.(formerly Kaiser)
    It's very convenient for her to see her primary physician.

    According to the Healthplan rep on the phone, after March 31, her current
    primary physician will no longer be in the network. She doesn't really care if
    they want her to see another primary physician.

    The problem is that the nearest primary physician will be 34 miles away(at
    least that's according to their current database, which the rep said would be
    updated) I assume Healthcare.gov won't allow her to switch, since Healthplan
    is still technically in business in the same metropolitan area, even if it's more
    than a 40-minute drive away? :(

    She doesn't speak English at all... so unless Healthspan hires a German-
    speaking rep, I will just have to speak for her. :( (getting correct information
    from Healthspan is about as easy as getting a politician to speak the truth,
    based on my numerous phone calls with them over the past 2 years)
     
  5. AllenChicago
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    Re: Healthspan Going Out of Business on 3/31/2016 in Cleveland, OH: Will Healthcare.gov Allow Switching to Another Compa

    It sounds like the policy she has now is being discontinued on 3/31/2016. This creates a Special Enrollment Period. The SEP begins 60 days before the March 31st trigger date.
     
  6. OldGeorge1950
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    Re: Healthspan Going Out of Business on 3/31/2016 in Cleveland, OH: Will Healthcare.gov Allow Switching to Another Compa

    Please see my reply just above yours...

    She probably won't qualify for SEP because the policy isn't being discontinued.
    (but the nearest doctor will be 40 minutes away, as opposed to 5 minutes
    away)

    It's almost like bait and switch sales tactic... :(


    Edit: since the current regular enrollment period doesn't end until Jan 31, can she make changes, if she already enrolled in Healthspan on Deember 15? I'm guessing the answer is no, but I just wanted to be sure. Thanks!
     
  7. AllenChicago
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    Re: Healthspan Going Out of Business on 3/31/2016 in Cleveland, OH: Will Healthcare.gov Allow Switching to Another Compa

    OldGeorge, I'm willing to bet that her policy will have a new name on April Fools day. If it changes from a Healthspan-103 Silver to a Healthspan-104 Silver, her 103 was discontinued (for her) and she's SEP eligible. I think you may be getting some incorrect information. For instance, your client (relative) told you that HealthSpan is going out of business, when it really isn't. You need to find out what exactly is going to happen to Cleveland (and possibly other) HealthSpan customers on 3.31.2016.

    During Open Enrollment, you can change to a new plan at any time, as often as you want. She should dump Healthspan all-together, IMO.
     
  8. CHUMPS FROM OXFORD
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    Re: Healthspan Going Out of Business on 3/31/2016 in Cleveland, OH: Will Healthcare.gov Allow Switching to Another Compa

    She can indeed change to a different plan and company effective Feb 1. The deadline is January 15th.

    If you live here in Ohio, you probably are aware of the many options she has. If not, send me a pm and I'll email you the best options.
     
  9. LGilmore
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    Re: Healthspan Going Out of Business on 3/31/2016 in Cleveland, OH: Will Healthcare.gov Allow Switching to Another Compa

    Part of the ACA now is when the plan changes it's name or some features they have to send out a cancelation notice 90 days prior. It is a PIA as it creates more fear than it needs to. The plan will most likely still be there, but have different features or name.

    If not, I think one of the events would be doctors leaving network. So if her nearest PC will be 34 miles away, I think she could move without too much problem. The thing is, get her an agent locally to help out now.

    What the ACA did actually is make it hard to DYI health insurance. Agents can be of great help to you and your mom.
     
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