If this Actually Works, then What?

[somarco]

real premiums will show up in 2015 and 2016

Yes, but (most) carriers have a good idea how to lag claims. They will have fed reinsurance available to help soothe some of the pain.

Just hope they do a better job than the feds did with PCIP and ERRP.

InsureBlog: ERRP . . . Obamacare Indigestion

Before PCIP started up, Medicare actuaries predicted that the program would have 375,000 enrollees by the end of 2010.
Actual enrollment was only about 49,000 at the end of 2011, and it increased to about 103,000 at the end of December 2012, Czerwinski said.

PCIP and ERRP both blew their wad before they knew what hit them.

 

[Yagents]

Crash and burn.............I hope their not using DOS

Federal Data Hub Hobbling Health Exchange Implementation

It sounds simple, but it's a significant headache for the 17 states that, so far, are building their own exchanges. For starters, the hub hasn't been completely built yet, nor have the rules that will govern its use been finalized. Because tax information will be exchanged through the hub, there is a laundry list of privacy and security standards that must be met. In addition, the IRS is accustomed to receiving and then processing this kind of information over long periods of time, up to a month, while the exchange is supposed to provide verification in almost real-time. Nobody is sure if and how the hub will be equipped to handle that workload.

All the while, states are already building the technical infrastructure for their exchanges, which includes a website and an eligibility system, without knowing exactly how their exchange is supposed to connect with the hub. It's a major problem with four months left until the exchanges are supposed to be operational, and Czerwinski believes "this is going to go way up until the very last day."

 

[stuy119]

I think they'll get it done, but I don't want to be using the system on Oct. 1. Maybe the problems will be worked out by Nov. 1.

Maybe.

 

[RayNY]

Quick question about the "real premiums showing up in 2015/16" comment.

My reps have told me that NY is making carriers submit 2 years of rates and locking them in (Jan 1 '14>Dec 31 '15), are other states doing this, or are we unique in this respect as well?

 

[stuy119]

Quick question about the "real premiums showing up in 2015/16" comment.

My reps have told me that NY is making carriers submit 2 years of rates and locking them in (Jan 1 '14>Dec 31 '15), are other states doing this, or are we unique in this respect as well?

I haven't heard of anyone doing this, and I can't imagine that there will be robust on-exchange companies if that's the case. Not knowing your projected claims is a big red flag if I'm a carrier.

 

[timsip]

This may be true in some state exchanges which would be another reason why some are staying out altogether in 2014.

 

[Ann H]

That would certainly explain insurers' reticence to participate. Their first option is to fully sit-out the first year. Second option would to be play partially the first year (for instance with a subsidiary company providing products with skinny networks, forumlaries, and gatekeeper access restrictions). Third option would to be join fully the first year. Why would any insurer choose option four, which is to lock in rates for two years?

 

[somarco]

Even if carriers don't have first hand experience with GI individual they can certainly get data and rates from folks like Milliman & Robertson.

Marketplace business is bad business. No need to throw your hat in the ring if you don't need to.

Seems like some of the states are doing everything they can to discourage carriers from coming to the party

 

[AllenChicago]

Seems like some of the states are doing everything they can to discourage carriers from coming to the party

How do states discourage carriers from participating in the exchange-marketplace, Somarco? Are they (or HHS) telling the carriers to reduce your proposed premium, or stay away?
-allen

 

[Yagents]

Most of the state run exchanges, are running an "active" purchaser model, meaning they can negate a company based solely on high prices. Basically, they are controlling pricing, and most carriers don't want anything to do with price controls that don't reflect accurate prices to say solvent. CA had 30 carrier applicants, only 13 made the cut.