Land Of Lincoln

[AllenChicago]

August 12, 2016

The Illinois Department of Insurance is attempting to convince BCBS-IL, Aetna, Harken, and other health insurers, to credit orphaned Land of Lincoln Health customers for the deductible $$$ that these customers have already paid for medical expenses in 2016... as New York and Oregon did when their ObamaCare Co-ops collapsed.

Full Story Here: Will Land of Lincoln members really have to pay deductibles twice? - Chicago Tribune

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[AllenChicago]

Blue Cross said today that it will not honor any portion of the deductible already paid by orphaned land of Lincoln Health customers.

 

[steven2244]

Weak D of I. Weak IL State

How bogus, every other mid-year Co-op failure credited the people with ded & OPX usage

 

[AllenChicago]

Weak D of I. Weak IL State

How bogus, every other mid-year Co-op failure credited the people with ded & OPX usage

Yes.. it's horrible how the Illinois Dept of Insurance lacks influence.

LOLH customers with ongoing medical needs, like Dialysis, Chemotherapy, etc., will need to meet their Deductible/OOP again starting October 1st, and then AGAIN starting January 1, 2017.

Three Out-of-Pocket maximums to satisfy over a 24 month period, instead of two.

 

[leevena]

A little difficult for me to understand why anyone would expect a carrier to pick-up this enrollment and credit them with past OOP expenses. These members all selected land of Lincoln with their own free will. How anyone could not recognize the potential risk of failure of a start-up is beyond belief, especially as others have failed. So now there is the expectation that another carrier take on this population and credit them for their OOP by using others people money?

 

[AllenChicago]

It was difficult for me to understand why the carriers in Oregon, New York, Et al., picked up the OOP for customers left hanging when those Co-ops went out of business.

I don't have time to find the articles now, but it was basically the states "working with" the remaining insurers to do this. In New York, some insurers agreed to cover OOP and some didn't.

Weakened Illinois has no such leverage.

 

[leevena]

I understand that other states did have carriers who gave credit, either because the carrier wanted to or because they were pressured to do so. The point I am trying to make is why would someone expect a carrier to do this? By allowing a credit for the OOP the new carrier will incur additional costs without the additional revenue. I realize not on all of these members, but on some.

Whatever happened to being responsible for your actions? These insured selected a plan that went out of business and now the expectation is to use someone elses money to help them.

 

[AllenChicago]

what about the state Guaranty funds for insurers that go belly-up. Where does that money come from? Are you suggesting that the guarantee fund should not exist?

 

[leevena]

what about the state Guaranty funds for insurers that go belly-up. Where does that money come from? Are you suggesting that the guarantee fund should not exist?

I contend that this is not the same.

State Guaranty funds are essentially funded with state tax dollars. Yes, the carriers are required to pay into the fund, but they are allowed to take state tax credits to offset, up to the full amount. It is very similar to a loan.

Secondly, these funds are not used to reimburse an insured OOP when they find coverage with another carrier.

If the state wants to use these funds they can. But I do not believe that the state should compell a private/non-governmental business to spend their money for purposes of crediting a persons OOP.

What I do believe is that any private company wants to voluntarily step-up and cover those expenses, they can. Or better yet, if a private citizen wants to step-up and contribute, they can.

 

[ARus]

I contend that this is not the same.

State Guaranty funds are essentially funded with state tax dollars. Yes, the carriers are required to pay into the fund, but they are allowed to take state tax credits to offset, up to the full amount. It is very similar to a loan.

Secondly, these funds are not used to reimburse an insured OOP when they find coverage with another carrier.

If the state wants to use these funds they can. But I do not believe that the state should compell a private/non-governmental business to spend their money for purposes of crediting a persons OOP.

What I do believe is that any private company wants to voluntarily step-up and cover those expenses, they can. Or better yet, if a private citizen wants to step-up and contribute, they can.

What you are saying is also not the same.
We should do not forget that LOLH went belly up because the company was promised money from the government and didn't recieve this money, either a loan because of many circumstances/factors on state and fed level. The biggest Part of the reason is exactly this fund LOLH should contribute to. My opinion is that this fund is exactly for purpose like this one.
Last year LOLH didn't show so bad indications based on the available public information (in this forum as well). I was pretty confident when offering their product.
When the transparency is missing, should be a protection in place. The local government should ask for transparency if they aren't ready to back up situations like this one.