NAIC Considers Merging Individual and Small Group Markets

[Crabcake Johnny]

"Beginning in January 2014, according to the health reform law, states will oversee both an exchange and the pre-existing traditional health insurance market. A key danger, regulators fear, is that without careful rules, one could become the equivalent of a high-risk pool. "This would certainly happen if one market is able to offer stripped-down plan designs while the other is required to offer more robust options that include mandated benefits. Ultimately, the more healthy population will select a lower-priced option while the less healthy will choose the more comprehensive plan," according to the draft paper.

Combining the individual and small group markets could provide stability and predictability through a balancing of risks, the draft advises. "Depending on the size and risk profile of the individual and small group markets, one will end up subsidizing the other -- increasing or decreasing premium levels accordingly."

Insurance News - NAIC Health Panel Considers Merging Markets, More to Combat Adverse Selection

 

[pahealthquotes]

the healthy will ultimately subsidize the un-healthy.

is this fair? hmmmm

 

[AndreaSti]

the healthy will ultimately subsidize the un-healthy.

is this fair? hmmmm

I think that is called insurance if I remember correctly. You know, the law of large numbers etc. At least that is the way it is supposed to work. The issue is utilization even if they combine the two types of coverages. Kind of like having your house weatherized, painted, etc or having your car maintenance done, and only paying a copay to get it done, and expecting insurance pays the rest.

But I am preaching to the choir here.

 

[CHUMPS FROM OXFORD]

And this...

Click on the link or your liver will be denied coverage.

Insurance News - Pros, Cons Still Spinning Year-Old Health Reform

 

[Ann H]

A key danger, regulators fear, is that without careful rules, one could become the equivalent of a high-risk pool. "This would certainly happen if one market is able to offer stripped-down plan designs while the other is required to offer more robust options that include mandated benefits. Ultimately, the more healthy population will select a lower-priced option while the less healthy will choose the more comprehensive plan," according to the draft paper.

It's a good thing they thought of this. It's too bad it's a year too late! Sheeeez.

 

[aheff]

It is called socialism. One group subsidizes another group, to make everything "fair". This is the goal of Obamacare. Taxpayers pay health insurance of non-taxpayers. Rich get taxed to pay for poor's healthcare. Healthy will pay a premium for unhealthy. Young males will now pay more for old males and young females. Play my rules or you lose. And so on.

 

[djs]

Insurance is all about everyone paying a little to cover the occassional unforeseen large loss. Insurance is a bit socialistic in nature, but its not socialism.

The problem comes when you start dictating that the 'unforeseen' part comes out. When you know you will have a loss, that's not insurance, that is charity, usually spelled g-o-v-e-r-n-m-e-n-t.

Dan