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- #21
Risk Pool is Up and Running
- Thread starter somarco
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I am trying to figure out why the Texas High Risk Pool is still accepting applications if it has a 12 month pre ex and double the rates of the Federal pool?
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Probably for those who don't meet the federal requirements.
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Again, will carriers really care about persistency after 2014 when there is NO underwriting? What am I missing here or am I correct?
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- #26
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I would think so, yes. Carriers will want a balanced block of business and will be keen on persistency and retention issues.
Given that GI does not cancel out things like network, formulary, and perhaps certain benefits, it might be important for carriers to have agents who know the overall landscape keeping their balance between the sicker subscribers and the healthy ones.
Since direct sales agents are not versed in competitors products (including formulary, network, subscontracted benefits and so on) they are ill-equipped to make an accurate comparison of total benefits between carriers standard plans (gold, silver, etc.).
I think under GI carriers would rely on independents to keep people on the best plan choice for their needs regardless of pricing practices, bells and whistles and other things that one carrier might do to pull people from another. Especially for plans sold outside of the state exchanges.
We have it daily in CA right now with the exchanges (KPChoice vs KP direct) and KP does things to woo business away from KPChoice and vice versa.
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...and with a $95 fine for not buying insurance the adverse selection will be unreal. There is also no pre ex wait for gaps in coverage.
I an talking about 2014 of course. The no pre ex on breaks in coverage will certainly have to change in time. NY tried this it failed.
Then again GI has failed everywhere as well. This pipe dream of fine and mandate is really laughable.
I an talking about 2014 of course. The no pre ex on breaks in coverage will certainly have to change in time. NY tried this it failed.
Then again GI has failed everywhere as well. This pipe dream of fine and mandate is really laughable.
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These High Risk pools are BS. They were developed with using math.
There is not enough funding for these high risk pool plans. So a couple of things could happen. Each state will have to limit the number of people they take onto the plan or they will have to raise the premium. I think they will end up doing both.
A state could really get hurt by one of these plans. If the plans runs out of federal funding in 15 months who is going to pick up the tab?
There is not enough funding for these high risk pool plans. So a couple of things could happen. Each state will have to limit the number of people they take onto the plan or they will have to raise the premium. I think they will end up doing both.
A state could really get hurt by one of these plans. If the plans runs out of federal funding in 15 months who is going to pick up the tab?
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California received $761M for the pool. All state dollars go to MRMIP (state risk pool) and no $$ beyond the federal $761M go to the federal risk pool.
MRMIP allows max 7100 enrollees and is mainly subsidized by tobacco taxes.
The federal CA risk pool will cover 25,000 max limit until 2014. CA has 6-7M uninsured currently.
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