SC Co-op Consumers' Choice is Out

Oct 22, 2015

  1. miscins
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    Consumers' Choice announced today that they will not offer health insurance in 2016. I'm sure we are all surprised. Unfortunately, it does leave a bit of a hole for individuals in our area that needed MUSC to be in network.

    There is a press release on the SC DOI website for those interested.
     
    miscins, Oct 22, 2015
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  2. somarco
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    somarco That Medicare Expert Guy

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    somarco, Oct 22, 2015
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  3. healther
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    That MUSC hole is big for people around the state.
     
    healther, Oct 22, 2015
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  4. RayNY
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    Compared to co-ops? Great, one of the strongest (rather, least weak)

    Compared to existing carriers? On track to spend a million more in claims than collected in premium, draining about 2% of reserves. Can certainly survive in the short term, but isn't doing so well right now.
     
    RayNY, Oct 22, 2015
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  5. AllenChicago
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  6. somarco
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    somarco That Medicare Expert Guy

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    The question about Consumers concerned their filing status. MEWA (not subject to guaranty fund) or insurance carrier.

    It apparently is a carrier per the DOI release
     
    somarco, Oct 22, 2015
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  7. Ron Van D
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  8. Post Quartermaster
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    The SC Health Cooperative MEWA is a different entity that went down last year. Most of the SC agent community saw that timebomb coming from miles away....


    Consumers Choice Health Plan is an ACA co-op. They decided yesterday to not offer plans for 2016. Looks to be a fairly orderly runoff (I hope). Upper management also ran the TN co-op.


    You have to give Republicans credit, they are sticking to their plan of "if we cannot repeal it, we will take it down piece by piece".....this is a direct result of the reinsurance changes passed in CROMNIBUS last December.....
     
  9. RayNY
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    To be fair, CROMNIBUS just codified the verbiage to make the risk corridor work as described- budget neutral indemnification of losses funded by excess profit based on MLR.

    If left as it was, the same thing would have happened, unless they somehow pulled a lot of money from thin air. There was no mechanism to cover excess payments due, and it was clearly going to have a massive shortfall (<5% of insurers expected to pay in, the rest expected a payment).

    Expect to see 20-40% rate increase requests next year when this program, and the reinsurance program, will no longer be available (both end in 2016)
     
    RayNY, Oct 23, 2015
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  10. Post Quartermaster
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    CMS is a big agency, and by all accounts I've heard, were prepared to move some $$$'s around to make things work. Of course, CROMNIBUS made that unworkable. Though it was certainly hoped by the administration to be a revenue neutral mechanism, that constraint wasn't black and white until CROMNIBUS made it so.....
     
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