UHC, They Are Releasing the News Monday....possibly Today

[Winter_123]

Is this in the news or in your thinking, Mary?
My thinking:
The working middle-class, who are hurting the worst, are WAY too busy struggling to make a living & pay for their insurance premiums to even make a 50cent trip downtown!

How they gonna get to DC?
Obama sure isn't going to pay them $15/hour & bus them in!

If Bernie holds a rally and offers free stuff there won't be enough room for everyone who shows up. And they don't have to worry about being "wayy too busy making a living" to go there. Good chance to score some weed too. Maybe even have Michael Moore show up and explain why the Cuban system is better and why he will be going there for his triple bypass.

Nothing like the smell of free shitt in the morning to motivate their troops.

 

[Duaine]

The turnaround led some analysts to ask the insurer what had changed.

Stephen Hemsley, UnitedHealth chief executive officer, said too many healthy people dropped coverage and noted slower than expected enrollment. A major factor, he added, was far higher costs for those who signed up for 2015 coverage under special exemptions after the general open enrollment period ended. Those exemptions included, for example, people who lost their insurance, moved or suffered a hardship, such as an eviction or had their utilities turned off. United said it did not see a similar increase in costs for people who bought policies from private brokers or websites instead of the government marketplaces after open enrollment, suggesting the reason was partly that the company’s eligibility assessments were more thorough.

The firm did not say it would halt sales in 2017 but warned that it would strongly consider doing so based on what happens in the next few months.

UnitedHealth Warns Of Marketplace Exit

 

[somarco]

The law as written was a nightmare. Never stood a chance of working. Surprised so many carriers stayed in to play. Figured all but BX would bail once they opened their Christmas present.

Single payer isn't going to happen, but BX as the lone survivor will (along with a smattering of regional HMO's).

ACO/Co-ops are dead too.

Better call Saul.

 

[Yagents]

I don't get it, how can Aetna avoid the massive claims?

http://www.businessinsurance.com/ar...ederal-health-exchange-business-performing-as

 

[somarco]

In October, Aetna had said it was not making money from the business,

Hoping to make up their losses on volume. Plus Uncle Barry might reach into his taxpayer bank account and come up with money to bail out the carriers.

HHS: Bailing out Obamacare insurers an 'obligation' of the federal government | Washington Examiner

 

[TxOnline]

Aetna didn't attract the high-risk folks (in Texas, anyway) last year.
UHC offered VERY-low MOOP's in 2015.
So, did Humana.

 

[AllenChicago]

Aetna didn't attract the high-risk folks (in Texas, anyway) last year.
UHC offered VERY-low MOOP's in 2015.
So, did Humana.

Same here in Illinois. UHC didn't enroll a lot of 2015 people because the premiums were the highest at the Marketplace, but the rich plan benefits were a magnet for those with the costliest medical conditions.

UHC didn't participate in the 2014 Marketplaces because they wanted to avoid enrolling the sickest Americans.. the "low hanging fruit". But they introduced health insurance plans in 2015 that were perfect for the very population they avoided in 2014. Duh! (Strongest magnet gets the most nails)

 

[FLM2]

Same here in Illinois. UHC didn't enroll a lot of 2015 people because the premiums were the highest at the Marketplace, but the rich plan benefits were a magnet for those with the costliest medical conditions.

UHC didn't participate in the 2014 Marketplaces because they wanted to avoid enrolling the sickest Americans.. the "low hanging fruit". But they introduced health insurance plans in 2015 that were perfect for the very population they avoided in 2014. Duh! (Strongest magnet gets the most nails)

I haven't looked at Humana's bottom line on ACA business but they seem to have it right-focus on Bronze and Silver plans, don't offer a low deductible Gold or Platinum plan that might attract the sick. They've even eliminated the separate Rx deductible (at least in Florida) for 2016,they wouldn't be doing that if they were getting killed on Rx claims (which is one of the biggest sources of loss, in all likelihood, under this law).

 

[TxOnline]

I'm seeing the same thing here. Also, seeing the Silver HSA eligible plan I was discussing with an Off Exchange client removed as an option from the system.

I've reached out to my contacts at UHC, no email response, no phone response and was told by a CSR at agent support to speak to someone regarding an off exchange plan would be an hour or longer due to 100 callers ahead of me.

We never know from day-to-day what we can offer in Texas.
Here's a funny conversation from a Texas forum....sad but still funny:

Post 1:

I had a client call UHC and they quoted a 2000 deductible which was not even on ehealth. SOOOO I called the number and found out that she was quoting On Exchange plans only and had no Off Exchange plans to quote but also told me that end of 2016 these plans would be going away.

Post 2:

ALL I am asking is what we can and cannot offer and how to quote what we can - the same options that are being afford to whoever ebroker is so we can represent the carriers we contracted with in good faith and give our clients what they ask for. It is a bad situation to have what happened this morning happen and I can't even explain it or understand it.

If we can only write Silver or Platinum, on the market or off the market, on Tuesdays from 9-1 am on cloudy days to Caucasians born between 8 pm and midnight so be it - just tell me what we can offer and how to quote it so I can service my clients rather than have them get it somewhere else. That's all I ask and I think it's a fair request. I had to go through training after training, certification, recertification, identity proofing, FFM anointing, carrier specific training one right after the other, AHIP training, re-training for the pleasure of working my buns off which I am willing to do - so please let me do my job so I can take care of my clients and pay my employees and appear somewhat intelligent to my clients in the process - that's ALL I'M ASKING here folks.

 

[FLM2]

The 'hidden' issue regarding the Marketplace plans is the way CSR benefits are calculated, it is absolutely ridiculous.

I had a client on Wednesday who is unsure of her 2016 income so we are guessing. If we guessed $17600, she gets the 94% CSR plan, if we guess $17,700 she gets the 87% CSR plan, which may not sound like a big difference but the it's the difference between a $500 deductible and $900 and $750 MOOP and $1500.

Multiply the extra $750 MOOP out by 10,000 or 100,000 (or 1,000,000 nationally) and those are big claims dollars that are most likely going to be paid out during the year. Who exactly is paying for these claims, the insurance company or the government?

Having these extra benefits available for a single dollar of income just makes no sense, it should be a sliding, linear scale that doesn't reward people for low balling income estimates (and it isn't a consumer or agent issue, the law is the law, until it's changed everyone is entitled to use it to their best advantage).