United Health Care - Opting Out of Most Exchanges!

[AllenChicago]

If a carrier doesn't offer an exchange plan, they cannot offer plans outside the exchange.

Ann, this can't be true.. can it? Everything I see in the Obamacare reference materials states that Non-Exchange QHPlans will mirror Exchange QHPlans, but nothing says that non-exchange insurers are prohibited from selling major medical in the open market.

What if a company (UHC?) is only in a handful of exchanges, but wants to continue to sell health insurance in all states on the open market. The company can't do that? Or, the 100+ clients I have with health insurers who say that they are NOT going to compete on any exchanges. Will they have their health plans ruled null and void by HHS?

Ann, can you direct me to the rule that details this insurer prohibition? If it's true, this is a BIG forking deal!
-ac

 

[somarco]

If a carrier doesn't offer an exchange plan, they cannot offer plans outside the exchange. YAgents said he heard they must offer 2 exchange plans...

Didn't Bill post something recently from his NAHU contact that indicated carriers may not be required to participate in the exchange if they want to sell outside?

So, what is the reason that carriers would decrease their market that dramatically?

UHC is so much more than IFP and even small group. They are diversified into health care related lines and a major player in large group and of course Medicare.

If they must forego participating in IFP or small group in a few markets because they don't offer an exchange plan, it is no big deal to them.

Frankly, I don't know why any carrier would want to participate in the exchange or offer GI IFP plans given the current political climate. At best it is a 3-4 year death spiral for that block of business.

 

[Dave020]

UHC is also taking over TRICARE West region 4/1

 

[HealthGuy]

Okay...so UHCs not playin in some state exchanges but what about the states where the feds run the exchange for the state? hmmmm? Wheres tatertot weighin in on this one?

 

[leevena]

This should not be a surprise to anyone, it is how carriers operate now anyway. (I also mentioned in other posts about this occuring and was skewered by some). Even if a carrier is in a geographic market, it does not mean that they are strong, or even marketable. So the carriers are now looking at where it makes sense to market and where it does not. Remember, if a weak (i.e., higher cost carrier) is in such a market, they will attract bad risk and high costs. Does not make much sense for them. I would expect to see the Blues in most major markets, along with one or two other serious options at the most.

 

[taterpeeler]

Wheres tatertot weighin in on this one?

tater just woke up and has a mapd appt. at noon.... let me rest

 

[Ann H]

Didn't Bill post something recently from his NAHU contact that indicated carriers may not be required to participate in the exchange if they want to sell outside?

Yes, he did, and NAHU said it is still being determined in some cases. Note that NAHU also mirrored the rumors that some carriers are not planning to be in the exchange. Following is the quote:

Can a carrier offer major medical insurance with all EHB's/AV's outside the exchange, and NOT offer plans inside the exchange? This is still being determined in some cases. But, there are a number of insurers who are quietly indicating that they will not participate in exchange plans.

Read more: Defining Affordable . . . - Page 3​

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This should not be a surprise to anyone, it is how carriers operate now anyway.

The part that is surprising to me is that it is UHC. They were so strong for the passing of Health Care Reform and exchanges. I often thought that the Blues, UHC and perhaps one more carrier would be the market in most states. Of course some states will have 1 carrier.

 

[somarco]

They were so strong for the passing of Health Care Reform and exchanges.

There were a lot of folks, including carriers, physicians, drug manufacturers, associations and voters that were for Obamacare before they were against it.

 

[leevena]

Yes, he did, and NAHU said it is still being determined in some cases. Note that NAHU also mirrored the rumors that some carriers are not planning to be in the exchange. Following is the quote:

Can a carrier offer major medical insurance with all EHB's/AV's outside the exchange, and NOT offer plans inside the exchange? This is still being determined in some cases. But, there are a number of insurers who are quietly indicating that they will not participate in exchange plans.​

Read more: Defining Affordable . . . - Page 3​

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The part that is surprising to me is that it is UHC. They were so strong for the passing of Health Care Reform and exchanges. I often thought that the Blues, UHC and perhaps one more carrier would be the market in most states. Of course some states will have 1 carrier.

The carriers were doing what was in their best interest, not your's, mine or their enrollees. As health care reform moved towards a reality, the BUCHA's realized that they could meet the govt half-way, which is what they did. The immediate impact was that many of the medium to smaller competitors are now gone, and more will follow as they falter in the environment. The idea is that the BUCHA's have the resources to get through this and then dominate a few markets. Govt happy, BUCHA's happy, for a time. More than likely they will look to expand into other geographically areas.

Also, they are now well positioned to act as administrators should the govt go further with reform.

 

[SportsNut]

There were a lot of folks, including carriers, physicians, drug manufacturers, associations and voters that were for Obamacare before they were against it.

And I can't wait to see how that number of the latter grows as folks truely understand what terrible situation we've had created for the good of all here.

I can't wait to hear the bee-otching over this when folks who thought that they were getting FREE healthcare are having to [forceably] pay a premium. You know, the part of the 47 mil Americans who are uninsured today because they would rather spend those premium dollars on a new car or 3 or 4 dinners out each month, and take their chances if their number comes up wrong.

So another thought that I have had on this

Today so many folks who are uninsured just head to the emerg room when they get sick. What will happen to those folks who opt for paying the penalty [tax] and decline being insured, and say in 2015 they get ill... go to that same emerg room with 0 coverage; will they still be seen and treated or turned away?