Why Did Aetna Pull Out of Indiana?

Discussion in 'Health Care Reform Forum' started by Crabcake Johnny, Jun 1, 2011.

  1. Crabcake Johnny
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    Crabcake Johnny Well-Known Member

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    If you're wondering why Aetna just pulled out of Indiana here's a likely clue:

    Indiana Residents Could Receive $30M in Rebates as Payors Fail to Meet Healthcare Reform Requirements

    "Indiana residents purchasing individual health insurance are expected to receive $30 million in refunds as new rules from healthcare reform take effect this year, according to an Indiana Business Journal report.

    The estimated refund amounts were calculated for Indiana Insurance Commissioner Stephen Robertson's agency this month, based on health insurers' most recent annual filings, to determine how easily insurers could meet new guidelines that require them to spend at least 80 percent of premium revenue of medical bills. According to the review, only 19 of the 63 companies writing individual health insurance policies have historically met the 80 percent standard.

    The other 44 Indiana companies would have to distribute rebate checks to customers to make up the difference between their actual spending and the 80 percent requirement. According to the report, those 44 companies cover approximately 94 percent of the 200,000 Indiana residents with individual health insurance.

    Some companies are relatively close to the 80 percent threshold, including Indianapolis-based Anthem Blue Cross and Blue Shield, which spends 76.6 percent of premiums on medical bills. Others, such as Indianapolis-based Golden Rule Insurance, are further from the goal; Golden Rule spends approximately 64 percent of premiums on medical bills. "
     
  2. STIBROKER
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    STIBROKER Super Moderator Moderator

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    hummmmmm.........Golden Rule Insurance next.......
     
  3. taterpeeler
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    taterpeeler Well-Known Member

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    HAHA... gotta love me some Aetna.... Been overcharging for years.
     
  4. AndreaSti
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    AndreaSti Well-Known Member

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    Overcharging...and underpaying.
     
  5. Crabcake Johnny
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    Crabcake Johnny Well-Known Member

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    For me it's hard to come up with excuses when some carriers can offer 10% to 12% comp and be MLR compliant while others are coming in at under 10% comp with a below 70% MLR. Seems to be nothing more than gross mismanagement.
     
  6. Newby
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    Newby Well-Known Member

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    Oh Goody! Uncle Sammy is gonna gimme a payday!

    How much do I get after the politicians and the lawyers scoop their fair share out of it?
     
  7. VolAgent
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    VolAgent Well-Known Member

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    Its always a mess when a carrier pulls out.
     
  8. ABC
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    ABC Well-Known Member

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    I did not see a loss ratio for Aetna. They never brought in a sale force to the state of Indiana. They BDS as the GA.

    I was at the kick off meeting for them a few years back. It was a joke. No one knew the products.

    It would not surprise me one bit if they ended up with a bad block in the state.
     
  9. somarco
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    somarco Well-Known Member

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    Sometimes when carriers pull out that is exactly what they do.

    Pull out and leave policyholders holding the bag.

    Mutual of Omaha did that a few years ago. No renewal offer, just bye bye.

    Obamacrap strikes again. This is going to get real nasty very soon and even worse going in to the 2012 election.

    Curious about Aetna (or any other carrier that follows suit). If they withdraw are they not liable for paying MLR refunds?
     
  10. Crabcake Johnny
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    Crabcake Johnny Well-Known Member

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