Health Plans Cautious On Where To Sell Obamacare Coverage - A SOLUTION IS OFFERED!

National health plans so far have announced participation in “fewer than 15 states” to provide benefits under the Affordable Care Act. (Photo credit: Wikipedia)

Health insurers are being selective about which insurance exchanges they will offer products on with national health plans so far announcing participation in “fewer than 15 states,” a health plan chief executives and a new report indicate.

Health insurance companies like Cigna Cigna (CI), Aetna Aetna (AET), Humana Humana (HUM) and UnitedHealth Group UnitedHealth Group (UNH) are so far staying in familiar territory where they already have business as they decide where to offer health insurance products to uninsured Americans via the so-called exchanges or online marketplaces that will open for business this fall as part of the Affordable Care Act. At that time, uninsured consumers will be eligible for federal subsidies of up to $5,000, depending on income to buy any number of private health insurance options. Benefits kick in in January 2014.

“The health plans are being very selective about entering markets,” Dan Mendelson, chief executive officer of Avalere Health, a research and advisory services firm on health policy issues tracking development of the exchanges, said in an interview.

Avalere’s latest report, issued this month, said “national payers are entering exchange markets cautiously in 2014, with national carriers announcing participation in fewer than 15 states.”

Health insurance companies are being cautious about the poor population of customers that will be buying benefits, perhaps for the first time. Therefore, they aren’t going into many new markets to sell coverage other than the states where they sell individual and small group coverage now.

“Seven out of eight people who purchase coverage are going to be poor or near poor,” Mendelson said. “If you don’t understand those populations, there is a higher risk. (Health insurers) are looking to mitigate risk by going into markets that they understand.”

The uninsured will still have plenty of choices among health benefit firms, but there are unlikely to be new players other than what the already-insured population has.

Health plans reason it makes sense to offer products in the markets they are already in because they already have preferred lists of medical care providers known as networks. Thus, they already have doctors and hospitals for new customers to choose.

Humana chief operating officer James Murray, for example, told Wall Street analysts and investors earlier this month on the company’s first quarter earnings
call that they were looking at “aligning around participating on 14 exchanges in various — of the states that we have significant network strength.” Humana has not disclosed the states it plans to enter with products on exchanges.

Meanwhile, Cigna chief executive officer David Cordani told analysts on his company’s first-quarter earnings call earlier this month that the insurer was “sharply focused on a limited number of markets.” It did not disclose the markets.

Aetna is targeting 14 markets to sell products on exchanges, but isn’t ruling out backing out of discussions in states where terms aren’t adequate, executives have said. “We are entering these exchanges very carefully,” said Mark Bertolini, Aetna’s chief executive officer, told analysts April 30 on the company’s first quarter earnings call.

Perhaps the safest bet for long term commitment to exchanges in their markets will be the Blue Cross and Blue Shield plans, analysts say.

“The Blues are in these markets forever,” Mendelson said. “They are not going to leave.”

But experts caution consumers on if the "Blues" are really the best choice. There are Assurants, Humana, Cigna, Aetna, etc. but none come close to the exceptional coverage being offered in today's market with USHealth Group. "The company's concept is simply - head-to-toe coverage, consumer payback and your very own health insurance advisor. Not to mention for better coverage than currently being offered in the market today, USHealth Group benefits generally save consumers between 10% -30% annually. They approach the market as financial advisors to their customers and in essense, that is what they really are to a degree," said Micheal Deer, expert health insurance advisor.  

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Original Article: ByBruce Japsen, via http://www.forbes.com/sites/brucejapsen/2013/05/18/health-plans-cautious-on-where-to-sell-obamacare-coverage/