Insurers leaving exchange affects few, state officials say

About 550 Arkansas customers faced shift to new plans

The exodus of some big-name companies from the health insurance marketplace prompted President Barack Obama's administration to create a plan that matches insured customers with remaining companies, but Arkansas officials say they are already pairing consumers with other insurers.

The departure of insurers has highlighted uncertainties regarding the marketplace in many states.

A federal notice was sent in June to insurance companies and regulators, including the Arkansas Insurance Department, that offered two options: States could decide how to "crosswalk" people covered by insurance companies leaving the marketplace to different plans, or the federal government could "automatically re-enroll" insured customers to another available company.

Arkansas took the first option.

"We did it ourselves -- we took the lead," department spokesman Ryan James said.

"This is a bigger story for other states," he said. "Here, UnitedHealth was a small player."

As the 2017 sign-up season starts, federal health care officials are planning to send out notices to consumers in states where major insurers left the market to help people continue their coverage with other insurers.

Open enrollment for healthcare.gov starts Nov. 1 and ends Jan. 31.

James said that only about 550 people in Arkansas had to be switched to another available insurer after UnitedHealth Group's pullout from the state's exchange. Those who do not like the new plan would be able to change it, he said.

UnitedHealth announced in April that it would stop offering plans at the end of this year. It sold plans on the state's individual exchange, along with four other companies.

The insurance exchange was created under the 2010 Patient Protection and Affordable Care Act. Plans are sold by private insurers to individuals at or above the poverty line. The program applies only to those who do not have job-based coverage.

Most covered under those plans in Arkansas fall into the so-called "private option" expansion of Medicaid and have incomes up to 138 percent of the poverty level: up to $16,394 for an individual, for example, and up to $33,534 for a family of four.

Consumers who do not qualify for Medicaid but with incomes below 400 percent of the federal poverty level -- which is $47,520 for an individual or $97,200 for a family of four -- can have their health coverage subsidized through tax credits.

Four insurers continue to offer plans on the state's individual consumer exchange: QualChoice Health Insurance, the national Blue Cross Association, Arkansas Blue Cross and Blue Shield and the Centene Corp., under the brand Ambetter Arkansas.

Arkansas Blue Cross and Blue Shield is the only insurer on the small-business exchange, which allows businesses with no more than 25 employees and an average wage of less than $50,000, to apply for a tax credit that would offset costs of providing coverage. Centene has also submitted a plan to sell policies on the small-business exchange next year.

In other states, other major insurers have also pulled out of the marketplace, citing rising costs and losses.

For instance, BlueCross BlueShield of Tennessee left the state's three largest exchanges in Nashville, Memphis and Knoxville, requiring 130,000 people to find new insurance carriers and cutting the number of insured enrollees under the Affordable Care Act in half. The company reported suffering three years of losses, projected to reach $500 million by December.

Information for this article was contributed by The Associated Press.

A Section on 10/07/2016

Upcoming Events