United Health May "play" Next Year

[somarco]

Chad, have never been a fan of carriers that play rope-a-dope with their policies. Seems like some carriers go out of their way to make something appear different from what it really is.

 

[Ann H]

Chad, have never been a fan of carriers that play rope-a-dope with their policies. Seems like some carriers go out of their way to make something appear different from what it really is.

UHC made the Rope-a-Dope mistake, in my opinion. To discourage sick enrollees, you should clearly show a very high deductible and high MOOP. If you must file Gold to be on the exchange, then don't do it with low deductibles! UHC did that. They made their plan APPEAR attractive. In AZ they have a $0 and $500 deductible plan on-exchange, and, no, that's not CSR. Well, duh. They will get the sick and the highly-subsidized, both of which are overutilizers. Then, they "hid" the cost control items. In Rope-a-Dope fashion, they say it's a PPO (but it really acts like a gatekeeper PCP-refer-to-Specialist HMO), and they have lower benefits for non-referral services. They should not have HID their cost control features. They should have played them up. That way, the young and healthy would take that high deductible if it meant lower premiums, but the sick and highly subsidized would pick a lower deductible, copay plan, and a PPO plan. Guess the dope on the rope was the carrier this time.

 

[bill3173]

Now that anyone can buy health insurance (as long as they can pay the premium) and risk pools have been neutered I suspect many of these extremely ill people are coming from risk pools.

I worked the State and Federal Plan (inclusive health in NC) until O'care, and those that could benefit from a subsidy jumped into Ocare, from the State Plan, and Fed they had to leave, and of course they have been heavy users of the system: Organ transplant, Knee rep, hip rep , brain rep, etc. but I thought that it would be a minimal impact considering the small percentage of people actually on these plans, but you believe that it may have had a significant impact on claims Nationwide?

If that's true, then it things should settle down after this year because it would be at most, a two year migration to O'care, if not then...can get worse.

 

[somarco]

Bill, I have no idea how many of these people (risk pool) went on Ocare or how much of an impact. I do know the few I had went with platinum or gold plans with broad networks. Carriers had to run 200% loss ratio's on them.

Sure, the number would be small compared to the total number of enrollees in Ocare but these are known money losers. Not all have once-and-done conditions. At least one of my clients had AIDS, a few others on a LOT of pain meds.

My suspicion is there are a fair number of very sick people that migrated to Ocare, probably more than the usual number of sick people since there is no underwriting.

At the same time many of the young healthy people are saying thanks, but no thanks.

The only way for loss ratio's to settle down is to have a few more years of significant rate increases, which of course can not lead to anything good.

 

[saintstigers]

Is United partnered with GoHealth now on their carrier quoting?

 

[WiscBroker]

United Healthcare can $*&^$ my $#$#@$... THEY ARE DEAD TO ME.