CareFirst BCBS Withdraws Bronze Plans?

[dgoldenz]

Saw this article yesterday:

Health Insurers Struggle to Offset New Costs - WSJ

In Virginia, CareFirst BlueCross BlueShield’s proposed average increases are around 25%, though that number reflects the insurer’s decision to withdraw all of its lowest-premium plans, the so-called bronze tier that has the highest cost-sharing for participants, and the increase is around 11% for plans that have a similar level of benefits, the insurer said.

Interesting....I wonder if we'll see more of this. Sounds to me like they don't want the ultra-low premium subsidized plans because they are probably the highest level of claims.

Edit - here's my thoughts:

In 2014, silver plans had OOP max in $3-5k range, gold plans in $2-4k range. Now, almost all silver and gold plans have OOP max in $6k range, so high level claimants that are guaranteed to hit the OOP max every year are shifting to bronze plan to reduce premium. BCBS responds by withdrawing bronze plans.

 

[Tkruger]

Hold that thought though...

Silver qualifies for cost sharing reducing deductible and MOOP. Bronze leaves the consumer responsible for a 6,450 K deductible and MOOP.

Basically the consumer is individually responsible for $ 537.50 per month before the coverage pays anything out.

Or

For a family that qualifies between 100% and 138 % FPL monthly costs would be $ 1,075 + any remaining premium per month.

Why would the carrier want to eliminate reducing their claims costs by not offering a Bronze plan?

 

[dgoldenz]

Hold that thought though...

Silver qualifies for cost sharing reducing deductible and MOOP. Bronze leaves the consumer responsible for a 6,450 K deductible and MOOP.

Basically the consumer is individually responsible for $ 537.50 per month before the coverage pays anything out.

Or

For a family that qualifies between 100% and 138 % FPL monthly costs would be $ 1,075 + any remaining premium per month.

Why would the carrier want to eliminate reducing their claims costs by not offering a Bronze plan?

I'm not referring to CSR plans, there are still plenty of people that qualify for $5/month plans without qualifying for CSR. Off-exchange people that are guaranteed to hit max OOP can do the math and figure out that bronze plan has lowest overall cost.

 

[somarco]

Absent help from a knowledgeable agent, do folks that order off the dollar menu really do calculations or just go for the plan with the lowest monthly premium?

 

[Tkruger]

I'm not referring to CSR plans, there are still plenty of people that qualify for $5/month plans without qualifying for CSR.

Sorry you lost me with the first response. If they are qualifying for a $ 5 per month plan then surely they qualify for the CSR...at least in the 20 or so states we work.

Confused is all.

 

[dgoldenz]

Sorry you lost me with the first response. If they are qualifying for a $ 5 per month plan then surely they qualify for the CSR...at least in the 20 or so states we work.

Confused is all.

Depends on your age, family size, and income. I have clients paying $0 that didn't qualify for CSR, or they did and CSR was a big difference in price.

 

[Ann H]

I agree with DGoldenz. I've seen clients figure out that a $6,850 out-of-pocket is the same on a Gold plan as a Bronze plan, if they are max utilizers anyway. I'll bet claims are very high.

 

[HealthRisk]

Why would the carrier want to eliminate reducing their claims costs by not offering a Bronze plan?

Simple. Risk Adjustment.