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Blues dropping ObamaCare in much of TN

BlueCross BlueShield of Tennessee will not sell insurance plans on the Obamacare exchange in the state’s three largest metro areas next year, reports The Tennessean.

The insurer made “an extremely difficult but necessary decision” to leave the Nashville, Memphis and Knoxville markets as it tries to manage its number of members to hit a break-even point amid three years of losses, said Roy Vaughn, chief communications officer of BCBST.

“It’s not something we want to do but we believe we must look out for the health care and financial security for all the members that we serve,” Vaughn said in an interview with The Tennessean.

(The Times-Free Press reports the total of 214,000 Tennesseans impacted is more than half of those enrolled through BCBS statewide.)

The company formally made the change to its 2017 plans in a Friday filing with the U.S. Department of Health and Human Services — roughly a month after it raised the possibility of scaling back. Earlier this summer, BCBST requested — and was granted — state approval for an average 62-percent premium increase. The rate hike is still pending federal approval.
By the end of 2016, BCBST anticipates losses from three years selling on the exchange established by the Affordable Care Act will approach $500 million.

…The Chattanooga-based insurer, which was the only insurer that originally planned to sell statewide, expects to shed about 112,000 people from its rolls under the change and keep about 80,000 primarily in rural areas. Shoppers in the three metro areas will not be able to buy either on-exchange plans, where tax credits may be used, or off-exchange plans, which are not eligible for tax credits.

The decision will reshape open enrollment, which begins Nov. 1, for people who buy individual plans in the state’s three largest markets — and where Cigna or Humana, or both, are expected to sell plans. According to BCBST, 52,000 people in Nashville, 31,000 in Knoxville, and 29,000 in Memphis, will have to look to another insurer for coverage in 2017.

Vaughn said the structure of its 2017 footprint was designed to make sure there was at least one insurer in every part of the state. The 95 counties are divided among eight regions. In 2016, BCBST and UnitedHealthcare were the only two insurers to sell statewide.

BCBST’s decision increases the number of counties in which people may choose from a single company to 73 counties — up from 57.

(Note: A BCBS map showing county coverage in 2017 is HERE.)

BlueCross Profits Reach Record Levels

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Tennessee’s biggest health insurer helped ensure its own fiscal health last year by boosting net income by more than 26 percent and swelling its reserves to more than 50 percent above what is legally required, reports the Chattanooga TFP.
BlueCross BlueShield of Tennessee, the state’s biggest nonprofit corporation with $5.6 billion in annual revenues, said Monday it earned record profits of $221.5 million during 2012. Even with its income gain last year, BlueCross officials said the 4 percent profit margin was still the lowest among the major health insurers operating in Tennessee.
“As a tax-paying, not-for-profit company we can operate on a lower profit margin than the investor-owned companies in our industry, but we still try to maintain a small profit margin to ensure we can continue to serve our customers and remain financially strong,” BlueCross Vice President Roy Vaughn said. “I think our customers want us to be strong financially and to do well so that they know they can depend upon our services.”