News and Blog

Friday, 4 March 2016
BlueCross BlueShield of TN expects loss in 2016 on ACA individual policies

After a moderately successful open enrollment period for 2016, BlueCross BlueShield of Tennessee did not see a significant change in demographics as they had hoped. The hope for insurance companies is the young, heatlhy individuals will sign up providing additional premium to pay for the older and sicker who are currently covered. Unfortunately even a 37% increase may not be enough to stem the losses. 

During the course of open enrollment, which ran from Nov. 1 to Jan. 31, federal officials with the U.S. Department of Health and Human Services said they were seeing more of the coveted "young invincibles" - people ages 18 to 34 - sign up. Younger members are generally healthier and less expensive to cover so insurers had hoped to see more in their membership pools.

For BCBST, however, the percentage is right around the 2015 number: 26 percent of enrollees account for these "young invincibles".

  • Fifty-one percent of enrollees are 45 or older.
  • The average age is 42. 
  • More than half, 53 percent, are female.

A similar mix of members mean the insurer is facing another year of losses, despite an average rate increase of 36.3 percent for 2016. The individual exchange has hit BCBST's bottom line. It's lost about $300 million in two years.

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March 4, 2016

Posted on 03/04/2016 2:39 PM by David Moore
Thursday, 3 March 2016
Donald Trump wants to sell health insurance across state lines | Will it help?

While details are very limited, we do know the main plan for Donald Trump to control rising health care costs and insurance premiums is to allow carriers to sell health insurance across state lines. Currently, each state has their own set of rules and regulations for health insurance sold in their state. This would allow a Tennessean to buy a Kentucky or Georgia policy if the wanted. The allure to insurance companies would be to attract more people and companies to their policies. The real challenge is for those states with the most regulations will also have the highest cost policies and have the most to lose. 

Will it work? For some, yes because they will be able to buy are more watered down policy from another state. Unfortunately, this does nothing to stem the ever increasing cost of prescriptions and the direct to consumer advertising that pushes high cost drugs rather than older similarly effective treatments. What about waste, fraud duplicated testing and procedures? Electronic medical records were supposed to be fully online and working seamlessly to allow providers to share notes, tests and histories. Unfortunately, most don't communicate with each other creating another barrier to streamlined care and cost savings. 

Time will tell who wins the election and changes are actually possible to the current system. For me and our clients we continue to promote low cost, high deductible health plans (HDHP) paired with a Health Savings Account (HSA). When you let consumers know the true cost of care, they make much better decisions and ultimately reduce the cost of healthcare spending. 

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Posted on 03/03/2016 10:21 AM by David Moore