Health-insurance plans grandfathered into the federal Affordable Care Act will not be provided by Blue Cross and Blue Shield of North Carolina in 2018, the insurer confirmed in a blog post.
About 50,000 individuals in the non-group category will be affected statewide.
Blue Cross Blue Shield did not provide a breakdown by county or region.
Those individuals will have to find a federal health exchange plan for 2018 coverage, said Gary Bolt, a vice president in sales and marketing for the health insurer, North Carolina’s largest.
Notices will be mailed to affected customers in October, which will include premium and comparable ACA plan information on deductibles and benefits.
Affected are Blue Cross customers who had a health plan in effect in March 2010 when the ACA was signed into law by President Barack Obama.
A key stipulation of the law to win support was the grandfathering of plans for customers who wanted to keep their orginial coverage rather than participate in the federal health exchange.
Bolt said participation level in the pre-ACA plans has dropped from more than 330,000 in 2010 to 50,000 currently.
“We know this will be tough news for our customers who love their grandfathered plans,” Bolt said.
“Because no new customers have joined this pool since 2010, the group as a whole has gotten older and sicker,” he said. “That means they have also become more expensive to insure, and we’d need to raise rates for these customers a significant amount to keep offering these plans in 2018.”
Bolt said there is a “good news-bad news scenario for most customers” who will transition to an ACA plan.
“The good news is their plan will cover more services, in most cases,” Bolt said. “The bad news is that this coverage will be more expensive than what many customers are paying today.”
The insurer did not provide an average projected monthly premium increase.
“Many will pay quite a bit more,” Bolt said. “Some customers will have fewer in-network providers in their new plan.”
Bolt said some grandfathered customers will qualify for ACA subsidies, as do many current ACA policyholders.
“Comparing current-year premiums for grandfathered plans to premiums for an ACA plan next year, young men and women over 50 will generally pay more for ACA coverage, while older men and young women will pay less,” Bolt said.
The end of the grandfathered plans comes about three weeks after Blue Cross lowered its premium-rate increase request for 2018 individual ACA insurance plans from 22.9 percent to 14.1 percent.
Blue Cross has filed an adjustment to the plan it submitted in May to the N.C. Insurance Department, which can approve, reject or reduce the rate increase.
The open-enrollment period for ACA insurance for 2018 will be shorter, from Nov. 1 to Dec. 15.
Blue Cross initially sought an 18.8 percent premium increase for 2017, but increased it to 24.3 percent after competitors left the insurance marketplace.
The request for a lower rate for 2018 comes at a time of great uncertainty about whether the Trump administration will agree to continuing to provide monthly federal cost-sharing subsidies that make most of the individual insurance plans on the ACA exchange more affordable.
The subsidies help lower-income individuals buy plans that have reduced out-of-pocket costs for medical care, such as lower deductibles and co-payments. President Donald Trump could make a decision on the subsidies any day, administration officials say.
“The individual market in North Carolina has become less volatile,” Brian Tajlili, the director of actuarial and pricing services for Blue Cross, said in a blog posting Aug. 1.
“We have gotten a better handle on the anticipated medical costs of people covered in this group (during June and July), which has made it easier for us to estimate the necessary price of our ACA health plans,” Tajlili wrote.
Mark Hall, a law professor at Wake Forest University and a national health-care expert, said that the overall Blue Cross ACA premium reduction decision “is encouraging news.”
“It indicates that the individual health-insurance market in North Carolina has become more stable, which means there is less reason to repeal the Affordable Care Act,” Hall said.
Date:Aug 22, 2017