By now, most of you have already heard the recent devastating news that Blue Cross Blue Shield of Kansas City will be exiting the individual health insurance market effective January 1, 2018. When I say “devastating” news, I mean DEVASTATING for several reasons:
- As the flagship carrier and market share leader in our area, most people who have individual health coverage in this town have BlueKC.
- Outside of BlueKC, there are very few alternative options in the individual market for our area.
- The options available outside of BlueKC have significant provider and benefit limitations. This means that your preferred doctor or hospital might not be in an alternative plan.
- The few insurance companies that have alternative plans may also exit the KC market leaving a complete void in our area for individual health.
I didn’t even mention that helping people in the KC area acquire and maintain BlueKC coverage is a large part of what I do, but this isn’t about me.
The immediate question that is sure to arise is “what am I going to do?” And, here are a few answers:
Watch and wait. We are going to have to really pay attention to what develops in the area market to see if anything viable becomes available. The main reason that insurance companies are fleeing the market are losses due to flaws in the Affordable Care Act. Since this affects all insurance companies, it is not unlikely that no insurance companies will be participating in the individual market next year.
Does your employer offer group coverage? For most people reading this letter, the answer is “no!” Otherwise, you would already be participating in employer sponsored coverage, right? For those of you who have coverage available through your own employment or your spouse’s employer, this is your out! It may have been more expensive than your individual coverage, but now that you may not have an individual plan in 2018, it’s good to have this option. By the way, if you work for an employer that doesn’t offer health insurance, LET ME KNOW! I am always happy to explore group health insurance options with a willing employer. Many employers are going through this for their own coverage and realize that keeping employees may require offering a group plan.
Can you be an employer? Unlike the individual market, there are still plenty of options for small businesses. The catch is that you must have an LLC or Corporation, and you have to have at least 1 W-2 employee participating in the plan who is not your spouse in order to qualify. If this describes you or can, then give me a call and we may be able to help you transition.
These are the main options available given the current crisis that we have in the individual health market. Short of the unlikely scenario where the government steps in and mitigates the losses of companies like BlueKC to temporarily maintain the current plans, we will all have to examine the scant options available to us.
I can assure you that the recent developments are significantly devastating to us as individual health is a large part of what we do. However, without viable options to offer in this market, Insurance Pros, will not be able to devote meaningful time to solving these issues for consumers outside of our existing client base. We will continue to help our existing clients examine transition plans, and we are still dedicated to providing excellent service to our clients in the employer group health insurance and the Medicare markets. I sincerely wish everyone the best as we move into the summer, and I hope that our next piece of correspondence is good news for everyone.