Industry Updates

Aetna, United Healthcare and Anthem Health Keepers are leaving the individual healthcare markets in Virginia for 2018. If you have Aetna or United Healthcare you will NOT automatically be enrolled with a new health insurance company. You will need to actively enroll with a different health insurance carrier. NOTE: As of Friday, August 11th 2017, Anthem Health Keepers officially pulled all of their products out of the individual on-exchange market in Virginia. In addition, they pulled all products off-exchange with the exception of City of Bristol, Washington County, and Scott County.

Deadline Change: 2018 Health Insurance Open Enrollment is Cut In-Half

Last year there were 92 days to enroll in a health insurance plan for you and your family, November 1, 2016 – January 31, 2017. This year the 2018 health insurance open enrollment period is cut down to 45 days, November 1, 2017 – December 15, 2017.When there was a 92 day window, there were issues with system overloads for multiple insurance programs and providers, and people who needed coverage missing the deadline. Now that there are only 45 days to enroll, these issues are expected to be even greater. The later you wait, the more potential issues you may have trying to enroll. The systems tend to overload the last few days of the enrollment periods due to the extremely high volumes of activity.

Optima Health is Coming Back to Richmond, VA

Optima Health will be returning to Richmond, VA for 2018 to offer individual and family health insurance coverage. Optima has serviced various areas of Virginia over the years, however they left the greater Richmond Market for 2017. With two providers leaving Virginia for 2018, there will now be three major health insurance companies to choose from in Richmond, VA: Anthem Blue Cross Blue Shield, Optima Health, and Cigna.

Potential Changes to COBRA for 2018

The U.S. House of Representatives are proposing changes to how people can use subsidies. This includes a proposal to allow for people to use their subsidies to pay for COBRA. COBRA, which stands for Consolidated Omnibus Budget Reconciliation Act, is the 1985 act requiring companies of certain sizes to offer extended health insurance to former employees and/or dependents after losing their employment.

2018 Health Insurance Rates Will Increase

The major health insurance carriers already applied for rate adjustments for 2018 with The Virginia Bureau of Insurance. As usual, rates are expected to increase. Health insurance companies applied for an average rate increase of 14%, with one carrier applying for upwards of 20%.

Q& A. Anthem Health Keepers leaves Individual/Family market in Virginia. Please See below

Q1 – Why did Anthem Health Keepers make the decision to leave the Marketplace/Exchange and to withdraw off Exchange from all but three cities/counties?

A1 – The current condition of Individual (this does include Family coverage) health insurance remains volatile. Anthem states “A stable insurance market is dependent on products that create value for consumers through the broad spreading of risk and a known set of conditions upon which rates can be developed.” “…due to a shrinking and deteriorating Individual market…continual changes…uncertainty in federal operations, rules and guidance” and unsure changes to the subsidies and restoration of taxes on coverage – are all contributing factors to Anthem’s decision

Q2 – Where does this leave me for 2018?

A2 – Currently, Optima and Cigna are still positioned to offer health insurance in Virginia. Unfortunately neither one of these carriers cover the entire state, which means there will be counties and/or cities that currently have no options. Legislators are working on this issue now.

Q3 – Could Anthem change their decision?

A3 – Yes, there is still time for Anthem to reverse or modify this decision, but Federal Leaders and Legislators are going to have to come to a decision on certain issues before Anthem with consider a change.

Q4 – Is there a possibility that Optima and/or Cigna will also pull out of the Individual market in Virginia?

A4 – There is always that possibility. We will update you via this website as soon as we hear of any changes

Q5 – If Anthem Health Keepers was my only option, what do I do now?

A5 – While the legislators are working on this and proposed a few options, no final decision has been made. We at Lyons & Associates are also trying to come up with some options for you. We already have the option for Short-Term coverage, but that isn’t a good options for many of our clients, so we are still exploring other ideas.

Q6 – Does this change affect my Grandfathered coverage with Anthem?

A6 – No it does not

Q7 – Does this change affect my Medicare coverage with Anthem?

A7 – No it does not

Q8 – Does this change affect my Medicaid coverage with Anthem?

A8 – No it does not

Q9 – Does this change affect the coverage that I get through my employer?

A9 – No it does not

Q10 – I currently have an Individual Dental, Vision, and/or Life Insurance policy with Anthem. Will any of these be affected by the recent changes by Anthem?

A10 – No they will remain active.

What Does All This Mean and What Should I Do?

With all the changes coming to the health insurance markets in 2018, working with a health insurance broker is even more important than ever. Lyons & Associates will help you find the plan that best fits you, both medically and financially. We do this by learning about you and your family’s needs, educating you on all the options available, and guiding through the health insurance process. Don’t wait, call us today at 804-330-5885 to start preparing for open enrollment.

Also, if you need to change your health insurance now due to a life changing event (referred to as qualifying event or special enrollment) or you need short term health insurance (90 days or less), you may have other options available. We can help. Call us today to learn more, 804-330-5885.