Blue Cross Adjusts to ACA Market

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Open Enrollment for 2016 is now in full swing and customers are asking a lot of hard questions, fair questions, questions that demand an answer.  Most of the questions and frustrations center around one thing:  rate increases.  On a near daily basis, insurance companies, agents and brokers are having to try to explain why the cost of insurance is soaring and how families and individuals are supposed to step up and meet the rising costs.  Prior to Open Enrollment, Blue Cross Blue Shield of North Carolina made a strenuous effort to try and answer some of these questions in advance, stating that the “goal, as always, is to offer health coverage that our customers can depend on at rates as affordable and sustainable as possible.”  Blue Cross went on to explain why a rate increase was imperative in order to maintain viability.  In fact, the company provided claims data for 2014 and the first half of 2015, reporting a $132 million dollar loss on ACA business alone.  At that time, BCBSNC explained two important trends:  First, there was no slowdown in any residual demand for medical services from new customers entering the health insurance marketplace after the induction of the ACA and second, there was a prevalence of more chronic health conditions needing medical treatment among ACA customers.

In more recent news, United Health Care has announced it may completely pull out of ACA Exchanges in 2017, citing significant losses on ACA business as the reason for this consideration.  The New York Times reported that United Health Group told investors “it was significantly lowering its profit estimates and blamed an expected loss of hundreds of millions of dollars selling individual policies under federal health care law” (11/20, B1, Abelson, Subscription Publication).   The article further stated “the company said it was estimating losses of more than $600 million from its exchange business, before taxes, in 2015 and 2016.”  With this announcement, customers are once again faced with hard questions about what is happening in the health insurance industry.

As a leader in providing health insurance to the residents of North Carolina, Blue Cross Blue Shield of NC has continued to maintain an outstanding reputation and has  remained committed to the residents of NC despite the strain of the last few years and the changes in the insurance market.  The company has adjusted and re-adjusted in an effort to maintain sustainability under crushing financial losses and accusations of corporate greed.  As insurance agents, we have experienced the strain from all sides, as both the corporation and consumers feel the pressure.  In the end, it is important for insurance consumers to consider a few important things.

First and foremost, as the latest news from United Health Care supports, every insurance company in North Carolina is experiencing these financial pressures, resulting in rate increases across the board.  Second, insurance companies are regulated by the Insurance Commission and are not allowed to raise rates arbitrarily without providing fact and statistics that persuade the Commission that a rate increase is necessary for the company to stay in business.  Third, although Blue Cross Blue Shield NC has always, and continues to, boast the broadest network of providers in the state, they have reluctantly, but diligently, worked to divide and limit networks in 16 major counties in order to try and reduce the cost of premiums for the consumer.  Finally, none of that changes the fact that rate increases are a frustrating and difficult reality that Blue Cross Blue Shield of North Carolina openly acknowledges.

As Blue Cross Blue Shield of North Carolina works to weather this new market, one thing is certain:  as consumers, you still have choices.  In answer to many of the hard questions currently surrounding the insurance industry, BCBSNC continues to encourage consumers that they are striving to remain viable and to provide quality coverage to the residents of North Carolina.

For more information on Blue Cross Blue Shield of North Carolina insurance coverage, please visit our website at or call our toll free number 888-765-5400 and speak with one of our experienced and professional agents. CLICK HERE to apply online in 8 minutes or less.

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