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Old 07-15-2013, 10:01 AM
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Default PPACA Exchange Watch

I thought to start a new thread just to aggregate news about info of various PPACA exchanges, whether state or federal, individual or business. If there are more mandate delays, I'll put it in the other thread. This is more of an operational/concentration/strategic risk watch.

First up is Illinois

http://www.chicagobusiness.com/artic...hange-scramble

Quote:
UnitedHealth Group Inc., the largest insurer in the nation and second-largest in Illinois, is not going to sell policies on the state's insurance exchange when it opens for business on Oct. 1, Crain's has confirmed. In fact, only six carriers have signed up for the Illinois exchange, including Blue Cross & Blue Shield of Illinois, which dominates the state's health insurance market, and Humana Inc., the third-largest carrier.

....
Instead of sparking competition, the Illinois exchange is serving up a prime opportunity for Blue Cross to tighten its grip on the state, where it already has more than 68 percent of the market for individual policies.
....
According to people familiar with the exchange applications, the six carriers are:
Blue Cross, a subsidiary of Chicago-based Health Care Service Corp.

Humana Inc. of Louisville, Ky., a spokeswoman confirms, declining further comment.

The insurance arm of Carle Foundation, a nonprofit hospital network based in Urbana, a spokeswoman confirms, declining further comment.

Aetna Inc. of Hartford, Conn.

Coventry Health Care Inc. of Bethesda, Md.

Land of Lincoln Health Inc. Co-op, a new venture financed by a $160 million federal loan.

Since the applications were filed in April, Coventry, the state's seventh-largest insurer, was acquired by Aetna, the fifth-largest, further narrowing the field. An Aetna spokeswoman declines to comment; a Coventry spokeswoman confirms the company's participation.

UnitedHealth is taking its time to evaluate the exchanges, a spokesman says. The Minnetonka, Minn.-based company has said it's participating in only a dozen state exchanges nationwide.
....
To get the exchange up and running, Illinois has received $115 million in federal funding. On July 12, the state selected the Fleishman-Hillard unit of Omnicom Group Inc. in New York for a $35 million contract to promote the exchange. This month, the state plans to award $28 million in grants to organizations to help consumers navigate the exchange.

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Old 07-16-2013, 07:38 AM
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Everything is on schedule!

https://www.youtube.com/watch?v=JTd9I8tFLyQ

Yes, that's an official HHS video. Does the typing sound effect help convince you? It's only a little over a minute, so see if that allays your fears of delay.





http://www.washingtonpost.com/blogs/...ns-this-video/

Quote:
Notably absent from the video is any mention of the employer mandate and small business health exchange, both of which have not moved ahead on schedule.
.....
Update: HHS spokeswoman Joanne Peters contends there has been no lowering of standards at all. Quite the opposite, the agency will be able to deliver on the law’s promises starting October 1. Her email:
HHS is focused on delivering quality, affordable health insurance to millions of Americans. Here are the facts: We’ve already implemented key insurance market reforms, with more scheduled to take place in January, that are ending the worst practices of the insurance industry and we are putting money and control back into the hands of consumers. The work to set up the marketplaces is on track. Despite Medicare’ s annual call traffic of 26 million calls, there were questions about our ability to get a call center up – that is done. There were worries about the web technology, however the beta version of the website is up nearly three months before October 1, when families will begin shopping for new insurance options.

So, they've got a call center and a beta site. I wonder if anybody has found this beta site.
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Old 07-16-2013, 07:44 AM
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http://www.cnbc.com/id/100882439

Quote:
Less than 90 days before Obamacare's government-run health exchanges are due to open up shop, Web insurers are still being locked out of helping sign up uninsured individuals—a lag that threatens to depress enrollments, and jack up insurance rates, experts tell CNBC.

Web insurers?

Quote:
So far, none of the government exchanges being run by the federal government, individual states, or federal-state partnerships has given ehealthinsurance.com and other for-profit Web markets the green light to enroll uninsured individuals under the Affordable Care Act's subsidized coverage scheme.
Oh, that's not an insurer. I'm not sure why they're whining (other than lost business - and they will lose business).

The subsidies were only supposed to go through official government exchanges -- I don't remember a private option.

Anyway, it sounds like he's trying to do a little negotiation in public, knowing that they already have some of the machinery in place, and various governments may not. So if he's public with his whining, the issue becomes: you (states/feds) knew you weren't getting your projects done on time, so why didn't you partner with "web insurers"?

Quote:
EHealth has been in discussions with the U.S. Centers for Medicare and Medicaid Services regarding a Web-based exchange agreement which would allow the company to enroll subsidy-eligible individuals in the states where a federal exchange will be operating, Lauer said.

Last Friday, Lauer said he has "grown confident and hopeful" that eHealth could ink that deal with CMS "very soon."

But similar hopes by the company on that front have all, to date, come to naught, according to people familiar with the matter.

And Lauer also noted that in the 16 states and District of Columbia, which "are developing their own exchanges, we have yet to enter into a Web-based broker agreement."


and then there's this bit, where it's pointed out that private efforts are being leveraged already

Quote:
California's exchange told CNBC that it has rejected the idea, at least for the first year, because of technical difficulties of interfacing between the exchange and the Web markets.

"In the first year, we can't custom interface, we don't have enough bandwidth, we don't have the technological capacity," said Anne Gonzales, spokeswoman for the Covered California exchange.

Ironically, Covered California in 2012 awarded a $359 million contract to Accenture to implement its state health exchange, which was being based in part on software from Web marketplace Getinsured.com. But Getinsured.com itself—like other Web markets—cannot sell subsidized coverage of plans that are available on the exchange because of California's rejection of that idea so far.
Anyway, good luck with your negotiations, Lauer.

Quote:
Lauer and other insurance industry figures said that if Web marketplaces aren't allowed to sell ACA-subsidized insurance plans being offered on the government exchanges, it could dramatically depress enrollment in Obamacare.
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Old 07-16-2013, 10:41 AM
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Quote:
We’ve already implemented key insurance market reforms, with more scheduled to take place in January, that are ending the worst practices of the insurance industry and we are putting money and control back into the hands of consumers.
Muahaha, that's just what we want them to think! Soon the whole world will be ours!!!
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Old 07-17-2013, 11:02 PM
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Wellmark BCBS in Iowa will not participate in the Exchange. Wellmark currently has about 85% of the individual market in Iowa.

"Wellmark Blue Cross/Blue Shield also decided not to list on the individual exchange in Iowa for 2014, due to a lack of information available in the state, according to a spokesperson for the Iowa Insurance Division."



http://www.foxbusiness.com/personal-...#ixzz2Yyys1knI
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Old 07-18-2013, 10:58 AM
ActuaryGuy23 ActuaryGuy23 is offline
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Did something happen today in the reform world? Health stocks are spiking up tremendously (3-5% in early trading).
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Old 07-18-2013, 11:02 AM
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Quote:
Originally Posted by ActuaryGuy23 View Post
Did something happen today in the reform world? Health stocks are spiking up tremendously (3-5% in early trading).
Across the board, or specific companies?
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Old 07-18-2013, 11:03 AM
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Headline: UnitedHealth Earnings: Company Raises Outlook as Profit Rises 7.4%

Earnings season is in effect.
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Old 07-18-2013, 11:04 AM
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That's what I thought. Next week is chock-full of earnings calls

The only thing that "happened" recently is this:

http://www.lifehealthpro.com/2013/07...parts-of-ppaca

and that's just political theater. It's not going anywhere.
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Old 07-18-2013, 11:05 AM
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Quote:
Originally Posted by Kyle View Post
Headline: UnitedHealth Earnings: Company Raises Outlook as Profit Rises 7.4%

Earnings season is in effect.
That would explain it. Didn't come up in the specific stock I was looking at... I guess the industry is expected to do very well this quarter.
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