Covered California contracts required insurers to cancel 'non-compliant' coverage

Dennis McCoy Sacramento Business Journal

Specific language in the contracts major health insurers signed with Covered California to participate in the exchange required them to cancel the individual coverage which is at the center of a growing national debate.

Anthem Blue Cross, Kaiser Permanente, Health Net and Blue Shield of California have confirmed to the San Francisco Business Times that their Covered California contracts, signed in August or September, required the cancellations. Other plans on the exchange are subject to the same contract language.

"All QHPs (of which we are one) had to sign that contract," said Darrel Ng, a spokesman for Anthem Blue Cross, referring to insurers known as qualified health plans.

"In order to participate in Covered California as a qualified health plan, the contract required us to cancel non-ACA-compliant plans on December 31," said Steve Shivinsky, a Blue Shield spokesman. "Blue Shield supports this policy because it assures a large and balanced risk pool of individual and family plan subscribers."
Health Net's Brad Kieffer said his company signed the contract Sept. 19, and Covered California counter-signed on Sept. 27 — just days before Covered California was set to begin accepting applications on Oct. 1.

Covered California officials didn't comment on the contract issue, but did direct the Business Times to the relevant contract language on its www.healthexchange.ca.gov web site.

Here's some of the relevant Covered California contract language:

"Contractor agrees that effective no later than December 31, 2013, except as otherwise provided in State Law, it shall terminate or arrange for the termination of all of its non-grandfathered individual health insurance plan contracts or policies which are not compliant with the applicable provisions of the Affordable Care Act. Contractor agrees to promote ways to offer, market and sell or otherwise transition its current members into plans or policies which meet the applicable Affordable Care Act requirements. This obligation applies to all non-grandfathered individual insurance products in force or for sale by Contractor whether or not the individuals covered by such products are eligible for subsidies in the Exchange."

The contract issue is significant, because many unhappy individual insurance plan enrollees — and much national and regional news coverage — have suggested that insurance companies made the decision on their own to cancel existing individual plans at year-end, and shift enrollees into other, sometimes more expensive alternatives.

The New York Times, for instance, in an Oct. 31 story with the headline "Why Some Can't Keep the Plan They Like," made no mention of insurers being required to make these moves...


[This likely will be found to apply to other state exchanges as well since most were created based on the same template.]

where's my free stuff