Anthem Statement on Individual Market Participation in Ohio

June 06, 2017

For more than seven decades, Anthem Blue Cross and Blue Shield has served consumers in the Individual market and throughout that time our commitment remained the same: to provide access to affordable, quality healthcare. And, since the inception of the exchanges, Anthem continued its commitment to serve consumers in all of the states where we provide fully insured individual health plans.

 

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.  Today, planning and pricing for ACA-compliant health plans has become increasingly difficult due to the shrinking individual market as well as continual changes in federal operations, rules and guidance.

 

We are pleased that some steps have been taken to address the long term challenges all health plans serving the individual market are facing, such as improving the eligibility requirements that allow consumers to purchase a plan outside of open enrollment and improved risk adjustment.  However, the Ohio Individual market remains volatile and the lack of certainty of funding for cost sharing reduction subsidies, the restoration of taxes on fully insured coverage and, an increasing lack of overall predictability simply does not provide a sustainable path forward to provide affordable plan choices for consumers.

 

As a result, Anthem has made the difficult decision to reduce its 2018 Individual plan offering in Ohio to one off-exchange medical plan in Pike County only. This decision does not impact individuals or families with grandfathered  or grandmothered plans, nor does it impact Anthem’s employer-based or Medicare Advantage plans.

 

As the Individual marketplace continues to evolve, Anthem will continue to advocate solutions that will stabilize the market to allow us to return to a more robust presence in the future. 

 

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