|Earlier last week Wellmark and Aetna both informed CMS & the Iowa Insurance Division that they will not be offering on-exchange or off-exchange plans in the state of Iowa for 2018. You can read their official releases below. We have contacted Medica and at this time they do not have any updates and are still evaluating what they need to do in 2018. OCI will continue to monitor the situation in Iowa and keep you posted about any possible changes as it relates to the Nebraska market.
As agents, you do a tremendous job helping our members understand their health insurance coverage and available options, as well as factors that contribute to rate increases.
Over the past three years, you’ve helped share challenging news to Wellmark members who have individual health plans governed by the Affordable Care Act (ACA) and who have endured double-digit premium increases. Even after the year-over-year rate increases, Wellmark has lost approximately $90 million in the individual ACA market during the same timeframe.
Finding solutions to stabilize this market is in the best interest of all Iowans, including health care providers and insurance carriers. No one truly benefits from rising costs. While there are many potential solutions, the timing and relative impact of those solutions is currently unclear. This makes it difficult to establish plans for 2018. Given this environment, Wellmark has decided not to sell or renew individual and family ACA plans in Iowa with a Jan. 1, 2018, effective date.
How does this impact your business?
Majority of Iowans are not impacted
We look forward to working with state and federal regulators to determine the best path forward to ensure Iowans have access to high-quality health care.
We’re here to help
The public exchange environment remains highly volatile, forcing Aetna to continually reevaluate our current footprint and make some difficult decisions.
Earlier today, we informed the appropriate federal and state regulators that Aetna will not participate in the Iowa Individual public exchange for 2018 as a result of financial risk and an uncertain outlook for the marketplace.
This decision applies to ACA-compliant Individual plans sold on and off the Iowa Individual public exchange. It does not apply to other products, such as Private Exchange, Medicaid, Medicare, Employer Group, Student Health and stand-alone dental, vision and pharmacy.
These changes do not affect 2017 member benefits or service. Iowa members can keep their coverage through December 31, 2017.
We are still evaluating our 2018 Individual product presence in our remaining states.
If you have any questions, contact your sales representative or the Aetna Concierge team at 1-855-867-2757. Representatives are available Monday – Friday from 7:30 a.m. to 5:00 p.m. Central time; 8:30 a.m. to 6:00 p.m. Eastern time.