Blue Cross and Blue Shield of Kansas City (Blue KC) today announced the company’s decision to not offer or renew individual Affordable Care Act (ACA) plans in the company’s 32-county service area in Kansas and Missouri for 2018. This decision will affect Blue KC members with both on- and off- exchange individual plans but does not affect individual plans that were purchased on or prior to October 1, 2013.
“Since 2014, we’ve expended significant resources to offer individual ACA plans to increase access to quality healthcare coverage for the Kansas City community,” said Danette Wilson, President and CEO of Blue KC. “Like many other health insurers across the country, we have been faced with challenges in this market. Through 2016, we have lost more than $100 million. This is unsustainable for our company. We have a responsibility to our members and the greater community to remain stable and secure, and the uncertain direction of this market is a barrier to our continued participation.”
Blue KC has more than 1 million members, and this will affect approximately 67,000. This decision will not affect 2017 coverage. It also does not affect Blue KC members who are covered under one of its “grandfathered” or “grandmothered” plans. These plans were purchased on or prior to October 1, 2013. Additionally, members who receive coverage through their employers, as well as those who purchased a Medicare Advantage, Medicare Supplement, short-term or student health plan from Blue KC, are not affected.
“This decision is necessary at this time, but we’ll continue to work with federal and state legislators to identify solutions that will stabilize the individual market and bring costs down for our members, the community and Blue KC,” said Wilson.
For more information, call 1-888-737-7086. Affected Blue KC members will be notified via mail by Blue KC by July 1, 2017.
Blue Cross and Blue Shield of Kansas City, the largest not-for-profit health insurer in Missouri and the only not-for-profit commercial health insurer in Kansas City, has been part of the Kansas City community since 1938. Blue Cross and Blue Shield of Kansas City provides health coverage services to more than one million residents in the greater Kansas City area, including Johnson and Wyandotte counties in Kansas and 30 counties in Northwest Missouri. Blue Cross and Blue Shield of Kansas City is an independent licensee of the Blue Cross and Blue Shield Association.
For more information on the company, visit its website at BlueKC.com
Why did Blue KC decide not to offer or renew individual Affordable Care Act (ACA) plans in the company’s 32-county service area in Kansas and Missouri for 2018?
Despite our best efforts to maintain individual ACA plans, losses in this market through 2016 of more than $100 million are unsustainable for our company. We have a responsibility to all of our 1 million members and the greater Kansas City community to remain financially stable and keep our policies affordable for all markets.
Who does this affect?
Individuals who have purchased individual ACA plans with Blue KC under the Affordable Care Act (ACA) are affected. We have approximately 67,000 individual members who currently have coverage under one of these plans. Overall, Blue KC has about 1 million members, most of whom will not be affected.
This does not affect our members who are covered under one of our “grandfathered” or “grandmothered” plans. These plans were purchased on or prior to October 1, 2013.
Also unaffected are members who receive coverage through their employer, or those who purchased a Medicare Supplement, Medicare Advantage, short-term, or student health plan from Blue KC. Call 1-888-737-7086 if you are unsure or have any questions about your coverage.
I have an individual ACA plan which will not be renewed in 2018. What are my individual ACA plan options?
Open enrollment for 2018 starts on November 1, 2017. You will be able to “window shop,” or see available plans for 2018 at HealthCare.gov sometime in mid-October. You can sign up now for email or text updates on HealthCare.gov.
If Blue KC is no longer offering individual ACA plans in 2018, will the company offer a similar type of individual plan that I can buy?
While Blue KC will not offer ACA individual plans in 2018, Blue KC will offer Short-Term Security plans, which may be an option for some individuals. Short-term plans are designed to protect your healthcare needs and financial security while you are in transition. Short-Term Security plans do not meet the ACA’s benefit requirements.
If you choose to enroll in a short-term plan rather than an ACA plan, you may be responsible for paying a penalty. These plans require underwriting, exclude pre-existing conditions and may not be renewable. If you have additional questions about Blue KC Short-Term Security plans, please call 1-816-395-BLUE (2583).
Should I expect changes to my individual ACA plan for 2017?
There are currently no planned changes to 2017 plans. This action will take effect January 1, 2018.
If I have a procedure scheduled in December, will it be covered?
All doctors’ visits and medical procedures that are currently covered under your insurance plan will continue to be covered in 2017.
If I have coverage from my employer, will I be affected?
No. This does not affect our members covered under their employers’ group health plans.
I have a Blue Cross and Blue Shield Medicare Supplement or Medicare Advantage policy. Will your decision to stop selling individual ACA plans change my coverage?
No. This does not affect our customers covered under one of our Medicare Supplement or Medicare Advantage plans. Your coverage remains in force and unchanged.
I have a student health plan I purchased from Blue KC. Will I be affected?
No. This does not affect our members covered under a student health plan.
I purchased my individual plan from Blue KC on or prior to October 1, 2013. Is my coverage affected?
No. This does not affect our members who are covered under one of our “grandfathered” or “grandmothered” plans.
If this affects my coverage, will I receive any formal notification from Blue KC?
Blue KC will notify all of our affected members by July 1, 2017. Households may receive more than one mailing, because each policyholder with an affected plan will receive a separate notice.
People can also call 1-888-737-7086 for additional information and resources.
Have you lost money in the ACA Marketplace?
Yes. We’ve lost more than $100 million during the first three years of the ACA (from 2014-2016). We anticipated that the individual market under the ACA would stabilize over time. However, this hasn’t happened, and the market’s current structure and uncertain future create a barrier for our continued participation.
Why are other carriers able to continue selling ACA individual plans and you’re not?
We cannot speak to other carriers’ situations or decisions, but the current landscape has created challenges for many insurers. Blue KC has a responsibility to our members and the greater Kansas City region to remain financially stable and secure, and the uncertain direction of this market, combined with our current losses, are barriers to our participation in 2018.
If a replacement plan passes Congress, will you re-enter?
Blue KC will continue to work with federal and state legislators to identify solutions that will stabilize the market and bring costs down for both Blue KC and our members.
We will continue to evaluate any legislative action, and will work with legislators and regulators on solutions that will make quality healthcare more affordable for our members and the community.
Affected Blue KC members will be notified via mail by Blue KC by July 1, 2017. For immediate questions or concerns call 1-888-737-7086.