August 27, 2015

Insurance company leaving individual NM HIX market at end of year

Blue Cross Blue Shield of New Mexico will not be offering individual plans on the New Mexico Health Insurance Exchange in 2016 after the Superintendent of Insurance rejected a large requested pay hike.

Little girl getting a flu shotAlbuquerque Business First reported the news and it comes just weeks after the company requested approval for a premium rate increase.

The insurance company had requested a 51.6 percent premium rate hike, but the Office of the Superintendent of Insurance rejected the proposal earlier this month.

The move will impact 35,000 individuals who bought insurance from the company both directly and through the exchange. Those who have BCBSNM insurance plans from other plans will not be impacted.

From Business First:

BCBSNM stressed that individual insurance policies will remain effective through the end of 2015 and small group, large group, commercial and individual dental product members will not be affected by the decision. In addition, Medicare Advantage Prescription Drug and Medicaid product lines will not be affected.

The Albuquerque Journal provided more information on why BCBSNM is leaving, including saying that the Insurance Superintendent was prepared to accept a smaller rate increase—but that proposal never came.

Insurance Superintendent John Franchini earlier this month rejected Blue Cross Blue Shield’s request for a rate increase averaging 51.6 percent. Franchini said he was prepared to instead approve a 24 percent increase and was waiting for Blue Cross Blue Shield’s response.

He had approved much smaller rate increases for the other insurance companies that offer plans on the exchange – Presbyterian Health Plan, Molina Healthcare of New Mexico, Christus Health Plan and New Mexico Health Connections.

Both the reports in Business First and the Journal include BCBSNM saying that they lost $19.2 million in New Mexico through individual plans.

Other health insurance organizations that are staying in New Mexico, with the lower rate increases, have indicated that they will work to sign up those who lose plans through BSBCNM.

The individual exchanges were set up as part of the health care overhaul signed into law by President Barack Obama in 2010.

Since the law went into effect, the uninsured rate of New Mexicans both in general and specifically among Hispanics have plummeted.

A Centers for Disease Control survey found that the uninsurance rate in the United States overall has dropped below ten percent.