END OF 2018 OPEN ENROLLMENT PERIOD (42 states)

Time: D H M S

Humana

After their attempted merger with Aetna was roundly shot down by the federal government, insurance giant Humana issued a press release today with some major news:

Regarding the company’s individual commercial medical coverage (Individual Commercial), substantially all of which is offered on-exchange through the federal Marketplaces, Humana has worked over the past several years to address market and programmatic challenges in order to keep coverage options available wherever it could offer a viable product. This has included pursuing business changes, such as modifying networks, restructuring product offerings, reducing the company’s geographic footprint and increasing premiums.

Hey, remember back in August 2016 when Aetna, just three months after saying how great things were going for them on the ACA exchanges (to the point that they might even expand into several additional states), did a complete 180º by announcing that they were instead going to leave 11 of the 15 states they had been participating in?

At the time, it seemed awfully suspicious; as I noted on 8/15/16:

Oh. Well, I'm sure that was just a sheer coincidence, right? No doubt Aetna will clear this up with an unequivocal statement to put any speculation to...

From Peter Sullivan of The Hill:

Asked if the DOJ’s actions on the merger had any relation to Monday’s announcement, Aetna spokesman TJ Crawford did not directly say yes or no.

Thanks to Louise Norris for the heads up:

UnitedHealthcare / Humana Insurance

For 2017, UnitedHealthcare, along with most of its subsidiaries, is discontinuing its participation in the individual market in Colorado, both on and off the exchange.  However, Golden Rule Insurance, a subsidiary of UnitedHealthcare, will continue to offer its individual plans in Colorado off of the exchange.  UnitedHealthcare will also continue its small and large group business in the state.

Humana will continue in the small group market for 2017 off the exchange, while exiting the individual market for both Humana Health Plans and Humana Insurance Company.  

OK, so UnitedHealthcare is out except for off-exchange Golden Rule; this is actually an improvement over the prior United news, since it was assumed they were pulling out of the state completely.

Last month there was much handwringing over the news that UnitedHealthcare has decided to take their ball and go home, pulling out of the individual market in more than 2 dozen states. Shortly after that came the news that Humana is also tidying up their books by dropping individual plans in at least 5 states.

However, capitalism abhors a vacuum. In Iowa, even as UnitedHealthcare is leaving, Wellmark Blue Cross Blue Shield is stepping in to fill the gap there...and today brings some welcome news about another major carrier, Aetna:

Health Insurer Aetna Inc on Wednesday said it plans to continue its Obamacare health insurance business next year in the 15 states where it now participates, and may expand to a few additional states.

This is really just a summary of my last 4 posts. I've combed through the SERFF databases for every state which uses the system for rate filings, and while very few have the actual 2017 rate filing requests listed yet, at least 4 of them have official individual market exit letters submitted for 2017 from Jane Rouse, the Product Compliance Process Owner for Humana Insurance Co:

This list may grow as additional state filing data and/or press releases come out from Humana, but assuming these are the only 4 states Humana is bailing on, the news isn't quite as bad as it appears at first.

To keep things in perspective, add the 4 numbers above up and it's 25,512 people across 4 states with a combined population of 21.8 million. Put another way, these 25.5K people represent only 2.9% of the 875,700 people Humana currently has enrolled in individual policies (both on & off exchange) nationally.

To be clear, I'm not saying this is a good development; when you combine it with the recent UnitedHealthcare Dropout Odometer it's more of a drip-drip-drip sort of thing. But it isn't disasterous for the exchanges either (at least not yet).

UPDATE: I've been informed by a reliable source that Humana is also dropping out of the individual market in Nevada next year, although I don't have any actual enrollment data there. Humana is not currently participating on the Nevada exchange, however, so any dropped enrollments would be OFF-exchange only. In fact, I'm pretty sure that the only individual market enrollees Humana has in Nevada are grandfathered policies anyway, so the numbers should be pretty nominal there.

Yep, sure enough, Humana is following UnitedHealthcare out the door of multiple states next year. That's 1,800 people impacted, although they're all OFF-exchange only:

I already noted last month that Humana is dropping out of Virginia's individual market next year, but since I'm in a "Humana pulling out!" mode this morning, I might as well post their official exit notice for completeness. Thankfully, the impact is nominal in Virginia, as only 1,800 people are being impacted total.

It's also worth noting that "grandfathered" enrollees only make up around 11% of Humana's total Virginia individual market as of this spring, which is somewhat higher than my overall ballpark estimate of around 1 million nationally.

 

Just like in Wisconsin, Humana appears to be pulling up stakes on the individual market in Alabama as well...but unlike Wisconsin, Humana is operating on the ACA exchange this year. With UnitedHealthcare already having announced that they're leaving Alabama as well, Humana dropping out in 2017 will leave Blue Cross Blue Shield of AL as the only individual market carrier operating on the exchange in the state unless someone else jumps in (although I believe there are some carriers offering individual plans off-exchange only):

Humana Inc. just released their Q1 2016 financial report, which includes this section:

As previously disclosed, in the fourth quarter of 2015 the company recorded a PDR associated with its 2016 individual commercial ACA‐compliant offerings.  Historically, this business has reported a profit in the first quarter of the year due to the related benefit designs.  Because the company continues to anticipate a loss associated with this business for the full year 2016, the seasonal earnings generated in 1Q 2016 are offset by an increase in the PDR, resulting in a higher benefit ratio year over year.  This first quarter seasonality was anticipated as the company developed its estimate of the full‐year PDR recorded in the fourth quarter of 2015.

Financial results associated with the wind‐down of the non‐ACA compliant (legacy) business, including the related release of policy reserves, as well as indirect administrative costs associated with ACA‐compliant offerings are included in the company’s 1Q 2016 financial results.

Thanks to Adam Cancryn for calling my attention to Molina's quarterly earnings report, which has this rather eye-opening section:

I've used Molina's Q1 2016 report, along with the Q4 2015 reports of Cigna and Humana, to further fill in the "Major Insurer" table I've been working on all this week; here's what it looks like now:

Humana Group is one of the largest health insurance companies in the country. As such, their enrollment data being made available is extremely helpful in seeing where things stand and how they've changed nationally.

Today, Bob Herman of Modern Healthcare provided me with a link to Humana's latest SEC filing. In addition to a whole mess of financial info which is of little interest to me, there's also all sorts of year-over-year data about their enrollment numbers...including a very handy section about their individual market, broken out by ACA exchange-based, Off Exchange and even their non-ACA compliant enrollments (ie, "grandfathered" and/or "transitional" enrollees).

Here's the key section: