The Kansas Insurance Department confirmed Coventry is pulling out of the health insurance exchange, but said they are working to smooth the transition for consumers.
Clark Shultz, director of government and public affairs for the department, said Coventry's exchange plans will end Dec. 31. Open enrollment runs from Nov. 1 to Dec. 15, with plans coming into effect on Jan. 1.
United Healthcare will join the exchange this year, and three companies under the Blue Cross and Blue Shield umbrella will continue to offer plans on the exchange in Kansas, Shultz said. Insurance Commissioner Ken Selzer is meeting with them to determine whether they are prepared to take on more customers, because one fewer company will be dividing up the market, he said.
"His interest is in protecting the consumer," he said.
Rohan Hutchings, spokesman for Coventry, said it will continue to offer large and small group plans, plans for state employees and retirees and individual plans that aren't part of the exchange in Kansas. He said he wasn't certain how many customers had bought Coventry plans on the exchange in Kansas, or whether it had pulled out of any other states' exchanges.
"We have a strong presence and commitment to the state," he said.
People who had purchased coverage from Coventry through the exchange should receive more information soon, Hutchings said. They can either choose a non-exchange plan from Coventry or buy a plan during open enrollment on the exchange, he said. The disadvantage of plans not purchased through the exchange is that the buyer can't use tax credits to offset costs.
"They don't need to make any hurried decision," he said.
Hutchings said Coventry had reviewed all of the exchanges it participated in based on their "competitive landscape," market conditions and the portfolio of plans Coventry offered in them. He declined to specify what factors the company had analyzed.
"We will continue to focus on markets where we can provide the greatest value to customers while also growing our business," he said.
Coventry indicated multiple factors were part of its decision, Shultz said, but the most significant one was the federal government's decision to lower the rate at which it would reimburse insurers who paid more than expected due to a pool of patients that needed more expensive care than anticipated. Coventry told the insurance department the lower reimbursement would affect its ability to operate profitably in Kansas, he said, but Selzer intends to meet with them to get more information on the decision.
"The federal government is not going to pay to the extent" expected, he said.
The insurance department received an estimate that Coventry covered about 51,500 "lives," which counts both the policyholder and any dependents, but is trying to get a more solid count, Shultz said.
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