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Florida Blue Says It Never Dropped 300,000 Customers, Only Their Current Insurance Plans

| November 1, 2013

Florida Blue wants to reassure its customers. Customers aren't convinced. (Facebook)

Florida Blue wants to reassure its customers. Customers aren’t convinced. (Facebook)

Hundreds of thousands of Floridians are currently afflicted with something critics of the Affordable Care Act long have warned about: rate shock. It’s the unpleasant experience of seeing your health insurance rates jump as a result of the healthcare reform law — in contradiction with President Barack Obama’s often-repeated promise that, “If you like your plan, you can keep it.”

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This month, Florida Blue, the state’s largest and oldest health insurer, notified 300,000 members that when their plans expire in 2014 they must enroll in new plans that comply with requirements of the ACA that insurers offer coverage to everyone, regardless of pre-existing conditions, and that plans cover 10 “essential health benefits’’ such as hospitalization, prescription drugs and maternity care.

Florida Blue executives insist the company isn’t dropping the members — it’s only dropping their plans, which no longer qualify under the law.

“We’re not terminating anyone’s coverage,’’ said Jon Urbanek, Florida Blue’s senior vice president of commercial markets. “We’re essentially going to go through a transition to qualified plans.’’

It’s a distinction that some Florida Blue members have a hard time seeing — especially when the new plan costs more and offers benefits they don’t necessarily want.

But there are others — generally older, sicker people who had a harder time finding health insurance in the past because of pre-existing conditions — who welcome the change. A qualified plan is likely to lower their monthly premiums and improve their coverage. And still other members will experience little or no change in their costs or coverage level.

“Each individual will experience very different impacts,’’ said Douglas Lynch, vice president and chief actuary for Florida Blue.

Urbanek said that more than half of the estimated 200,000 individual and family policies affected by the change have comprehensive benefits comparable to those required under the health law.

But it’s unclear how many Florida Blue members will pay more and how many will pay less for their new, qualified plans, because an unknown number of those policy holders also may be eligible for federal financial aid to help pay their monthly premiums. That aid is available to individuals and families earning up to four times the federal poverty level, or $45,960 a year for an individual and $94,200 a year for a family of four.

Another factor affecting the cost of health insurance rates is the ACA itself, which requires that insurers now cover anyone who applies, even with a pre-existing condition — a requirement known as “guaranteed issue.”

“Guaranteed issue and no pre-existing conditions will impact practically all of our members,’’ Lynch said, “and represent a significant portion of the overall impact our members will experience.”

But it was the Florida cancellations, followed by complaints of rising prices, that caught the public’s attention, triggering another onslaught of criticism of the ACA. Obama had promised many times in 2008, 2009 and 2010 that Americans could keep their health insurance if they liked it.

What the president did not say, and what many Americans were unaware of, is that insurance companies could close those plans at their discretion, said Julie Bataille, press director for the Center for Medicare and Medicaid Services, the agency within the U.S. Department of Health and Human Services that oversees the public health programs and the online insurance exchange.

“There’s nothing in the healthcare law that makes insurers force people out of plans that they were enrolled in before the law,” she said. “The truth is that insurers are upgrading their plans.’’

But that’s only part of the truth. The rest? Only people enrolled in so-called “grandfathered” plans can keep their current health insurance plan, and even then only if the insurer chooses to continue that plan.

Urbanek said Florida Blue still covers about 30,000 individuals through grandfathered plans — defined as plans that existed before the enactment of the law in March 2010 and that have kept the same level of benefits, copayments and deductibles.

Individuals in Florida Blue’s grandfathered plans will not be transitioned into new, qualified health plans.

“Those folks can keep the plan that they have,’’ Urbanek said.

But Florida Blue is no longer enrolling new individuals into grandfathered plans, either.

Officials with Florida’s Office of Insurance Regulation said they do not know how many grandfathered plans exist in Florida, but that some insurers were closing those plans.

Florida Blue is not the only insurer moving members out of their old health insurance plans and into new, qualified plans. But Florida Blue is the leader in the state’s individual major medical health insurance market, which is where people who do not get healthcare coverage through an employer buy insurance if they can afford it.

In 2012, the state of Florida’s individual market accounted for $2.5 billion in direct premiums earned by insurers. Florida Blue earned $1.08 billion, or 42 percent of the market, for covering 421,000 lives.

Some Florida Blue members say they were content with the old, more basic health insurance plans.

Anyoli Font, 29, of Hollywood, pays $45 a month for a Florida Blue limited benefits plan that covers her annual wellness visits and not much else. Then she received a letter telling her that her limited benefits plan expires Jan. 1. The new plan Florida Blue has recommended will cost about $250 to $280 a month.

If Font does not reply by Nov. 1, she said, Florida Blue will automatically enroll her in the qualified plan. But she doesn’t intend to let that happen.

“I’m going to get back to them and tell them I don’t want this,’’ said Font, who is a healthcare benefits administrator. “I do not need all that extra stuff.’’

Font said she bought a limited benefits plan from Florida Blue a few years ago to reduce her health insurance costs, which were rising annually.

She refused maternity care because she does not plan to have children, and she considers it “ridiculous” that she now has to buy a plan that includes pediatric dental benefits when she doesn’t even have a child.

“I’m pretty sure if I took that premium and put it into a bank account,’’ she said, “I would use less than if I paid for [health insurance] services.’’

Other Florida Blue members, though, are having the opposite experience: premiums are dropping. Typically, they are individuals who had trouble finding coverage on the individual market because of pre-existing conditions, were over 50 and basically were considered a bad bet for insurers.

Carolyn Newman, 50, of Plantation, was diagnosed with breast cancer in May 2006, about a month after she left her job with a nonprofit organization that provided an employee health insurance plan.

Newman said she had gap coverage provided through COBRA when she was diagnosed, and that she planned to join her husband’s individual health insurance plan with Florida Blue once her COBRA ran out.

But Newman’s pre-existing condition locked her out of the market.

“I was denied across the board,’’ she said. “Everywhere I went, no one would cover me.’’

Newman said she eventually enrolled in a high-risk pool plan run by Florida Blue, which has been her insurer since about 2007.

Her monthly premium has been $1,270. But after receiving a letter from Florida Blue, she learned that in January she’ll have a new health plan at a rate of $640 a month — about half her current rate.

Newman said her new plan has “all the same benefits” of her old plan, but with a lower deductible and no lifetime limit on benefits. She said it has higher copayments for some services and lower copayments for others.

Overall, she feels liberated by the change.

“For me, $640 is a lot of money,’’ Newman said, “but it is a hell of a lot less than what I was paying because I was hostage to what I could get. I’m not a hostage anymore. If I choose to use the Internet and shop around, I can’t be denied now.’’

Liz Buzone of Palmetto Bay never had trouble finding health insurance. Buzone gets coverage through her employer, but she buys individual policies from Florida Blue for her 16-year-old daughter and 12-year-old son.

Buzone said she pays $152 a month for her son’s plan, and $180 for her daughter’s plan. When she got her Florida Blue notice in the mail, the prices had gone up — to $170 a month for her son and $200 a month for her daughter — but she’s pleased because her children will get better coverage, including pediatric dental and vision plans.

But her copayments for doctor visits will increase from $25 to $80, and her deductible is also higher. “When I look at it,’’ she said of the health plans, “I think you gain some, and lose somewhere else.’’

Still Buzone noted that in the past, her health insurance costs rose every year and benefits decreased.

“To me, this a $15-to-$20 dollar increase. I’ve had more than that for the past seven years,’’ she said. “Every year, it went up $30 or more. Every year I lost a little bit more. The deductible would be higher, or the copay would be higher. So it was never for a better plan. It was always going to go up.’’

–Daniel Chang, Miami Herald in Partnership with Kaiser Health News

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17 Responses for “Florida Blue Says It Never Dropped 300,000 Customers, Only Their Current Insurance Plans”

  1. James says:

    My wife was one that received the letter from BC/BS it informed her that effective 01/01/14 her current insurance would end and if she wished they would now offer her a bronze plan for $456/mth more than what she was paying. Though this plan would be an upgrade from the one she has/had it now leaves her without insurance as there is no way can we afford the increase per month. So in theory she is not getting cancelled just priced out of their company.

    • A.S.F. says:

      @James says–Have you and your wife researched whether you and she are eligible for tax-credit subsidies? If you need some more info. on this, perhaps this might be a useful website to look

      • Anonymous says:

        So the good news is that maybe she can get tax $ from government taken from others to pay for the increas of cost caused by Government

  2. tulip says:

    This whole insurance thing is a debaucle, confusing and unfair to some people. However, the insurance companies will benefit.

    • A.S.F. says:

      You know, Tulip, in a way, I agree with you. Many Democrats are not exactly crazy about the way this whole thing is turning out. The fact is, this plan is very similar to the Romney Plan and is actually based on plans put forward and recommended B.O. (Before Obama) BY Republicans in the past. However, since it is now coming to life under a Democratic President (Kenyan Socialist Obama), the Republicans want nothing to do with it, had nothing better or other to suggest and were only interested in repealing it, repeatedly. The theory behind the ACA is (was) that free market competition would drive prices down –You know, that wonderful Republican Trickle Down Free Market doodie that Conservatives love to hawk like a fake religion to their adoring public all the time. Now we see Insurance companies literally blackmailing subscribers and subscribing groups by telling them that, if they don’t sign up immediately at an increased percentage now, they will be forced to pay more later because of the effects of Obamacare. What they are really doing is protecting their profit margin by trying to hedge possible projected future losses. So, people, if you want to blame President Obama for all that is happening with these rate increases, and the dumping of what insurance companies perceive to be loser risks, then, go ahead. I could MAYBE understand this sort of behavior from from For Profit insurer groups although their trigger-happy drastic response it is still pretty disgusting. Coming From Non-Profits, it is simply despicable. I hope there is accountability built into the system as we go along, so that any overly-inflated profits these insurance companies may be grabbing now are returned to the consumer, either in terms of increased services or actual refunds. Health Insurance companies have historically gotten away with murder, as have Pharmaceutical Companies. We should have negotiated more, as we do now with the services and products provided to Medicare recipients. You want to guess which political Party fought the most to protect the money that flows to them from the Insurance and Pharmaceutical lobbies (I’ll give you two guesses and the correct one has to do with a rampaging Elephant on Steroids?)

  3. Sherry Epley says:

    If we would just all “pull together” we could have much better health care and essentially much better lives for everyone. Isn’t that a good thing? Or should we turn back the clock to “I’ve got mine. . . to hell with you!”

  4. JAMES says:

    To Anonymous, I have worker for 40 years and have never taken unemployment, ssi, food stamps, or any other govt aid. If there is someone out there that needs help its the govt responsibility to help. Stop fighting wars and having the politicians line their pockets. Congress gets paid about $175,000 AND WE PAY FOR THEIR HELTHCARE. Do you think they can afford to buy their own. Don’t worry I wont use up any govt $ that might affect your lifestyle.

  5. Genie says:

    This is bullshit. More lies by this administration. Sebelius and Obama belong in jail. THEY LIED, knowingly.

    I’m sorry, folks, but anyone still supporting this liar in chief is stupid, stupid, stupid.

  6. fruitcake says:

    Where does the money come from to cover the tax credit subsides?

    • barbie says:

      It comes from the savings overall, as healthcare costs are reduced. That’s already happening, too, although you won’t see it here in Florida, thanks to our felon governor Rick Scott, refusing to help his constituents in ANY WAY.

      • Genie says:

        No, Barbie, it comes from the taxpayer….every dime of it.

        Would you care to show us where actual costs are being reduced, or is that with the same charts that show us how many have signed up?

  7. The Truth says:

    It seems those who oppose the ACA act as if the insurance companies are angels who try and help us every chance they can get. Insurance companies have been dropping people left and right far before the ACA due to pre-existing conditions, maximum coverage, etc. Insurance companies post record profits and we are the ones who get hurt in the long run.

    The answer to our health care crisis is far more than just insurance companies, but they are the root cause of all of our problems along with greed from pharmaceutical companies, people not taking responsibility for themselves, etc.

  8. A.S.F. says:

    I am having a lot of issues with people who are receiving Medicare grumbling about how any tax money they may pay may have to go towards underwriting healthcare for anyone else. You may have worked once and contributed money into the fund but the services you are receiving now are being funded by others who are currently working and should be entitled to live without the fear of death, pain and financial ruin hanging over the heads, the way YOu feel YOU should be forever exempted from those same worries. Stop being so selfish!

    • Dennis says:

      Not to worry A.S.F., this overhaul of the health insurance will hurt those on medicare too! New folks getting into medicare may find it difficult to find a doctor to take the insurance. As unintended the consequences may be everyone will be impacted. Shouldn’t be a surprise to anyone. President Obama said from the very begining that wealth distribution was a good thing for this country.

      • A.S.F. says:

        @Dennis says–That argument does not hold any water with me. There have always been doctors who have refused to take Medicare patients because they don’t like dealing with the associated paperwork or waiting for their reimbursement. In the past, some simply felt that they could get more money from patients with private insurers. If anything, I think you will see Drs. who previously shunned Medicare patients opening up their doors to them because they may feel safer trying to collect money from a more tried and true system. Greed is greed, whether you are talking about greedy Doctors, greedy insurance companies, greedy pharmaceutical companies…Everyone should be pulling together to make this work, if for no other reason that it is appalling to let so many of our fellow citizens sicken and die for lack of insurance. For all those out there whose bottom line always comes down the almighty dollar (and how much of it is THEIR’S), YOUR interest might be served better if healthcare costs level out, rather than continue to rise obscenely, the way they have been. We should be able to save some bucks if more people didn’t wait until they were in dire straits to get help. Since people who let their health concerns languish usually require more expensive and invasive interventions and end up in the ER, we might save a few lives as well as not having to be stuck making up for the costs of bills that others without health insurance cannot pay.

      • barbie says:

        It’s only hurting you because your governor refused to expand its sister program and offer state exchanges.

        It’s amazing, too–he’s supposedly all for “competition”, you think he’d want the state to get in on it. But no. His hatred of the idea of helping his constituents is bigger than his love for The Free Market. Little wonder, since his friends in The Free Market are as rich as he is, with all their ill-gotten gains. They don’t care–they got theirs.

  9. Sherry Epley says:

    This from the Tampa Bay Times:

    On June 29, 2012, Gov. Rick Scott told Fox News anchor Greta Van Susteren, “We’re not going to implement Obamacare in Florida. We’re not going to expand Medicaid because we’re going to do the right thing. We’re not going to do the exchange.”

    Bravo, Gov. Scott.

    Thank you for pointing out a potential flaw in the health care marketplaces being set up around the state.

    You’re absolutely right that the navigators being hired to help residents buy health insurance should be properly trained and completely trustworthy.

    Related News/Archive
    Romano: Is anticonsumer insurance law just designed to damage Obamacare?

    5 Months Ago

    Romano to lawmakers: You know what you need to do on Medicaid

    8 Months Ago

    Romano: Scorched earth on Obamacare but slow going on flood insurance

    1 Month Ago

    Romano: Rick Scott is right. We Floridians have tons to brag about

    5 Months Ago

    President Barack Obama in Tampa: ‘We can write the next chapter together’

    1 Year Ago

    Just one question:

    Why now?

    I mean, why are you and Attorney General Pam Bondi suddenly so concerned about privacy issues for the low-income people most likely to use health care marketplaces?

    You didn’t seem like a privacy advocate a year ago when you tried to trample Fourth Amendment rights by ordering drug tests for assorted citizens and state employees.

    And why would you wait until now — a matter of weeks before health care marketplaces were launched — to raise your voice about this set of privacy issues?

    After all, the plans for these marketplaces (once known as exchanges) have been around since you were elected.

    Or don’t you recall?

    It was in the fall of 2011 when you famously said Obamacare was not the law of the land, and you did not believe it ever would be the law of the land. But then you graciously allowed that if Obamacare somehow became a reality, Florida would be ready for it.

    The truth is the Affordable Care Act was the law of the land in 2011, and you were too arrogant to accept it. It was reaffirmed as the law of the land by the Supreme Court in 2012, and you were too childish to admit it.

    Now, here we are in 2013, and — Guess What! — Florida is not ready for it.


    Well, I could point out that one of the reasons is you turned down millions of dollars in federal grant money to get an early start on setting up marketplaces. That would be millions of dollars Florida residents paid in federal taxes only to see it spent elsewhere.

    I could also point out the federal government asked you to establish the state health marketplace yourself. They all but begged you to set it up.

    The idea was that marketplaces would be better handled at the state level where they could be tailored to the particular needs of an area. So if privacy was a concern, you could have set up your own safeguards. If training was the issue, you could have set your own standards. If costs were a concern, you could have monitored them yourself. And if Floridians needed help, they could get it locally.

    Of course, you declined to do any of that.

    Instead of figuring out ways to improve health care for Floridians, you ran around trying to sabotage and poison the legislation.

    You said it would cost Florida $1.9 billion a year (which your own state agency pointed out was laughably incorrect). You said it would be the biggest job killer ever (and yet the state’s Chamber of Commerce endorsed Medicaid expansion). And you allowed the Legislature to remove the state insurance commissioner’s ability to regulate rates (throwing your own constituents to the wolves).

    It didn’t matter that Florida has one of the highest rates of uninsured residents in the nation, you were focused on your personal politics instead of the needs of actual people.

    And now that we are in the final days before health insurance marketplaces are set to launch, you continue to spend your time on the sidelines lobbing grenades.

    I’m not sure that’s part of the definition of a true statesman.

    Or even a caring person.

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