Health insurance brokers who sell individual policies say they are swamped with complaints from customers receiving letters telling them the plans they have now won’t be offered next year because of the Affordable Care Act.
It’s been known since the law passed that a provision of federal health care reform requires that individual-market health insurance plans have certain minimums in medical coverage starting Jan. 1, 2014. The minimum coverage is called “essential health benefits.”
If existing plans don’t meet the minimum requirements, insurers are telling people they cannot keep their current health insurance
Health plans that were in place when the law passed in March 2010 were eligible for grandfathered status and did not have to meet requirements of the new law. However, if the insurer or employer that offers the plan made significant changes to benefits, premiums, copays or deductibles, the plan lost its grandfathered status, according to the Kaiser Family Foundation, a health policy research group.
Some insurers may have scrapped grandfathered plans or decided it was not feasible to continue them considering rates of inflation in medical care.
Fairfield health insurance broker Alan Sheketoff said 1,400 of his 2,300 customers in the individual market across Connecticut received a letter saying their health plan has been discontinued by their insurer because of mandatory changes in the Affordable Care Act.
“We’re calling it the ‘screw you’ letter because that’s what some of my clients basically have said,” said Sheketoff, 58, manager at Macman Insurance Associates in Fairfield.
The letters tell customers that their health plans are lacking — they didn’t have the “essential health benefits” mandated by the Affordable Care Act. As a result, the insurer is not able to offer those plans and many customers were informed in letters that they have been put into a pre-selected plan without knowing the rates or the benefits, Sheketoff said.
They had the money and they budgeted for it, Sheketoff said, but now they are forced to buy more expensive plans — hundreds of dollars more expensive each month, in some cases.
For example, he said, Anthem currently offers Lumenos health plans that have different options for deductibles, depending on the medical issue. One plan would have a deductible of either $1,250 or $2,500, another would have deductibles of $5,000 or $10,000; and another, $6,350 or $12,700. When the essential health benefits are added to the plans, a person with a high deductible version next year will pay more per month in premiums than a person in the lower-deductible plan does today, Sheketoff said.
Some people may find they will pay less for a health insurance plan. For example, people who buy a plan on the state’s health exchange are eligible for a federal subsidy if their income is up to 400 percent of the federal poverty level, which is $44,680 for an individual or $92,200 for a family of four. The law also reduces the effect of a person’s age and gender on pricing, meaning that young people and men could pay more so that women and older people pay less.
Another health insurance broker, David A. Richman of Simsbury, said the individual health insurance market has been “polluted” by the Affordable Care Act and online health exchanges. He described the open enrollment period this fall as “Obamacare hell.” Richman rattled off more than a dozen problems that immediately came to mind, and, of course, the letters that health plans won’t be offered next year are among them. Individual plans are only a small part of his business, he said, but he is a broker for small-group plans that are affected by the changes, too.
“ConnectiCare had some really good plans, and they had to terminate these plans because of the Affordable Care Act,” Richman said. “So, now what they’re doing is they’re renewing them into different plans.”