PHP To Leave Individual Health Insurance Market

Aug. 23--PHP is leaving the individual-insurance marketplace, the company announced on Tuesday.

Existing customers of Physicians Health Plan of Northern Indiana will have insurance through Dec. 31. The company will continue to serve "small -- and large-group markets, employers and brokers," it said in the Tuesday news release.

The company said that individual policies -- both those sold through the Affordable Care Act marketplace and through the company's individual product lines -- make up only a small percentage of its business. The company did not specify what percentage of its revenue or customers come through individual policies.

Individual policies have been losing propositions for the PHP, the company said. "In 2016, for every premium dollar received, we estimate PHP will pay $1.20 for medical expenses. We estimate this number would increase to $1.36 in 2017," its statement said.

PHP attributed the trouble to three factors.

First, the Risk Adjustment Program in the ACA, which was intended to move monies between health insurers based on the relative cost of the populations attracted, didn't take into account many important measures of risk and was not designed for the commercial individual insurance marketplace.

Second, "the Risk Corridor Program, put in place to keep premiums down and make products affordable in the early years, was ultimately not funded by Congress leaving most insurers with large, unexpected medical costs."

Third, federal mandates and state mandates for health insurance have "left some insurers, including PHP, unprotected in several areas."

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