State taking steps to avoid chaos in health insurance markets

June 02--Amid ongoing uncertainty about health care, the state Insurance Department on Friday issued a reminder to health insurance companies in the state regarding the rules they must follow if they plan to stop offering a certain policy or decide to leave the market altogether.

"Because of rising costs and uncertainty about what is going to happen at the federal level, New Hampshire residents are facing potential instability in the 2018 individual health insurance marketplace here in the state," said New Hampshire Insurance Commissioner Roger Sevigny.

"The Insurance Department is contemplating steps to help stabilize the market, but we also will make sure that consumers are given the protections granted to them under federal and state law."

Although all four of the health insurance companies currently offering products in the state have filed notice with the Insurance Department that they intend to return in 2018, that notice does not constitute an iron-clad commitment, according to Jennifer Patterson, the department's health policy legal counsel.

"All of them filed plans, which is a prerequisite," she said. "That's not a commitment. They could still make a decision to pull those plans off the market."

The memo to insurance companies issued on Friday reminds them that because health coverage in New Hampshire is guaranteed renewable under state law, a company must give consumers advance notice and enough time to obtain other coverage if it decides to stop offering certain policies in the state or if it plans to pull out of the state altogether.

A company planning to leave the state entirely must provide 180 days notice ahead of Jan. 1, which puts the deadline around July 1.

If a company decides to pull out of the Obamacare exchange on healthcare.gov, but will continue selling off-exchange products, it would be required to provide 90 days notice, which puts that deadline around Oct. 1

Open enrollment on healthcare.gov starts Nov. 1 for coverage taking effect Jan. 1, which means some consumers could learn as late as Oct. 1 that their company would not be available in New Hampshire.

Companies that exit a market altogether will be barred, according to state law, from re-entering that market for five years.

"Companies want to continue to offer coverage, but they must include many factors in their analysis -- rising claims costs, doubt over receiving cost-reduction payments from the federal government, and continued uncertainty about what reforms may be coming from Washington, D.C.," said Sevigny. "This is why I asked the New Hampshire Legislature to approve legislation that would give the state the authority to consider a range of options to stabilize the individual market."

The legislation, an amendment to House Bill 469, was approved Thursday by the state Senate. The amended bill will now proceed to the House for a vote.

It would authorize Sevigny, operating under legislative oversight and with the cooperation of Gov. Chris Sununu, to take steps aimed at shoring up the state's individual market.

Those steps could include seeking federal funds to stabilize the availability and pricing of health insurance in the state.

The four carriers currently offering products on healthcare.gov are Anthem, Harvard-Pilgrim, Ambetter and Minuteman. While encouraged that all four have filed plans to return in November, Sevigny said the future is unclear.

Reuters reported last week that Anthem is assessing whether or not it's going to participate in the exchange in the 14 jurisdictions where it now does business.

"We're one of those 14, so if Anthem or anyone comes to us at some point and for whatever reason says we don't want to do business in New Hampshire any more, we've got to be prepared to assist consumers or inform them as best as we can with regard to what their rights are," Sevigny said.

The health insurance carriers submitted their rate information for November in confidential filings with the Insurance Department on Friday. While the Insurance Department cannot release that information, some of the carriers chose to do so independently once the rates are approved.

The federal Centers for Medicare and Medicaid Services will release rate information in August for any products that are seeing rate hikes of 10 percent or more. Beyond that, the rates are not widely known until they go live on the exchange on Nov. 1.

"We are trying to give as much clarity and stability as we can to the carriers in uncertain and unstable time, as they make their decision because we think that will result in a positive decision for New Hampshire consumers," said Patterson. "We don't know what's going to happen. There are a lot of carriers trying to make these kinds of decisions."

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