WPS subsidiary Arise leaving health insurance exchange

Oct. 01--Arise Health Plan is following the lead of other major health insurance companies and abandoning the Affordable Care Act exchange.

The wholly owned subsidiary of Madison-based WPS Health Solutions no longer will sell or renew individual health plans through the exchange in Wisconsin in 2017. WPS, a nonprofit firm, does not report earnings, but the company said it was losing money on the individual health plans.

"The marketplace was telling us that these are not profitable products," Ellen Foley, spokesperson for WPS, said Friday.

"We could not continue to remain in an unstable market without creating problems for our other customers so we decided that we would no longer sell products for the 2017 benefit year that were unprofitable," Foley said.

Open enrollment for next year opens Nov. 1.

Healthinsurance.org reports most of the 224,208 individual market plans in Wisconsin will have 14 insurance options to choose from, which is down two from last year.

Humana, Ambetter and UnitedHealthcare have said they are leaving the individual health plan market in Wisconsin, Healthinsurance.org reported.

Health insurers that have left Wisconsin's exchange and others around the country say they have been losing money despite receiving government subsidies for some of the plans sold through the exchange.

In Dane County, insurers remaining in the exchange are seeking rate hikes ranging from 5.4 percent to 37.9 percent to help offset rising costs.

Foley said an issue faced by insurers in the exchanges is that there were more people with illnesses signing up for coverage and using health insurance than healthy individuals simply signing up for plans. It's important to have a balance to control costs, she said.

WPS said a majority of the individuals on the Arise plan purchased through the exchange were eligible for a government subsidy to offset premium costs.

Foley said many exchange participants signed up for "silver level" plans, the most widely used, which cover about 70 percent of an enrollee's medical costs.

WPS sent letters Friday to those affected by the company's decision and will contact customers to help them with problems.

Those affected will have health insurance coverage through Dec. 31 but will need to find a different health insurance plan during open enrollment.

Foley said the government also has safeguards in place, which would automatically enroll those affected into similar-tier plans temporarily so that their health coverage would continue until they enrolled in another plan.

In January, WPS announced it was partnering with Aspirus in Wausau to form Aspirius Arise Health Plan of Wisconsin.

The plan will be participating in Wisconsin's exchange but will only be available to residents in 16 counties in north central Wisconsin.

Foley said in this case, Aspirus, which provides health care services, and Arise, an insurer, can work together to manage care costs, which can lead to better control of premiums.

WPS and Arise will continue to offer "ACA-compliant bronze level and catastrophic health plans" but outside the exchange in 2017 and only in select counties.

WPS plans will be available in Douglas, Bayfield, Burnett, Washburn, Sawyer, Polk, Barron, Rusk, St. Croix, Dunn, Pierce, Pepin, Eau Claire, Buffalo, Trempealeau, Jackson, La Crosse and Monroe counties.

Arise plans will be available in Marinette, Oconto, Shawano (certain ZIP codes), Door, Kewaunee, Brown, Outagamie, Waupaca, Waushara, Winnebago, Calumet, Manitowoc, Marquette, Green Lake, Fond du Lac, Sheboygan, Dodge, Washington, Ozaukee and Waukesha counties.

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