Announcement from Baptist Health:
Baptist Health Plan entered the individual market in support of the Affordable Care Act and the expansion of coverage for Kentuckians in January 2016. However, changes in the market – including the departure of the Kentucky Health Cooperative and Aetna – make participation unsustainable for a regional health plan our size. Beginning January 2017, we will no longer offer products in the individual market, including plans on the exchange. Baptist Health Plan remains committed to the employer market through the offering of our group health insurance products, and will continue to offer Medicare Advantage plans to Medicare-eligible individuals.
1) How many members does Baptist Health Plan have in individual plans?
Baptist Health Plan’s enrollment far exceeded projections with nearly 7,500 members enrolling in our individual plans (both on and off the exchange).
2) What counties are affected?
Baptist Health Plan offered individual plans in 18 counties in 2016 with the majority of members in Jefferson and Fayette counties. Counties are Jefferson, Trimble, Oldham, Henry, Shelby, Spencer, Bullitt, Webster, Hopkins, Fayette, Woodford, Mercer, Jessamine, Garrard, Madison, Estill, Rockcastle and Whitley.
3) How did the federal risk adjustments affect Baptist Health Plan?
The Affordable Care Act redistributes funds from plans with lower-risk enrollees to plans with higher-risk enrollees. Insurers that provide coverage for sicker-than-average members receive payments from other insurers that have healthier-than-average members.
In 2016 Baptist Health Plan’s members within the individual market were healthier than the average members of other competing health insurers. Again, due to a higher-than-projected enrollment, Baptist Health Plan’s participation is unsustainable for a regional health plan our size.
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