The state’s individual health insurance market is undergoing major change this fall, in part a direct result of the federal health law and in part because of business decisions by insurance companies.
Data released Friday by the Connecticut Insurance Department show that the vast majority of the state’s 66,437 individual-market policyholders will have to either pick a new plan or renew their current plan early to keep it.
But the way each insurance company has handled the changes varies, as do the choices members have. Here’s a look:
Connecticut’s individual market had 66,437 policyholders as of Thursday. Because some of those plans covered families, the total number of people covered was 108,287.
Health plans that were in effect before the federal health law took effect in March 2010 can be renewed as long as they don’t change significantly, even though they don’t meet the law’s requirements. These plans are known as “grandfathered,” and they’re not open to new members.
Although insurers are not required to cancel grandfathered plans as a result of the health law, they don’t have to continue them either. This fall, Anthem Blue Cross and Blue Shield, the state’s largest insurer, told members their grandfathered plans were being discontinued.
The only other carrier to discontinue any grandfathered plans was Aetna, which is ending 57 of its 3,000 policies. Spokeswoman Susan Millerick said the company believes those policies are no longer needed.
The early renewal option
Plans that are not grandfathered can’t be sold or renewed after Jan. 1 because they don’t meet the new requirements taking effect as part of the federal health law.
Some people with these plans were given the option of renewing their policies effective Dec. 1, which allows them to get 12 more months of coverage from a plan with current market rules and prices. In other cases, people were given the choice of buying a different plan that would start Dec. 1. Others weren’t given either option.
How companies handled these options differed too. Aetna, for example, gave members the option of buying a new plan that starts Dec. 1. It’s proven to be a popular option, with 40 percent accepting it. People have until Nov. 27 to decide.
Anthem automatically renewed members’ plans, effective Dec. 1, for plans it opted to continue for another 12 months. ConnectiCare did not offer the option of renewing plans early, but allowed some customers who requested it to do so. Golden Rule, which is part of UnitedHealthcare, automatically enrolled its members of nongrandfathered plans into plans with a Dec. 1 start date.
According to Gov. Dannel P. Malloy’s administration, there are 38,561 individual-market policies in the state that won’t be continued in 2014, covering 63,698 people. But those numbers could drop if people who have been offered the option of buying or renewing a plan by Dec. 1 choose to do so. Insurers are required to offer members of discontinued plans a new option, but members don’t have to take it.
These people will have the option of buying new plans through the state’s health insurance exchange, Access Health CT, or through insurers or brokers. Plans sold in 2014 will have to cover more benefits than individual-market plans typically cover, including maternity care and pediatric dental and vision care. Their prices will also reflect the fact that insurance companies, as of Jan. 1, will have to sell policies to anyone who seeks them. In the current market, carriers can decide whether to cover people based on their health.