BlueCross BlueShield of Tennessee to restore individual coverage in Knoxville

BlueCross BlueShield of Tennessee to restore individual coverage in Knoxville

Improved results this year allow Chattanooga insurer to expand coverage in 2018

May 9th, 2017 by Dave Flessner in Breaking News

Staff Photo by Dan Henry / The Chattanooga Times Free Press- 10/28/15. J.D. Hickey, the new president and CEO of BlueCross BlueShield of Tennessee.

Photo by Dan Henry /Times Free Press.

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Health insurance marketplace deadlines

* June 21: Health insurance companies must apply to offer individual plans in any of Tennessee’s eight regions

* July 1: Rates for 2018 must be submitted to the Tennessee Department of Commerce and Insurance

* Aug. 16: State regulators approve insurance carriers and premium rates for 2018 in each Tennessee market

* Sept. 27: Insurer sends signed agreements to the federal government for next year

Document: BlueCross CEO J.D. Hickey's letter to the Tennessee Department of Commerce and Insurance

Read BlueCross CEO J.D. Hickey's letter to the Tennessee Department of Commerce and Insurance.

Julie Mix McPeak

Julie Mix McPeak

Photo by Contributed Photo /Times Free Press.

Tennessee's biggest health insurer will restore individual health insurance coverage to the Knoxville market next year, helping to ensure that the East Tennessee market maintains individual coverage in 2018.

BlueCross BlueShield of Tennessee, which withdrew its individual coverage under the health care exchange market in 2017 in Tennessee's three biggest markets, said today it will resume selling individual insurance plans under the exchange market in the 16-county Knoxville area where Humana announced plans to withdraw from the individual market next year.

In a letter to state insurance regulators, BlueCross President J.D. Hickey said BlueCross is showing improved results in the ObamaCare health exchanges this year after suffering more than $400 million in losses in such markets during the first three years in which the insurer offered such plans statewide.

"Though still very early, our 2017 performance has improved due to a combination of better claims experience and a more sustainable rate structure based on the medical needs of the members we're serving," Hickey said in a letter to state regulators. "With this in mind, I want to confirm that BlueCross is willing to serve the Knoxville region in the 2018 individual Marketplace."

State regulators welcomed the decision by BlueCross to ensure that the Knoxville market has at least one provider of individual plans under the exchange markets.

"This is very much a glimmer of hope for those on the individual exchange in the Knoxville area so that they will have an option for coverage using their tax subsidies and tax credits for 2018," said Julie McPeak, commissioner of Tennessee's Department of Commerce and Insurance.

Hickey said the decision to return to the Knoxville market "is in no way a political decision nor is it a reflection of our perspective on the stability of individual Marketplace overall."

The BlueCross CEO said based on current political uncertainty about health care reform, there is a lot of uncertainty about the future of the health exchange. As a result, BlueCross is conditioning its return to Knoxville on being able to sign its specific agreement for the Knoxville market in September when the market dynamics may be clearer for next year.

Hickey said BlueCross does not plan to return to the Memphis or Nashville markets in 2018. BlueCross this year continued to offer individual health plans under ObamaCare in five of the Tennessee's eight regions, including the Chattanooga area, and maintained coverage in the 57 counties of the state where BlueCross is the only provider of ACA individual plans.

"With our past losses and the continued uncertainties associated with the individual Marketplace, we are not willing to consider expanding our current footprint in 2018 beyond the addition of the Knoxville region, as the other geographies are currently covered by other carriers," Hickey said. "We believe this fiscally conservative approach to limit our risk profile in this market continues to be in the best interest of all the members BlueCross serves across all lines of our business."

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This story was updated May 9 at 10:30 p.m. with more information.