At least one big health insurer has officially decided against trying to offer individual major medical coverage in its home state in 2018.
Wellmark Blue Cross and Blue Shield announced Monday that it will not keep any individual or family coverage written under the Affordable Care Act rules in force in Iowa after Jan. 1, 2018.
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The decision applies both to individual coverage sold through the ACA public exchange system and to coverage sold through the off-exchange market, according to Traci McBee, a Wellmark corporate communications team leader.
Customers can keep any “grandfathered” or “grandmothered” individual or family coverage they own.
Insurers use the term “grandfathered” to refer to coverage sold under the rules in effect before March 23, 2010, when President Barack Obama signed the two bills that created the ACA into law. The ACA itself gives consumers the right to keep grandfathered coverage in effect as long as the issuers are willing to provide the coverage.
The term “grandmothered” refers to coverage sold from March 24, 2010, to Dec. 31, 2013. That’s the period after the ACA became law but before most ACA major medical requirements took effect. The U.S. Department of Health and Human Services lets states decide whether insurers can continue to keep grandmothered coverage in effect.
Wellmark’s decision to leave the individual market will affect 21,400 of Wellmark’s 1.7 million enrollees in Iowa, the company said.
The decision will have no effect on Wellmark’s group health coverage, or on holders of Wellmark’s Medicare supplement insurance coverage.
Wellmark generated $2.9 billion of its $3.6 billion in 2015 accident and health insurance premium revenue in Iowa, according to the National Association of Insurance Commissioners. Wellmark accounted for 50% of all 2015 Iowa accident and health premium revenue.