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Pennsylvania allows insurers to reinstate canceled policies

| Tuesday, Nov. 26, 2013, 12:42 p.m.

President Obama's fix for individuals whose health plans are being canceled by their insurers ultimately won't help everyone in Pennsylvania — and some could be paying higher premiums for keeping their policies.

The state agreed on Tuesday to allow insurers to reinstate or extend policies that didn't meet the more robust requirements of Obamacare. The decision helps a majority of the people who were threatened with cancellations, but thousands still won't get to keep their plans.

State Insurance Commissioner Michael Consedine didn't compel insurers to go along with the plan proposed two weeks ago by Obama to help individuals whose coverage was to be canceled. Obama reacted to criticism that he misled the public about his signature health care program by promising that those who liked their existing health insurance plan could keep it.

Obama said insurers could reinstate canceled health plans if state insurance commissioners gave their OK.

Many Pennsylvanians facing cancellations will benefit from the reprieve. But two of the state's largest insurers — Highmark Inc. and Independence Blue Cross of Philadelphia — still plan to push thousands of their customers with discontinued policies to the health insurance exchange that was set up under the president's program, known as Obamacare.

Pennsylvania joins 14 other states that have granted extensions. Fifteen states have said they won't allow extensions because it would spur too much confusion and could lead to higher premiums. The remaining states haven't announced decisions.

Consedine said he directed insurance companies to reach out to their customers with canceled plans to discuss “options to ensure that they have continued coverage.”

But, he said, “Options will be insurance-company specific, and consumers are encouraged to call their current insurance carrier for information.”

The state's four Blue Cross insurers said they will extend policies for their members with Special Care plans, which were sold to low-income workers who couldn't afford any other coverage.

Highmark, the state's largest health insurer, said that decision affects 19,600 of its members, who would have their plans reinstated until June 30. Independence will extend plans for 6,300. Numbers weren't available from Capital Blue Cross and Blue Cross of Northeastern Pennsylvania.

Highmark said it would seek a rate increase from the state to offset the cost of reinstating its plan but didn't disclose how much it would seek.

Highmark spokeswoman Kristin Ash said any Special Care members who purchased an Obamacare plan and who want to come back to Highmark can contact the insurer to discuss their options. But, Ash said, “in most cases, Special Care members will have lower rates in the marketplace.”

Special Care members, who do not need to notify Highmark that they want to keep their plans, will miss out on tax credits.

“Many Special Care members are expected to be eligible for cost savings available through the federal marketplace,” Highmark warned in a statement.

An additional 140,000 Highmark members who pay low premiums for their coverage because they are healthy had been given the option to renew their policies until the end of 2014. There is no change in those plans, Highmark said.

“These members will remain in their current plan through Dec. 31, 2014, simply by continuing to pay their monthly premium,” Ash said.

Highmark and Consedine said the additional time would allow members to shop for coverage on Healthcare.gov, the federal government's troubled website for buying insurance. There has been concern that website problems might prevent people from meeting a Dec. 23 deadline to have coverage kick in on Jan. 1.

But the move doesn't address all people facing cancellations.

Another 16,500 members with pre-existing conditions, who have so-called guaranteed-issue plans, will be enrolled by Highmark into a Community Blue plan being sold on Healthcare.gov. Community Blue is a limited-network plan that does not offer in-network access to UPMC hospitals and doctors.

Any member enrolled directly by Highmark won't qualify for tax credits, the insurer said: “Such cost savings are only available in connection with coverage purchased directly through the federal marketplace.”

Owners of small businesses who bought insurance as sole proprietors through an association won't have their policies reinstated, either, Ash said. About 2,000 sole proprietors were canceled under Obamacare, and Highmark can't bring them back, she said.

Aetna Inc., which sells individual plans in Pennsylvania through its HealthAmerica subsidiary, declined to comment on whether it will bring back canceled policies.

UPMC Health Plan, the insurance subsidiary of UPMC, said it will extend all individual plans that were canceled.

The insurer, which only sold medically underwritten plans to healthy individuals, previously said that it, like Highmark, had already given its members the option to renew for an additional year.

Alex Nixon is a staff writer for Trib Total Media. He can be reached at 412-320-7928 or anixon@tribweb.com.

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