Oscar had 130,000 customers losing about $100 million a year. OK, that's $770 per customer per year. Plans were under-priced. Did they know they were mis-pricing the plans or did their data fall down?
Here's the thing with ACA -- it's a consistent set of terms and conditions that you can shop against. Some of the terms might not exist otherwise, particularly eliminating pre-existing conditions. Ideally insurance companies would price the plans correctly, operate efficiently, and break even. Then Americans would benefit from access to plans with these shared terms.
But here's the scary thing, that $100 million a year could be from 10-100 expensive patients. Unlimited Lifetime Benefits is a pretty awesome term. I really don't know how you write a policy like that.
It is strange to think you could face the independent mandate while also not having any ACA plan to choose from in your marketplace? Is the mandate specifically waived in these cases?
Here's the thing with ACA -- it's a consistent set of terms and conditions that you can shop against. Some of the terms might not exist otherwise, particularly eliminating pre-existing conditions. Ideally insurance companies would price the plans correctly, operate efficiently, and break even. Then Americans would benefit from access to plans with these shared terms.
But here's the scary thing, that $100 million a year could be from 10-100 expensive patients. Unlimited Lifetime Benefits is a pretty awesome term. I really don't know how you write a policy like that.
It is strange to think you could face the independent mandate while also not having any ACA plan to choose from in your marketplace? Is the mandate specifically waived in these cases?