High risk insurance pool to close

Louisiana’s high-risk health insurance pool will close Dec. 31, and the plan’s roughly 1,900 policyholders will have to find other coverage.

There was some discussion about extending the plan’s policies, as some other states have done, but Louisiana doesn’t really have that choice, Louisiana Health Plan Chief Executive Officer Leah Barron said.

With private insurance available under the federal Affordable Care Act, the Louisiana Health Plan must terminate its policies.

The plan, which began operating in 1991, was created to make sure health coverage was available to Louisiana residents who couldn’t buy coverage because of their health conditions.

Under the Affordable Care Act, health insurance companies can no longer deny coverage to people because of pre-existing health conditions.

Louisiana Health Plan has been warning policyholders that the move was coming since 2012, Barron said. In September, the plan sent policyholders information about buying coverage through the federal Health Insurance Marketplace, HealthCare.gov.

“There were a lot of problems, obviously, in October with people not being able to get on the website,” Barron said. “We had a lot of people who really had a lot of trouble signing up.”

Policyholders were concerned and confused, and they were calling the Louisiana Health Plan for help. With all of the problems on HealthCare.gov, Barron went to private insurers to get information about coverage options for Louisiana Health Plan members. That way Louisiana Health Plan members could go directly to the companies for questions about new coverage, whether the policies were bought inside or outside of the federal marketplace.

In November, the health plan sent policyholders paper applications for the federal marketplace along with the guidelines that showed who qualified for health subsidies.

Under the Affordable Care Act, federal subsidies are available for people with low to moderate incomes.

Most of the people who want to buy coverage through the exchange qualify for the subsidy, Barron said.

The health plan is still fielding calls from concerned policyholders, although the number of calls has fallen since the November mail out, Barron said.

The health plan typically provides coverage to around 2,400 policyholders in a year, Barron said. But the numbers have fallen this year because many people are waiting to get coverage until Jan. 1, when policies kick in under the Affordable Care Act.

Some 1,215 people buy coverage through the Health Insurance Portability and Accountability Act Plan, and 680 through the High-Risk Pool. One major difference between the plans is that the high-risk pool requires a six-month waiting period before covering care involving pre-existing conditions.

The average monthly premium in the High-Risk Pool is $377. The average monthly premium in the HIPAA Plan is $566 per month. The deductibles range from $1,000 to $5,000. The most popular option is the $2,000 deductible.

Louisiana Health Plan expects to continue processing claims through August and appeals of coverage denials until September, Barron said. All of the claims and appeals will have been processed by the end of 2014.

The agency has seven full-time employees. Most of those positions will be eliminated by the end of January. The agency will close at the end of 2014.