Dive Brief:
- Humana says it will lose up to 300,000 members on its 2016 individual market plans, according to a Securities and Exchange Commission (SEC) filing last week.
- Like UnitedHealth Group, Humana is grappling with the ACA's markets and is the second investor-owned insurer to publicly disclose such problems.
- Details on the expected financial losses weren't provided. An estimated 814,000 people bought individual plans on or off the exchanges since Sept. 30, 2015.
Dive Insight:
Although the company didn't provide details for the big drop in membership, it has already lost thousands of members who lacked proper naturalization or income documents. Other members stopped paying their premiums. Humana is also phasing out noncompliant ACA plans.
The company is evaluating the 2016 enrollment process and its "pricing assumptions," which will result in a premium deficiency reserve. According to the SEC filing, the company stated, "This evaluation includes membership changes resulting from its product discontinuances, changes by geography, age bands, and metallic tier, and whether the new members who enrolled were previously covered by insurance."
Despite the future losses from their individual market health plans, Humana expects up to 120,000 seniors and disabled to enroll in their Medicare plans by the end of this year. This would increase their membership to nearly 3.4 million. An additional 330,000 are expected to enroll in the company's Medicare prescription plans also by year's end.