Scott & White Health Plan to withdraw from Obamacare in 2017
By Lew K. Cohn
Managing Editor
The Highlander
Scott & White Health Plan (SWHP) will pull out of the federal health care marketplace in 2017, the health insurer announced Wednesday, Aug. 17.
The Temple-based company announced it would continue to offer selected bronze off-marketplace HMO individual and family plans, and that the Insurance Company of Scott and White (ICSW) will offer selected bronze off-marketplace PPO plans.
However, neither SWHP or ICSW will offer gold, silver and selected bronze benefit marketplace plans in what is commonly referred to as “Obamacare.”
“At Scott and White Health Plan, we are committed to supporting the Affordable Care Act by offering affordable medical insurance to consumers in North and Central Texas. However, the market for our individual marketplace plans carries higher risk than other plans,” the company said Wednesday in its announcement.
“Like many other health insurers, we have determined that we cannot currently serve marketplace plans on an effective and financially sustainable basis. Exiting the federal health care marketplace and refining our off-marketplace plans is the most effective way for us to uphold our commitment to offering affordable plans that are complemented by a renowned network of Baylor Scott & White Health facilities, clinics and physicians.”
Earlier this week, the nation's third largest health care insurer, Aetna Healthcare, announced that it would be pulling out of the federal health care marketplace in 11 states, including Texas. And earlier this year, United Health Group, the nation's largest insurer, shuttered most of its federal marketplace plans, citing heavy losses.
Participants in both SWHP and Aetna may keep their insurance through the remainder of the year, but will be required to either sign up for a different policy from an insurer in the “Obamacare” exchange or seek out off-market individual insurance plans when open enrollment occurs later this year.
This means that some patients could lose preferred doctors and hospitals, including Baylor Scott & White Hospital in Marble Falls or Seton Highland Lakes Hospital in Burnet, if those providers are not included in network coverage on the new plans they obtain.
To see if your doctor is in the SWHP bronze HMO or PPO, use the provider search tool at https://portal.swhp.org/#/search.
Open enrollment for federal health care plans will begin Nov. 1 and continue through Jan. 31, 2017.
It is possible that individuals forced to purchase a different plan could see their insurance premiums and out-of-pocket costs increase, depending on which plan is selected. Also, qualifying individuals and families who purchase health care plans outside the federal marketplace are not eligible for tax credit subsidies, which may only be used for plans purchased through the federal exchange.
An estimated 85 percent of people who purchased health care plans through the marketplace received tax credit subsidies in 2016, according to the U.S. Department of Health and Human Services.
Insurance premiums for federal marketplace plans were already expected to increase on average plans by just under 10 percent next year.
SWHP customers who purchased health insurance through the marketplace or who enrolled in a gold or silver plan will receive a letter describing their enrollment options for next year. Letters should begin arriving to customers between Aug. 17-30.
Customers who do not receive a letter but think they should have may call SWHP customer service at 844-769-3998, from 7 a.m. to 8 p.m., seven days a week.
