News: CJ Exclusives

Obamacare Exchange Down To Two Insurance Providers

FirstCarolinaCare pulls out, leaving BCBSNC and Coventry as only options

FirstCarolinaCare Insurance Company is withdrawing from participation in the federal health exchange. Uninsured North Carolina consumers will have only two provider options from which to purchase policies approved by federal regulators and mandated under the Affordable Care Act (aka Obamacare) from the electronic marketplace.

FirstCarolina, a wholly owned subsidiary of FirstHealth of the Carolinas, announced Thursday afternoon it had alerted the North Carolina Department of Insurance of its intention to reverse course on its plan to sell federally approved policies on the exchange.

“This was not a step taken lightly,” Kenneth J. Lewis, president of FirstCarolinaCare Insurance Company, said in a written release.

“When we originally proposed participation in the Exchange, we recognized that there were many unknowns for all of us. However, after months of review, there continue to be uncertainties in the Exchange implementation and processes for insurers,” Lewis said.

“After further assessment of the uncertainties related to the Exchange and consideration of our overall business strategy, we reluctantly came to the conclusion to withdraw our application to participate in the Exchange,” Lewis said.

The announcement comes with just 18 days remaining before the Oct. 1 date on which the federal exchange is set to open.

With FirstCarolina’s pullout, only Blue Cross Blue Shield of North Carolina, which already services 85 percent of the individual insurance market in the state, and Coventry Health Care of the Carolinas maintain an active interest in offering insurance plans on the exchange.

FirstCarolina had received federal certification to offer 16 plans for sale that meet federal minimum requirements. It was the first of the three insurers to release its premium plans and prices.

But the FirstCarolina release hinted also that the company might have had a difficult challenge competing against the other two larger insurers.

“Although we were unsure of the competitiveness of our proposed rates, we felt it was important to share the information as soon as possible,” Lewis said. “The earlier we could share information about our proposed plans, the earlier people living in our community could begin to take an interest in the Exchange process.”

“The individual marketplace landscape will undoubtedly change in the coming months, and we will re-evaluate our decision next year to determine if it will be a more competitive environment in which to participate.”

Participation in the Exchange would have been the first time FirstCarolinaCare sold to individuals rather than to groups. It would have sold policies only in its six-county service area of Moore, Richmond, Montgomery, Hoke, Scotland, and Lee counties.

“FirstCarolinaCare proposed participation in the Exchange to initially ensure coverage options for our local community,” Lewis said. “Despite our withdrawal from the Exchange, we believe our community will have viable options for individual insurance coverage.”

“Transparency is important to us,” Lewis said.

FirstCarolinaCare will continue to serve its large and small business customers and will continue to offer a Medicare Advantage product for Medicare-eligible individuals.

Dan E. Way (@danway_carolina) is an associate editor of Carolina Journal.