Dive Brief:
- Cigna has filed plans to sell health policies in the ACA marketplace, Chicago Tribune reported.
- If approved, individuals and families that purchase coverage via the market can begin purchasing health plans on November 1 for 2017 coverage.
- The Tribune's Ameet Sachdev received confirmation from Joe Mondy, Cigna's spokesperson, that the carrier's focus remains on the Chicago metro area and not the whole Prairie State.
Dive Insight:
There's been a lot of media coverage devoted to certain insurers' exit of the individual marketplace and money lost from their participation. In January, UnitedHealth stated it lost $720 million in 2015 over exchange plans. Later it revealed it would remain only in a handful of state marketplaces in 2017. In May, the carrier confirmed it would not sell plans on the Illinois marketplace.
However, perhaps curiously, United Healthcare's affiliate Harken Health is going all in and tackling the individual markets in Chicago and Atlanta (with about 35,000 members total as of mid-April).
In addition, Land of Lincoln, an Illinois co-op created under the ACA, made headlines when it lost $90.8 million in 2015 and confirmed this month it would liquidate and fold operations.
Sachdev noted Aetna will discontinue its PPO option which will force close to 12,000 customers to seek new care. One reason payers are moving away from PPOs could be because such plans make transitions to alternate value based-payment models difficult since patients are not necessarily tied to a particular provider.
Displaced policyholders (about 50,000 from Land of Lincoln alone) would likely embrace a new individual plan market entrance such as Cigna.
Mondy noted it was too soon to provide details about the proposal but added the entrance into the Chicago market is part of a broader plan to expand its business into "a few new geographies," Sachdev reported.
Currently, Cigna sell plans within the ACA marketplace in seven states and off-exchange plans in six.