Thursday, June 01, 2017

The $1 Million Question

Recently, we reported that The Hawkeye State will be facing a severe shortage of health insurers quite soon:

"Medica, the last insurer selling individual health policies in most of Iowa, likely to exit"

But before that development, Wellmark Blue Cross had already announced their departure from the state's market next go-round. One of the reasons cited was an extreme case involving a claim that (according to Wellmark) is costing the carrier some $1,000,000 a month. As expected, there was some (much?) skepticism about this, but now the carrier's Exec VP has disclosed - at a Des Moines Rotary Club meeting - that the insured is a teen-aged boy with hemophilia.

She didn't mention his name or hometown.

But here's my question: should she have even disclosed this much? I wonder because it seems to me that this comes pretty close to the line regarding disclosure of PHI (personal health information). On the other hand, folks are constantly railing on carriers to "put up or shut up" about the effects of claims on premiums.

On the gripping hand, I just have this feeling that a line was crossed here.

What say y'all?

blog comments powered by Disqus