Friday, April 24, 2020

Pelican State Blues

Well, Blue Cross/Shield of Louisiana, anyway:


Now to be fair, most carriers have long since discontinued "sole proprietor group" plans (which would generally include husband/wife small businesses). Pre-ACA, the only real advantage to these plans versus individual policies were maternity coverage (generally excluded under individual major med plans) and, often, coverage for folks with major health issues. Since ObamaPlans cover maternity and pre-ex, this advantage went away.

Recently, Ohio re-introduced MEWA/Association plans, and at least one (that I'm aware of) allows "one man group" plans (provided it's a legitimate business).

But let's get back to Louisiana; I reached out to a colleague 'in the know' about that Tweet, and she replied:

"The BX legal department has picked an odd time to start enforcing what I believe is clear ACA policy (a group with only husband and wife as “employees” is not a group) but since they only have a couple of thousand total members this could potentially affect, so unlikely to “destroy” any particular markets...my 2cents"

She followed up this morning:

"Update: the insurance commissioner has intervened and made a “finding” that spouse only groups are still groups no matter what the ACA says.  So appears that BX will keep renewing and writing them for now."

So, good news for micro-groups in The Bayou State.
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