Here's how the ACA has changed health insurance in NH. NH is a very small market which never had much competition. Only one provider participates in the Exchange, Aetna. Aetna's network includes only 13 of the 26 hospitals in NH which is already causing a problem. You can keep your doctor? Not really, people who have been going to see a doctor at one of the 13 hospitals "out of network" who sign up have a choice; see your doctor "out of network" and pay the entire bill, or find a new doctor at one of the 13 "In network" hospitals. In effect the Exchange has created a demand/supply problem. Out of network hospitals won't see any exchange participants and In network hospitals will see many more patients without any more doctors....Ooops.
Aetna has announced that it won't have a separate rate schedule of SHOP. So it begs the question, unless the company gets a subsidy, if SHOP is the answer just terminate your plan and have your employees enroll individually. An incentive to offer health insurance??? Not really.
I have contracted with Harvard Pilgrim for years, the premiums are very high but the coverage is good and it's a PPO with a network that includes much of New England. They came to me in September and said they were offering their small group plans the option off resigning a 12 month contract as of 12/1, or signing the normal 12 month contract with the new 2014 rates. The kicker, for my PPO plan with 2K/4K deductibles a hike of 12.1%, or going to a 3K/6K deductible and a decrease of 5%. I opted for what I "knew" as opposed to what didn't (the 2014 premiums). We had a company meeting and my employees wanted to switch to the higher deductible, so we did. Good thing because Harvard Pilgrim just release the 2014 premiums...Oh they also changed all the PPO's in addition to the deductible there is a copay 80/20. The new out of pocket maximum is 4K/8K and 6K/12K. The premium increase for 2014 was 2%. They also said that based on the movement of insured in the state they haven't a clue if they will be offering PPO's next year (2015). They're also thinking of entering the Exchange, but only offering 2 hospitals, Elliot and Mary Hitchcock (Dartmouth)...that's beyond small, but I get it, they're going for the "savings" and efficiency.
Assuming Harvard Pilgrim joins the Exchange and drops their PPO in NH, we won't have more competition, we'll have less.
2014 should be an interesting year, and 2015 even more interesting.
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