Anthem Individual Exits the Buckeye State

As of June 6th, Anthem announced they are exiting the Ohio individual exchange market. They are going to offer just one off exchange plan and that will be in Pike County. Pike County, Ohio, has a population of less than 30,000, so this is really a complete exit from Ohio.

Anthem was one of the only Ohio carriers to offer Individual plans throughout Ohio. Which is interesting because Ohio has 2 insurance companies that have corporate headquarters there.

Caresource is in Dayton Ohio.

Medical Mutual of Ohio is in Cleveland.

If these 2 companies are not offering Individual plans throughout the state, the question is why?

Simple answer, the individual market in Ohio, under the ACA, is high risk which results in high claimants which ends with carrier losses. When Individual carriers are seeking to make a 4% profit margin and they can’t reach that goal, they must reduce their exposure.

Then we add in the uncertainty of the cost sharing reductions being paid by the Government, why would a carrier take on any additional risk.

At this point, I can’t blame the carriers for making decisions to exit the individual market. I don’t like it but I understand it.

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