Oscar Health will exit the California individual ACA insurance market for plan year 2024 as part of a push to make its insurance business profitable.
On a May 9 call with investors, transcribed by Seeking Alpha, Oscar Health CEO Mark Bertolini said the company is exiting underperforming markets to improve its profitability.
"The company has been disciplined in managing its portfolio and improving the sustainability of our margins over time," Mr. Bertolini said.
Oscar Health plans to reenter the California market in the future, Mr. Bertolini said.
Interim CFO Sid Sankaran said the California market represents less than 5 percent of Oscar Health's membership, with around 35,000 members in the state.
This suggests that Oscar has roughly 700,000 ACA exchange enrollees nationally, FWIW.
Consumer Advisory: Former Individual Market Bright Health & Oscar Health Enrollees Have Until March 1 to Choose New Coverage
Special Enrollment Period allows them to still get insurance for 2023.
DENVER - People who had individual health insurance plans (insurance not from an employer) from Bright Health and Oscar Health in 2022 are reminded that they have until the end of February to choose a health plan from another company for 2023 insurance.
Even though the regular open enrollment for individual health insurance plans concluded on January 15, consumers who had their Bright or Oscar coverage finish at the end of December are allowed a 60-day special enrollment period (SEP) because those companies did not offer plans for 2023. This 60-day SEP started on January 1 and will continue until March 1, 2023.
A week and a half ago, on a Saturday Night, my friend Jenny Chumbley Hogue, a Texas-based health insurance broker, gave me a heads up about a rather concerning and suspiciously-timed notice regarding Oscar Health of Florida:
Hello agent, please view the below information in reference to Oscar. We have received this information from Oscar and are passing it along to you.
Beginning at midnight Monday, 12/12/2022, (00:00 am Tuesday morning), Oscar in Florida will cease all new sales for IFP. All previously enrolled members and auto-enrolled members can keep their current plan by paying for January coverage. If members need to make a plan change, they need to do so by this time, midnight Monday.
...With this announcement, in addition to the previously announced market exits, Bright HealthCare will not offer Individual and Family health plans in Alabama, Arizona, Colorado, Florida, Georgia, Nebraska, North Carolina, Texas, and Tennessee after 2022(1), or Medicare Advantage plans outside of California and Florida. This focused footprint reduces Bright Health’s overall regulated capital need and is expected to release excess regulated capital of approximately $250 million upon settlement of all medical liabilities and approval from state regulators.
County by County Analysis of Current Projected Insurer Participation in Health Insurance Exchanges
The Centers for Medicare & Medicaid Services (CMS) is releasing a county-level map of 2018 projected Health Insurance Exchanges participation based on the known issuer participation public announcements through June 9, 2017. This map shows that insurance options on the Exchanges continue to disappear. Plan options are down from last year and, in some areas, Americans will have no coverage options on the Exchanges, based on the current data.
