by Andrew Walden

Thousands of customers of HMSA individual PPO and HMO plans are now receiving policy cancellation notices in the mail.  

In the letters, signed by HMSA President Michael Gold, customers are told:

We’re writing to inform you that the individual medical plan you have now won’t be available after December 31, 2013.  The Affordable Care Act (ACA), also known as health care reform, is bringing many changes that will affect plans and premiums.  Your plan is among those that won’t meet ACA requirements.  

To make sure your coverage isn’t interrupted, HMSA is transitioning you to a new medical plan that meets ACA guidelines.  Beginning January 1, 2014, your new plan will be HMSA’s Bronze PPO plan with pediatric dental.  Your monthly premium/s will be ….

The premium/s listed above may be significantly different from what you’re paying now.  The benefits will also be different.  This is a result of added essential health benefits that are included in all plans and a different way of rating premiums, as required by ACA.

If you have HMSA’s Children's Plan and Dental Plan, we’ll cancel your Dental Plus automatically effective January 1, 2014, since the new Bronze plan includes pediatric dental benefits.

The low budget Bronze PPO and HMO plans have a sky-high $6350 deductible and no prescription drug benefits for non-generic pharmaceuticals.  Other plans feature co-pays as high as 30-40%.  Subsidies are available to help pay premiums for low income families and individuals but the high deductible and co-pay will remain a burden.

Regarding family plans, the HMSA mailer explains: “children 21 years of age or older will be rated as adults.  For children under the age of 21, only the three oldest will be rated and added to the premium….The family premium will be based on totaling the age rates for the adults and the three oldest children under 21."

The PPO and HMO 'dump' is just the beginning.  According to HMSA sales staff, individual student plans will be cancelled August 20, 2014 and catastrophic plans will be cancelled in November, 2014.

According to HMSA sales personnel, Bronze is the plan that existing PPO and HMO customers are being “dumped into” if they do not act to select another plan.  It is also the only plan for which a premium rate is now available.  Premiums for Silver, Gold, and Platinum plans will not be published until October 1.  Customers will have from October 1 through December 15 to select another plan in time for the January 1, 2014 switch-over date.

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PDF: HMSA Cancellation Letter