Wellmark decision won’t have heavy impact on Lee County



FORT MADISON –  A local health insurance broker says Iowa may be down to one insurance provider for marketplace insurance programs next year.

Justin Pieper, co-founder of Group Benefits Partners and an insurance industry consultant, said Wellmark Blue Cross and Blue Shield is pulling out of the marketplace plans effective Jan. 1 2018.

Pieper said it was important to note that any plans purchased prior to Affordable Care Act mandates that were put in place in 2014 will still be honored by Wellmark as well as any large and small employer plans and senior Medicare Supplement plans.

Group Benefits Partners had only sold about 15 Wellmark policies because Wellmark didn’t offer policies in Lee County, but many more will be affected across the state when enrollment periods start in November.


“We haven’t sold many of these policies that are going to be affected…only about 15.  Most of our individual clients purchased through the Marketplace, and since Wellmark was not participating in the Marketplace in Lee County, we won’t be as affected as many other counties across the state,” Pieper said.

Other insurance companies, such as Aetna’s Coventry have also backed off on policies available in Lee County. Pieper said he hopes that isn’t a continuing trend.

“We certainly hope not, but when the competition is as limited as it is here, and this marks the second year in a row of an insurance carrier exiting, it would be hard to argue that we’re not already on the wrong side of a trend,” Pieper said.

With Wellmark’s announcement last week, Peiper said Medica will be the only option for individuals under the age of 65 to purchase health insurance coverage in Lee County in 2018.

“Medica has a long history of stability in the markets where they exist (mainly Minnesota), so we have hope that they’ve been conservative in their approach, and will be able to continue to offer plans to Iowans,” he said. “Critics of the ACA will be quick to point out the fact that Wellmark certainly had a long history of stability prior to the market reforms enacted by the ACA.”

All Wellmark plans will remain in effect until January 1, 2018.  When open enrollment approaches in November, Pieper said Group Benefit Partners be able to help residents choose a plan from whichever carriers remain in the market at that time.

In a release issued Monday, Wellmark Chairman and CEO John Forsyth said over the past three years, Wellmark members with individual health plans in Iowa, governed by the ACA, have endured double-digit premium increases, all the while Wellmark has lost approximately $90 million in the individual ACA market during the same timeframe.

The release said the move will effect 21,400 Iowans who currently have Wellmark ACA compliant plans.

“Finding solutions to stabilize this market is in the best interest of all Iowans, including providers of health care and insurance carriers,” Forsyth said.  “No one really benefits from rising costs. While there are many potential solutions, the timing and relative impact of those solutions is currently unclear. This makes it difficult to establish plans for 2018.”

Pieper can be reached at Group Benefit Partners at 914 Avenue G in Fort Madison, 319-372-0088 or on their website.




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