Health Alliance Reaches Capacity for Individual Enrollment

With the exit of many plans from the individual market and large premium increases from other plans, we knew we couldn’t absorb all of the potential members from the areas we serve. Therefore, we reached an agreement with the Illinois Department of Insurance and the Centers for Medicare & Medicaid Services to cap the number of marketplace and direct individual members we accept.

Health Alliance has received a significant number of applications for both our marketplace and direct individual plans, and we’ve reached our capacity. Over the next week, we will be working to remove our plans from HealthCare.gov, third-party vendors and our website. Any comprehensive applications for new members must be postmarked on or before January 19, 2017. Otherwise, they will be denied. You should forward any applications to Health Alliance immediately. You can fax them to 217-337-8055 or email them to IndividualEnrollment@healthalliance.org. If you submit an application after January 19, it must be date stamped or include proof that you received it on or before the 19.

The enrollment cap on our individual plans does not affect short-term plans or our other products. We will continue to offer our short-term plans, Medicare, small group, large group, and self-funded products in 2017.

While we will continue to serve current individual members, this will impact those who want to make a plan change during the remainder of Open Enrollment. Once our plans have been removed from HealthCare.gov, members will still be able to see their accounts, but they will no longer be able to make a plan change. HealthCare.gov will still allow current members to add new dependents (due to a birth, adoption, marriage, etc.) to their plan for 2017.

The removal of our plans on HealthCare.gov will be in place for at least 180 days unless Health Alliance, the state, and the federal government agree to a different time frame. During this period, we will continue to evaluate our individual enrollment and prepare for 2018.

With all the changes to the individual market, we believe this will best position us for the future. Health Alliance is a strong company focused on the financial stability required to continue serving our broker partners, employer groups, and members for many years to come.

Ideally, we would have announced the enrollment cap at the same time the individual commission change was announced. However, the timing of each of these changes did not align. The enrollment cap was based on reaching a threshold of new members and approval from the Illinois Department of Insurance and the Centers for Medicare & Medicaid Services. We could not discuss the enrollment cap until we had approval from both these entities.

Contact your client consultant with any questions.