Premier Health Plan to exit ACA exchange

The Premier Health Plan — the commercial health insurance arm of Dayton-based Premier Health hospital network — is leaving the federal health insurance exchange “in the face of significant uncertainty surrounding the future direction of U.S. health care policy,” the plan announced Thursday.

Premier Health Plan will join several other health insurers in exiting the exchange in Ohio by discontinuing its Premier HealthOne On-Exchange plan at the end of 2017, the plan said.

RELATEDNew health care act could cost this region billions, study shows

The decision does not affect Premier Health Plan’s off-exchange, Medicare Advantage or commercial group plans, the company also said.

“The uncertainty in Washington, D.C., around the future of the Affordable Care Act — through which the federal exchange was created — and the associated volatility in the marketplace have led us to conclude that we cannot effectively plan and price affordable health insurance to sell on the exchange,” Renee George, president of Premier Health Plan, said in a statement.

“As a Dayton-based, physician-led health plan that believes strongly in value-based care, we’re disappointed that we must discontinue our participation in the exchange in 2018,” George said. “However, we will continue to offer a range of other insurance plans, including to individuals off of the exchange.”

George was named president of the plan in March.

During the open-enrollment period this fall, members enrolled in this plan will have the option to choose alternative coverage for 2018, including on-exchange and off-exchange plans, the plan said. Premier Health’s off-exchange plan (Premier HealthOne Off-Exchange) will be one option they can consider.

Premier Health Plan’s exit from the exchange affects only a “small percentage” of its membership in a nine-county area, the company further said.

A Premier spokesman said the number of those affected by the exit will be less than 10 percent of total Premier Health Plan membership. That number includes the company’s on- and off-exchange membership, Medicare Advantage, Next Generation accountable care organization membership and more.

But he declined to give an exact number of those who will be affected, saying it was proprietary.

Affected members will receive a written notice with additional details before the open enrollment period for 2018, which runs from Nov. 1 to Dec. 15, 2017.

Dayton-based Premier Health operates four area hospitals, a primary and specialty care network, along with home health services. The health system is the second largest employer in the region and the largest health-care system in Southwest Ohio.

About the Author