United Healthcare remains an option for Valley health plan shoppers – for now

Health consumers in Fresno, Kings and Madera counties who are enrolling in health plans through the state’s insurance exchange may have noticed two new options – United Healthcare and Health Net.

The two plans join Anthem Blue Cross, Blue Shield of California and Kaiser Permanente in offering health coverage to people shopping for individual health plans in 2016.

It’s the first time that United Healthcare, the nation’s largest insurer, has participated in Covered California, the state’s insurance exchange created for the Affordable Care Act. But a month into its entrance in the California market, the insurer’s future in the exchange market beyond next year has been thrown into question.

Last week, United said it could not commit to continuing participation in Affordable Care Act exchanges in 2017.

In a Nov. 19 news release, United said that it was pulling back from its marketing efforts for individual exchange products in 2016, and that during the first half of 2016 it would determine “to what extent it can continue to serve the public exchange markets in 2017.”

Consumers have until Jan. 31 to pick a health plan for 2016 through Covered California, and Executive Director Peter V. Lee hopes that the national news about United Healthcare doesn’t dissuade Californians from considering the health plan alongside others.

“This is another potential example of distracting ‘sky is falling’ messages that doesn’t apply in any way to California and in many ways to what is happening around the nation,” Lee said.

United asked to participate in the state’s insurance exchange, Lee said. Covered California agreed to let the company aboard, but only in certain regions – the Valley, Northern California and Central Coast – with limited health plan choices for consumers. United has a contract to provide health coverage in those counties in 2016, and there has been no indication of any change there, Lee said. “Consumers can look to United just like to other plans on the shelf.”

Beyond next year, however, Lee offered no predictions. “There is no guarantee any plan will be on the shelf in 2017, because we will be looking at every one of them.”

Whether consumers will choose United is uncertain. Gordon Paul, a Fresno insurance agent who helps people enroll in Covered California health plans, said United’s prices are in line with other products. “They have a contract; it’s there for a year. From a customer’s standpoint, I don’t think it put up too many alarms here,” he said.

Covered California scrutinizes health plans for participation in the exchange. Since 2014, health plans have had to offer the same standard benefits.

Plans allowed on the exchange also have had their premium rates studied for sustainability as well as affordability. “We made sure they weren’t too low,” Lee said. Other states have seen rates whipsaw up and down, he said. “That’s not good for consumers.”

These measures have set California apart from Affordable Care Act exchanges nationwide, Lee said. “Many health plans lost money outside of California because they didn’t have the ability to price well,” he said. “Plans are not losing money here in California.”

Health Net, for example, which has participated in the exchange since 2014, has had a positive experience with Covered California and the state’s expansion of Medi-Cal, said spokesman Peter O’Neill. “California is a great state for us to be operating under the ACA,” he said. “We have done well as a company and we believe our members have benefited from that.”

This story was originally published November 25, 2015 at 12:14 PM with the headline "United Healthcare remains an option for Valley health plan shoppers – for now."