BCBS of North Carolina raises rates after $282M loss on ACA customers

Blue Cross Blue Shield of North Carolina reported a $282 million loss on plans sold on the Affordable Care Act exchange in 2015. To stem losses, the insurer increased rates by 32.5 percent for 2016 and has requested to raise rates an additional 18.8 percent for 2017, according to the Charlotte Business Journal.

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BCBS of North Carolina said emergency room use among its ACA customers was higher than those with more traditional plans, which negatively affected the insurer’s bottom line last year. A higher volume of orthopedic procedures and expensive drugs also contributed to the insurer’s losses.

“In 2015, we saw rising prices for many drugs, both generic and name brand drugs, that a large number of ACA customers use,” Brian Tajlili, director of actuarial and pricing services for BCBS of North Carolina, told the Charlotte Business Journal.

BCBS of North Carolina isn’t the only insurer in the state to request rate increases. Aetna is looking to increase premiums by 24.5 percent, on average, in 2017, according to The News & Observer.

The North Carolina Department of Insurance must approve the proposed rate increases, which would take effect Jan. 1, 2017.

More articles on payer issues:

UnitedHealth to leave California’s ACA marketplace
Feds fine Clover Health for deceptive marketing to consumers
State to seize control of Ohio insurance co-op

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