Virginia insurer posts record profits after charging some of nation's highest ACA premiums, group says

Optima Health, which was the only health insurer to offer policies on Virginia's ACA exchange in 2018, recorded record profits after tripling individual marketplace premiums, a consumer group told the The Daily Progress.

The Norfolk, Va.-based insurer charged some of the highest out-of-pocket insurance rates in the U.S. last year, according to an analysis by consumer group Charlottesville for Reasonable Health Insurance cited by The Daily Progress. After the hikes, Optima reported a gross profit on individual products of $332 million, according to the report.

Optima disputed the group's conclusion, stating that its net underwriting gain for the individual marketplace — which considers administrative expenses — totaled $152 million.

"Optima's filings reflect a year of unique challenges after all of the national health insurance carriers — Anthem, Aetna and UnitedHealthcare — left Virginia's Affordable Care Act exchange market due to uncertainty in Washington around the elimination of cost-sharing reduction payments," Optima spokesperson Kelsea Smith told The Daily Progress. "When factoring in the burden of CSR elimination, Optima had to alter rate structures for individual products to maintain quality of service. We recognize the significant impacts the increase has had on some families in the Charlottesville market who did not qualify for federal subsidies."

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