John C. Molina has taken the time to address some of the recent developments in the health care sector. Knowing the struggles insurers, such as United, Aetna, Humana and many of the state based co-ops, face in the Marketplace line of business with some exiting the Marketplace all together, Molina has reached out and shared their position.
Firstly, Molina Healthcare has performed within their growth and membership expectations in the majority of their states. Furthermore, they are committed to the Marketplace product, evident by their expansion strategies. In 2017, they will be adding counties in California, Washington, Utah, Michigan, Florida and Ohio. For 2018, they are also planning to expand into new states as well.
To further reassure you, Molina has shared what is being said of them in the news. Not all carriers are having the same experience with their Marketplace products as noted by recent Associated Press articles by Tom Murphy:
“Insurers like Aetna, and UnitedHealth are scaling back their exchange participation; competitors like Cigna and Molina Healthcare are expanding.”
“Insurers like Molina that have reported success so far on the exchanges say they have focused on covering low-income customers in markets where they already have an established presence in Medicaid, the state-federal program that covers the poor.”
Molina Healthcare will make every effort to ensure the success of the Marketplace and will continue to partner with you to serve their Marketplace members as well as potential members. As part of their commitment, they have stated that they will continue to pay agent commissions, provide first-in-class broker support, service, and infrastructure. They are also investing in the future of the Marketplace by providing support and sharing feedback to improve the system. This includes:
- Developing an advocacy initiative with CMS to improve SEP validation process for the future
- Advocating for redefining the risk transfer process and a sustainable risk pool
At the same time, they continue to improve their own infrastructure to support the Marketplace product. Examples include:
- Making changes to their internal process as needed
- Establishing the Broker CARE team
- Hiring additional staff in the Broker Support Unit (BSU)
- Implementing IT system enhancements
- Adapting their broker portal to meet the needs of their brokers
While the competitive space continues to change and evolve, Molina hopes that you will remember that they have consistently been a mission-driven company focused on the low-income population for more than 35 years, which they believe has played a significant role in their success in the Marketplace. They’ve targeted the same low-income individuals for their Marketplace product. They have knowledge, familiarity, and expertise in serving the unique needs of this population, and they plan to stay this way.
Molina hopes this helps ease the uncertainty you may have felt and reinforces your understanding that they are committed to succeeding in the Marketplace line of business.