SWHP is exiting the FFM in 2017

In 2017, Scott & White Health Plan will leave the federal health care Marketplace and refine our off-Marketplace individual and family plans. We know that our changes impact your business, so we wanted you to be the first to know. Members will receive a letter regarding this information in the next few days.

What is changing?

Scott & White Health Plan will no longer offer its individual and family plans through the Marketplace, beginning January 2017. Your clients/our members who are currently enrolled in one of our Marketplace plans will lose their coverage unless they either enroll with us in an individual/family plan off-Marketplace or enroll with another carrier.

There will also be changes in our off-Marketplace individual/family plan offerings for 2017. Gold and silver plans will not be available. We will, however, offer a limited selection of off-Marketplace bronze plans, to include an HMO and PPO offering.

You may find these answers to frequently asked questions useful when discussing 2017 coverage options with your clients.

Why did we reach this decision?

Scott & White Health Plan is committed to supporting the Affordable Care Act, which has changed the lives of many Americans and expanded access to insurance for people across the country. At the same time, however, political gridlock and incomplete implementation have led to systemic challenges in Marketplace plans. Marketplace plans carry higher risk, and like many insurers, we have determined that we cannot currently serve Marketplace plans on an effective and financially sustainable basis. We have instead opted to remove our plans from the Marketplace, but still offer affordable plans on an off-Marketplace basis.

Exciting new products for small groups!

While leaving the federal health care Marketplace, we will also be introducing seven new small group PPO plans for 2017 and are excited to share more details about those plans with you very soon. With out-of-network benefits, in-network copays for primary care office visits ranging from $25 to $50, and individual deductibles from $0 to $6,600, the plans will offer a wide range of benefits and affordability to meet customers’ diverse needs.

We appreciate the relationship that we have built together. We will continue working to build comprehensive, sustainable, and competitive products and networks that give Texans access to high-quality, affordable care.