Humana, Anthem accused of misleading customers in renewal letters


Humana and Anthem Blue Cross may have sent renewal letters that are "misleading" to their individual members in Kentucky, state officials say.

For example, Humana mailed a letter to one customer saying he can renew his current health plan for another year with a $279 monthly premium or enroll in a new plan under the reform law with a $619 premium each month. Of particular concern, Humana said the member must decide by Sept. 20--before the Oct. 1 enrollment period begins for the health insurance exchange, reported the Louisville Courier-Journal

Kentucky officials say they're investigating Humana's letters, which were sent to about 6,500 people. The state's insurance commissioner, Sharon Clark, called the letters "misleading intentionally," and said her office already has received calls and two official consumer complaints about the matter. "They are aware of our serious concerns," she said.

This could be an example of insurers trying to take advantage of an obscure loophole in the reform law that lets them avoid covering additional mandated benefits by getting their members to renew their current policies for an extra year, FierceHealthPayer previously reported.

But Kevin Gibson, director of consumer experience for Humana One, said the letter doesn't prevent its members from shopping on the exchange. "If someone wants to explore their options for on-exchange coverage and financial assistance, Humana can help them do so, starting Oct. 1," he told the Courier-Journal.

Meanwhile, Humana is "cooperating with the (state insurance) department to address this issue and respond to any member concerns," Humana Spokeswoman Kate Marx told the newspaper. "We feel the need to clarify that although we've asked for a 30-day selection, we will continue to make ourselves available to assist members with plan selections until the end of the year."

Although Anthem is less specific in its letter than Humana, it similarly advocates that members renew before the exchanges open. For example, it urges consumers to "call now to keep today's affordable rates for the next 12 months" and says "we can only offer current plans and rates for a limited time."

"The letter's purpose is to let the member know that he or she has the choice to keep their current benefits and coverage for another year by renewing early," Anthem Spokesman Tony Felts told the Courier-Journal.

But D.J. Wasson of Kentucky's insurance department said Anthem's letter improperly conveys a sense of urgency.

To learn more:
- read the Louisville Courier-Journal article

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