Highmark extends Special Care coverage 6 months due to Obamacare problems

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Highmark Inc. said Tuesday that it was giving people who are covered under its low-cost SpecialCare health insurance program a six-month reprieve because of the problems with the launch of the federal government's health insurance website.

The coverage, which was set to expire Dec. 31, will be extended through June 30.

Approximately 19,400 policyholders -- who received cancellation notices earlier this year -- do not need to contact Highmark to request an extension. They need only to continue to pay their premiums, the Pittsburgh insurer said.

Another 16,500 policyholders covered under guaranteed issue individual plans that also were canceled effective Dec. 31 will not have their plans extended, Highmark said.

The insurer said it would be seeking approval from the Pennsylvania Insurance Department for a rate increase "to offset a small portion" of the cost of extending the SpecialCare policies.

Highmark spokeswoman Kristin Ash declined to say how much premiums might go up. "We will work with the [insurance department] on our rate increase filing, so no additional details are available on the actual rate increase," Ms. Ash said in an email.

The SpecialCare program, offered through Pennsylvania's Blue Cross Blue Shield plans, offers a limited-benefit policy designed for individuals who do not qualify for Medical Assistance or Medicare and who cannot afford to buy private health care coverage.

The policies were originally set to expire by year end because they did not meet the minimum coverage requirements of the 2010 federal health care law. An extension became possible about two weeks ago when President Barack Obama asked that states allow insurers to extend noncompliant policies for at least a year.

On Tuesday, Pennsylvania's insurance commissioner announced that insurance companies statewide would have the option of continuing individual policies originally set for cancellation.

Policyholders "are faced with significant challenges in obtaining coverage through the new health insurance marketplaces by the enrollment deadline of Dec. 23, 2013, for Jan. 1, 2014 coverage," Highmark said in a statement. The company said it "has expanded our individual insurance options for these members to ensure that they have no gaps in coverage."

SpecialCare policyholders can choose a new plan through the federal marketplace at any time during the open enrollment period that ends March 31.

They also can choose to keep SpecialCare through June 30. Policyholders who want to keep their plans for the full extension period will receive a notice from Highmark prior to the expiration date explaining what they need to do to continue coverage under a new plan starting July 1, Ms. Ash said.

The company said that within the next week it would be reaching out to policyholders with guaranteed issue plans expiring Dec. 31 to give them a deadline by which they must choose a new plan. Otherwise, Highmark will assign them to a plan "to ensure that members have the continuous coverage they need."

In Allegheny County, those guaranteed issue policyholders who don't pick their own alternative plan will be automatically enrolled in Health Savings Blue PPO 2750, a Community Blue plan, which is the lowest-cost silver plan, Highmark said.

Highmark's health care overhaul support line is 1-877-959-2550.

Patricia Sabatini: psabatini@post-gazette.com or 412-263-3066.


Patricia Sabatini: psabatini@post-gazette.com or 412-263-3066. First Published November 26, 2013 2:55 PM

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