Aetna to dump 600,000 members

[debbierlus]

http://pnhp.org/news/2009/november/aetna-to-dump-600000-members

Aetna to dump 600,000 members
Aetna prepares for loss of 600,000 members as it raises 2010 prices
By Emily Berry
American Medical News
November 30, 2009


Back when it was the largest private health plan in the country, Aetna downsized its membership by millions but boosted profits during an overhaul of its business several years ago.

Now it looks to be making a similar -- but smaller -- move with a planned price increase for many of its customers in 2010.
The company figures it will lose between 600,000 and 650,000 members next year because of the price hikes.
In a conference call with investment analysts to discuss the company's third-quarter earnings, Chair and CEO Ron Williams told analysts, "The pricing we put in place for 2009 turned out to not really be what we needed to achieve the results and margins that we had historically been delivering."

Aetna President Mark Bertolini laid out how the company planned to raise prices to improve the company's profit margin. He said the firm had "implemented a combination of underwriting enhancements, pricing actions and plan design changes, intended to ensure that each customer is priced to an appropriate margin."

Laying out specific expected membership losses is "pretty candid," said David Gibbs, a retired health insurance industry consultant from San Luis Obispo, Calif. He worked for and consulted with health insurers, including Aetna, for 25 years.
He said Aetna's decision comes from a system that encourages insurers to drive away sicker members -- a strategy not unique to one insurer. "They're running a business, and their obligation is a very singular one: to increase shareholder profits."
Gibbs said simply raising prices probably would not get Aetna what it wants. That actually tends to result in sick people who are more "desperate" for coverage to keep it, and healthier groups to drop it. Instead, Aetna might change benefit designs, scaling back prescription drug coverage, for example, which sicker populations tend to value but healthier ones don't notice as much.

http://www.ama-assn.org/amednews/2009/11/30/bisb1130.htm

[FarLeftFist]

1. 600,000 more people on board for a public option. n/t

[KansDem]

2. "They're running a business, and their obligation is ...: to increase shareholder profits."

You would think this would sink into the minds of our Congress.

"Shareholder profits" should not be the reason for health-care in this country...

[Gold Metal Flake]

3. Our Congress benefits from their profits.

[gateley]

6. Good point. Election reform. nt

[gateley]

5. Agree. By law their obligation is the profits for shareholders - not our health.

I guess I just said the same thing, but it seems so cut and dried -- I don't understand how anybody could think a for-profit entity has our health as its main concern.

[debbierlus]

The entire health insurance reform CENTERS around maintaining profits

The FIRST priority of this legislation is to ensure the ability of big pharm and private insurance to maintain and EXPAND profits.

Is it any wonder this legislation sucks so much ass?

[Javaman]

4. the market share dropped 29% last quarter, they are hemorrhaging money

they had to make a cut or face bankruptcy.

I'm not apologizing for them in the very least.

Our company had them last year for our carrier, we dumped them before they dumped us.

[PRETZEL]

7. Aetna's not the only one,

where I work (county gov't) the cost of insurance has become a budget breaker.

For the first time in it's history, we're going to have to pay a portion of the premiums. That was always the selling point that many of the departments used in lieu of private sector comparable pay. Not any longer.

For my part of the budget, I'll be taking somewhere around a $4k pay cut. That is assuming no health issues for me or my family, then it could end up being double that.

[debbierlus]

8. We need to excise these leeches.

[Newsjock]

9. Bastards

My employer had a flu-shot clinic earlier this year, where we were promised free flu shots, all we had to do was bring our Aetna cards.

A couple weeks back, I got an "Explanation of Benefits" from Aetna saying that they were denying "my" claim for a flu shot because it was subject to my annual deductible. It took intervention from my company's HR people to get that corrected.

Makes me wonder how many other people Aetna tried to fleece.

And we won't even talk about the time earlier this year when Aetna sent me a letter inviting me to convert my employer-based insurance to individual insurance because they were sensitive to the challenges I was facing during this difficult employment situation. Problem was, I still had my job.

I say again, bastards.

[Vinnie From Indy]

10. I guess after trimming executive pay to the bone they had no choice - NOT!

Ron Williams - Aetna

Total Compensation: $24,300,112

Details: Williams earned $24,300,112 in total compensation for 2008, with more than half of that ($13,537,365) coming from option awards. He also received an additional $6,456,630 in stock awards to go along with his base salary of $1,091,764.

Personal use of a corporate aircraft and vehicle, as well as financial planning and 401(k) company matches added up to $101,487 for Williams.
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Hey c'mon folks! Let's not give the CEO Ron Williams too hard a time. After all, the guy is BARELY getting by on his $66,575. dollar daily wage. He probably wakes at night in a cold sweat wondering how him and the family will survive.