What’s changing for 2017 individual/Marketplace plans

If you buy health insurance for yourself and/or your family, we want you to know about changes to our Individual/Marketplace plans in 2017. (If you have insurance through your work or are enrolled in Medicare or BlueCare, please know that these changes do not apply to you.)

BlueCross is offering Individual/Marketplace plans in 5 out of 8 regions in 2017

We’re trying hard to make the Affordable Care Act (ACA) work in Tennessee and are offering plans in most of the state for 2017.

Because of many challenges, we have made the difficult but necessary decision to end coverage in three regions for 2017 – the Memphis, Nashville and Knoxville regions (shaded in orange below).

BlueCross BlueShield of Tennessee will offer individual/Marketplace plans for 2017 in the blue-shaded regions.

We’re disappointed in this development, but want to help you understand how we made this decision and how it affects you.

Dates You Need to Know

  • November 1, 2016: Open Enrollment begins
  • December 19, 2016: Deadline to enroll in a new plan or make changes to your coverage effective January 1, 2017
  • January 31, 2017: Open Enrollment ends for 2017

Your Questions Answered

Why are you only offering plans in some parts of Tennessee?

Since the ACA passed in 2010, BlueCross has been working hard to make the law work for Tennesseans who need health coverage and care. By the end of 2016, we anticipate losses approaching $500 million on ACA plans.

We are raising rates to address the gap between what we charge and what we pay for medical care, but those aren’t the only factors we considered. Uncertainties surrounding the ACA at the federal level also played a role.

We are taking this step to protect our financial stability on behalf of our more than 3 million members.


How did BlueCross decide where to stop selling Individual/Marketplace plans?

BlueCross has been committed to making the ACA work for Tennesseans from the beginning. As we considered how to scale back our participation, we deliberately chose to stop selling plans only in regions where we anticipated consumers would have other options for coverage.

We hope the ACA Marketplace will stabilize and that we will be able to serve you again in the future.


Are you ending my coverage to earn higher profits?

No. BlueCross is a taxpaying not-for-profit company, and profit isn’t our primary goal. But a small amount (usually around 2-3% per year) is necessary so we can protect the financial reserves we are required to hold. Members count on us to be financially strong, too.

We typically earn less net income than our for-profit competitors, and also less than companies in other sectors of the health care industry.


Why are you not using your reserves to cover losses and continue offering coverage?

Our mission is providing peace of mind and access to quality health care for our members. To do that, we must remain financially strong. We can’t risk our reserves dropping below the legally required minimum.

Our reserves have dropped significantly since we began serving the ACA Marketplace, so now we must act to protect the financial security our more than 3 million members rely on.

Download a full Q&A about our 2017 Marketplace participation.

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