Health Plan Weekly
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On 3Q Earnings Call, CVS Lays Out Path for Aetna Rescue
CVS Health Corp.’s third-quarter 2024 earnings call — which it held on the same morning when many Americans woke up to learn Donald Trump had won the presidency — focused largely on how the firm’s new management aims to turn around its struggling health care benefits business. In response, Wall Street analysts expressed a range of reactions, from lukewarm optimism to outright skepticism.
“We believe CVS is overbought today,” Cantor Fitzgerald’s Sarah James wrote in a Nov. 6 research note, observing that CVS’s stock closed that day up 11.3%. “The response to the 2024 presidential election is too strong against disappointing 3Q24 fundamentals and 2024/2025 outlook.”
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Employees’ Satisfaction With Health Care Coverage Ticks Up in 2024, Survey Finds
More employees were satisfied with their current health insurance plan in 2024 than in prior years, according to the 2024 Workplace Wellness Survey published by the Employee Benefit Research Institute and Greenwald Research.
The fifth annual survey, which interviewed more than 1,500 full-time and part-time workers ages 21-64, found that about 83% of employees said their employers offered health insurance, a slight increase from 81% in 2023. And 59% of these employees said they were “extremely satisfied” or “very satisfied” with their current health insurance plan, compared with 55% last year.
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News Briefs: More Insurers Curtail Medicare Broker Commissions
Elevance Health, Inc., The Cigna Group, and CVS Health Corp.-owned Aetna will no longer pay brokers commissions for new enrollments in some Medicare Advantage plans. Cigna will stop commissions for some PPO plans in 25 states and Washington, D.C., while Aetna is ceasing payments in nine states and D.C. Elevance is halting commissions for some Anthem plans in 15 states, Becker’s Payer Issues reported. The companies will pay commission for renewals. On Aug. 23, Centene Corp. informed its brokers that it would cease paying commissions for new and renewal enrollments for its stand-alone Prescription Drug Plans. “Higher drug costs and declining star ratings have driven some Medicare carriers to take drastic actions this fall,” the National Association of Benefit and Insurance Professionals said in a statement. “The individuals most affected by these changes are the millions of Medicare beneficiaries who, through no fault of their own, are losing benefits within their Medicare Advantage (MA) plans and, alarmingly, their options to work with trusted agents to find the best healthcare coverage.”
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ACA Open Enrollment 2025: ‘Calm Before the Storm’ of Subsidy Cliff
As the 12th open enrollment period (OEP) for the Affordable Care Act exchanges kicked off Nov. 1, some noteworthy market trends include health insurers expanding into “farm belt” states, lower median deductibles, and a smaller number of plans available due to new regulatory limits on how many plans carriers can offer. And although industry experts say the 2025 plan year is slated to be largely uneventful for the exchanges, they caution that the stability is likely to be short-lived.
“This is the calm before the storm,” says Fritz Busch, a principal and consulting actuary at Milliman, referring to the fact that enhanced premium subsidies that have been in place since 2021 are set to expire after 2025. If Congress moves quickly early next year to extend the enhanced subsidies, “maybe there’s not a storm,” he tells AIS Health, a division of MMIT. Still, Busch says his clients have been talking for months about how to plan for various scenarios.
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The ACA Marketplaces in 2025, at a Glance
HealthCare.gov enrollees have more health plan options in 2025 compared to previous years, yet the average benchmark plan premium in states that use the federal enrollment platform increased modestly, according to CMS.
In most states, the open enrollment period for Affordable Care Act marketplace coverage runs from Nov. 1, 2024, to Jan. 15, 2025. Out of the 31 states that are using HealthCare.gov, eight have more Qualified Health Plan (QHP) issuers in 2025 than in 2024, and 97% of enrollees have access to three or more issuers, compared to 78% in 2021. Seven HealthCare.gov states have counties with a single QHP issuer in 2025, compared to nine states in 2024. Georgia stopped using HealthCare.gov in 2024 and transitioned to a state-run exchange, and Illinois is scheduled to move to a state-based marketplace for the 2026 plan year.
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