Health Plan Weekly

For the 2025 plan year, Centene Corp. will not offer Medicare Advantage plans in Alabama, Massachusetts, New Hampshire, New Mexico, Rhode Island and Vermont, Modern Healthcare reported, citing an Aug. 5 note from investment bank Stephens. However, Centene will continue offering Medicare Part D Prescription Drug Plans in those states. Pinnacle Financial Services, a health insurance brokerage, also posted to its website a notice from Centene about exiting those markets, which account for about 3% of the insurer’s MA membership.  

BlueCross BlueShield of Vermont, the state’s largest insurer, is on the verge of insolvency, according to a July 29 article in the Burlington Free Press. However, Kevin Gaffney, commissioner of the state’s Department of Financial Regulation, told the newspaper, “BlueCross BlueShield of Vermont is a big tanker. We have to start to turn it. We can do that and there are steps to do it.” Gaffney said he is requiring the insurer to file a plan of solvency by early September. In October 2023, BCBS of Vermont finalized an “affiliation” with Blue Cross Blue Shield of Michigan in which the Vermont plan became a subsidiary of BCBS of Michigan.  

With Affordable Care Act premium rate requests now filed for 2025, industry observers are eagerly awaiting data from the federal government detailing how exchange insurers are pricing their health plans. In the meantime, a new analysis that combs through some of the earliest rate filings offers insights into the various factors insurers and their actuaries are considering.  

“One piece of good news is that there’s just not the turbulence that we’ve seen in past years,” Sabrina Corlette, co-founder of the Georgetown University Center on Health Insurance Reforms (CHIR), tells AIS Health, a division of MMIT. In a July 29 CHIR blog post, Corlette detailed what she learned from a deep dive into insurers’ rate requests in Maine, Maryland, Oregon, Vermont and Washington, D.C. — states where regulators require health plans to submit their rate filings one to two months before the July 17 federal deadline that applies to most states.  

Although The Cigna Group reported second-quarter 2024 results on Aug. 1 that were strong on paper, the company’s decision to reaffirm — not raise — its full-year earnings guidance and executives’ remarks regarding health care utilization trends appear to have led to a mild stock selloff. 

For the quarter ending June 30, Cigna reported adjusted earnings per share (EPS) of $6.72 and total revenues of $60.5 billion, beating Wall Street’s consensus estimates of $6.43 and $58.5 billion and representing 25% and 10% year-over-year growth, respectively. Cigna said its revenue increase was “primarily driven by significant growth in Evernorth Health Services, reflecting large client wins.” 

Despite Humana Inc. beating second-quarter earnings and revenue expectations, Wall Street did not react kindly to the insurer’s latest financial results. Humana shares closed at $361.61 on July 31, the day the results were released, a 10.6% decline from the previous day. Wells Fargo analyst Stephen Baxter primarily attributed the negative sentiment to higher-than-expected inpatient admissions and the company not raising its full-year guidance as many had expected it would do. 

Humana had adjusted earnings per share (EPS) of $6.96 in the second quarter, well above the Wall Street consensus estimate of $5.92. Still, Humana reaffirmed its full-year EPS of about $16, which CEO James Rechtin said “prudently assumes that the higher inpatient costs will continue even as we work to mitigate that pressure.” Humana in January surprised investors by lowering its EPS guidance to about $16 for the year, down from its previous estimate of about $25, which it attributed to elevated care utilization.