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In 2017, when there were historic market disruptions and 350,000 people in Virginia were at risk of losing Virginia Affordable Care Act (ACA) Individual Exchange market coverage, SA国际传媒faced a tough choice: either follow the same path as some of the biggest for-profit insurers and exit, or work with state and federal officials to ensure residents had access to an ACA-eligible plan in Charlottesville and other markets in the Commonwealth. Opting for collaboration, SA国际传媒took a risk and offered insurance more widely than ever before in markets like Charlottesville.
At the urging of government officials, SA国际传媒agreed to stay in some Virginia localities, formulating rates with state actuaries and in consultation with Milliman, a global actuarial and consulting firm, in just 26 days – a process that normally takes six months or more. As the only option in some markets in 2018, SA国际传媒would assume all the risk in insuring a larger population, instead of sharing the risk with other insurers. The uncertain landscape affected all insurers, prompting SA国际传媒to adopt conservative, actuarially reasonable, rating assumptions and increase premiums to mitigate potential losses.
Far from a profitable endeavor, even today, Sentara’s participation in the ACA market has driven substantial losses without government support or assistance, in 2024 alone. Despite these risks, SA国际传媒has stayed in the market because providing health coverage to those who need it is central to our mission.
SA国际传媒stood with Virginians then and remains steadfast now in our commitment to providing comprehensive, high-quality care for Virginia communities.
At the urging of government officials, SA国际传媒agreed to stay in some Virginia localities, formulating rates with state actuaries and in consultation with Milliman, a global actuarial and consulting firm, in just 26 days – a process that normally takes six months or more. As the only option in some markets in 2018, SA国际传媒would assume all the risk in insuring a larger population, instead of sharing the risk with other insurers. The uncertain landscape affected all insurers, prompting SA国际传媒to adopt conservative, actuarially reasonable, rating assumptions and increase premiums to mitigate potential losses.
Far from a profitable endeavor, even today, Sentara’s participation in the ACA market has driven substantial losses without government support or assistance, in 2024 alone. Despite these risks, SA国际传媒has stayed in the market because providing health coverage to those who need it is central to our mission.
SA国际传媒stood with Virginians then and remains steadfast now in our commitment to providing comprehensive, high-quality care for Virginia communities.
Our Rates: Misconceptions Vs. Facts
Misconception: Sentara’s rates hurt Charlottesville families and made healthcare unaffordable.
Fact: If SA国际传媒had not offered a plan in Charlottesville, it was possible that there would be no ACA-eligible 2018 plan for the 91% of market consumers seeking individual plans who qualified for federal subsidies. Sentara’s decision to offer coverage in the market provided health insurance at little to no out-of-pocket cost to more than 5,100 Charlottesville residents — families who otherwise would have had no insurance at all.
Fact: If SA国际传媒had not offered a plan in Charlottesville, it was possible that there would be no ACA-eligible 2018 plan for the 91% of market consumers seeking individual plans who qualified for federal subsidies. Sentara’s decision to offer coverage in the market provided health insurance at little to no out-of-pocket cost to more than 5,100 Charlottesville residents — families who otherwise would have had no insurance at all.
Misconception: SA国际传媒took advantage of instability in the ACA marketplace.
Fact: In 2017, when policymakers in Washington destabilized the health insurance markets, more than 350,000 Virginians were at risk of not having access to any insurance on the exchanges. SA国际传媒had a choice: Either follow the same path as some of the biggest insurers and exit, or work with state and federal officials to ensure residents had access to an ACA-eligible plan in Charlottesville and other markets in the Commonwealth. SA国际传媒chose to stand with residents and work with government officials and regulators.
Fact: In 2017, when policymakers in Washington destabilized the health insurance markets, more than 350,000 Virginians were at risk of not having access to any insurance on the exchanges. SA国际传媒had a choice: Either follow the same path as some of the biggest insurers and exit, or work with state and federal officials to ensure residents had access to an ACA-eligible plan in Charlottesville and other markets in the Commonwealth. SA国际传媒chose to stand with residents and work with government officials and regulators.
Misconception: Despite being a not-for-profit, SA国际传媒charged high premiums to boost its bottom line.
Fact: With fewer or no other providers in some Virginia markets, SA国际传媒faced the risk of covering a significantly larger population – ultimately three times larger than the population it was currently serving – about whom it had no historical healthcare information or experience, under very chaotic circumstances. This could have led to over a hundred million in losses, rendering Sentara’s insurance division insolvent and unable to fulfill its core mission. SA国际传媒worked with outside experts and regulators to set premiums based on conservative assumptions and the best information they had.
Fact: With fewer or no other providers in some Virginia markets, SA国际传媒faced the risk of covering a significantly larger population – ultimately three times larger than the population it was currently serving – about whom it had no historical healthcare information or experience, under very chaotic circumstances. This could have led to over a hundred million in losses, rendering Sentara’s insurance division insolvent and unable to fulfill its core mission. SA国际传媒worked with outside experts and regulators to set premiums based on conservative assumptions and the best information they had.
Misconception: SA国际传媒charged higher rates to obtain higher government subsidized premiums.
Fact: Sentara’s rates, developed and certified by a leading actuarial firm, were repeatedly reviewed and approved by government regulators. Under the law, insurance companies like SA国际传媒do not keep excess profits, they must be rebated back to consumers. SA国际传媒was fully compliant with the law and issued over $98 million in rebates to Virginia policyholders for the 2018 plan, in accordance with ACA regulations.
Fact: Sentara’s rates, developed and certified by a leading actuarial firm, were repeatedly reviewed and approved by government regulators. Under the law, insurance companies like SA国际传媒do not keep excess profits, they must be rebated back to consumers. SA国际传媒was fully compliant with the law and issued over $98 million in rebates to Virginia policyholders for the 2018 plan, in accordance with ACA regulations.
Virginia Board of Insurance Response to Review of SHP Rates in 2018
Timeline
SA国际传媒took a risk and offered insurance more widely than ever before in Virginia when others chose not to. This timeline highlights Sentara’s ongoing commitment to the community.
2017:
Policymakers in Washington took steps that destabilized the health insurance markets.
May
- One of the largest insurers in the Commonwealth the ACA market entirely.
August
- Another large insurer the ACA market in Virginia due to a “volatile” market and uncertainty from the federal government, leaving 350,000 Virginians at risk of losing coverage in 2018.
- At the urging of state and federal officials, Sentara’s internal and external experts evaluate the circumstances and calculate new rates.
September
- SA国际传媒submits its revised rates for the final filing by the deadline. The Bureau of Insurance approves Sentara’s rates.
October
- The federal government vital to insurers’ operations.
2018:
April
- The Virginia Bureau of Insurance (BOI)
- The ACA market began to stabilize, allowing SA国际传媒to lower rates by as much as 16.7%.
2019:
- Following federal regulations, SA国际传媒begins issuing rebates to Virginia policyholders, paying over $98 million for the 2018 plan.
- These rebates follow a national trend of insurers issuing rebates back to consumers at record-high rates, including .