UnitedHealth leaves AHIP

June 24, 2015 at 07:30 AM
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UnitedHealth Group Inc. (NYSE:UNH) says it will be leaving America's Health Insurance Plans (AHIP), the top health insurance company trade group, June 30.

"UnitedHealth Group believes the interest of our company and the customers we serve are no longer best represented by AHIP and accordingly are ending our membership," UnitedHealth spokesman Matt Stearns says in a statement about the decision, which surfaced in WSJ.com.

"AHIP has set forth a strategy and direction it feels best serves a membership profile and need that does not fit UnitedHealth Group and our diversified portfolio," Stearns says. "AHIP has to respond to its needs and interest of many members, which understandably resulted in a more limited and complicated advocacy focus."

AHIP said its board is focusing on the critical issues facing health insurers and their customers, including affordability, the high cost of drugs, and Medicare Advantage.

AHIP was formed in 2004 through the merger of one group that represented managed care plans, the American Association of Health Plans, and another group that represented carriers that thought of themselves as insurance companies.

One factor complicating relations between health insurers may be the start of two Patient Protection and Affordable Care Act (PPACA) programs that could require some insurers to provide cash for their competitors.

One, the risk corridors program, is supposed to use cash from carriers with solid underwriting results in 2014, 2015 and 2016 to help insurers with poor results.

The second PPACA risk-management program, a risk-adjustment program, is supposed to use cash from insurers with relatively low-risk enrollees to help insurers with relatively high-risk insurers. 

Insurers are supposed to get information from the federal government about their reinsurance benefits for 2014, and they're supposed to file the information they need to participate in the risk corridors program by July 31.

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