But their renewal is imminent. The party’s over.

Thanks to the curiously named ‘Protecting Affordable Care for Employees Act (PACE),’ Visse’ is considered a large group; i.e., their Average Total Number of Employees (ATNE) is well over 50. (Several FT employees waive coverage and numerous PT employees aren’t even eligible.) As such, they are experience rated. The logic of the PACE Act is argued here.

With just 6 employees incurring claims north of $778,000, the renewal calls for an eye-popping 79.9% increase. (Apparently 80% would have been unconscionable.) C’mon; $200K of added cost for an industry crushed by the pandemic.

Visse’ indeed!

What’s in Blackstone’s hat this week?

Another insurer might take a flyer on this case and shadow price at 30-40 instead of 80.

Or, Visse’ could drop the group contract altogether, sending their employees to the individual market supported in part by defined contributions to an ICHRA (Individual Coverage Health Reimbursement Arrangement. (About $500/month would keep their costs level.)

Tirer sur le messager? That’s an option, too.