LDA Health Plan Trust Final Notice to Members
November 1, 2019
Dear LDA members,
The Louisiana Dental Association Health Plan Trust (LDAHPT) was formed with the intention of providing a quality alternative in the health benefits market for LDA members. The hope of the LDA board was that many, though probably not all members, would be able to obtain benefits from LDAHPT that were comparable or better than those available elsewhere in the health benefits market at competitive premium rates.
LDAHPT was based on one of the few models that the LDA board believed could give LDA a reasonable chance of achieving those goals after the Affordable Care Act resulted in the departure of any options in Louisiana similar to the health plan sponsored (but not run) by the LDA several years ago. However, LDA had much less in the way of both members and resources compared to the handful of dental associations that had implemented similar models in other states. And NO other such model even exists in Louisiana. Basically, the LDA board’s very strong desire to develop a groundbreaking member benefit led LDA to tackle something rarely achieved with no charted path to follow for the particular circumstances the LDA faced. As it turns out, this portended the many constraints on LDAHPT and numerous obstacles to success LDAHPT has continually faced.
Ultimately, LDAHPT was simply not able to grow sufficiently large sufficiently fast enough to satisfy the requirements of all the partner companies that are needed to provide services to the plan. At the beginning, LDAHPT was only able to get a single company that provides stop-loss coverage interested in our plan, and that initial policy was for the current year. (Note: stop-loss coverage is insurance that assumes the risk after claims reach a certain dollar level.) Low enrollment equates to higher risk, as they can’t collect nearly enough premium to cover the costs of really big claims (e.g., cancer or major injuries). And LDAHPT’s enrollment in 2019 was MUCH lower than anyone had expected.
However, LDAHPT was in a position to offer at least some members what were expected to be more attractive options for 2020. And, LDAHPT and Brown & Brown had begun a strong marketing effort to make members aware of this. So, when the stop-loss carrier recently notified us they would not renew our coverage for 2020, it came as quite a shock – even though it was also understandable, given the current low enrollment.
The LDA and LDAHPT boards felt this was such an important member benefit, they did not want to give up on it until they were absolutely certain there was no possibility of contracting with another stop-loss carrier. However, the only realistic way to attract another stop-loss carrier would have been to enroll more participants very quickly. Accordingly, LDAHPT and Brown & Brown were directed to continue to market the plan while also reaching out to as many stop-loss carriers as possible.as quickly as possible. Meanwhile, we were very cognizant that, if we had to shut down for not having stop-loss coverage, our highest priority HAD to be ensuring our members currently enrolled in the plan had ample time and assistance to find comparable coverage.
So, when no option for stop-loss coverage had been identified by the last week of October, the decision was made by the both boards to cease issuing new quotes, as provided in the Trust’s governing documents, and start helping members find other coverage beginning 11/1/19, the start of the open enrollment period. In accordance with Louisiana insurance law, LDAHPT has been informing LDA members that it will discontinue offering health benefits 180 days from the date of this notice.
LDAHPT will also not be issuing renewal quotes for 2020 as had been originally intended and has discontinued issuing quotes for new business. As the primary concern is to take care of the needs of LDA members who are already part of LDAHPT, plan participants are being advised that LDAHPT’s exclusive agency, Brown & Brown Association Services Professionals, will shortly be contacting them to assist with obtaining comparable coverage with another health plan to be effective January 1, 2020. In most cases, such coverage will need to be bound by December 1, 2019. So, if you are a current plan participant and do not get a call from Brown & Brown within the next few days, you may want to proactively contact them by calling 1-888-503-5547.
Coverage for current plan participants remains in effect and claims for dates of service through 12/31/19 will be covered by LDAHPT, subject to the normal conditions, limitations and exclusions of the plan. This includes claims for covered services rendered prior to 12/31/19 but submitted after 1/1/20.
Should you have any questions, please feel free to contact Brown & Brown Association Services Professionals or the LDA. Bear in mind that Brown & Brown can assist LDA members in finding great options for a wide variety of insurances lines, including health benefit plans. And, Stormy Blair, Vice President at Brown & Brown Association Services Professionals, would be more than happy to visit your district meeting to talk with members about options.
It felt as though we’d come oh so close to achieving our goal of a valued member benefit with LDAHPT, and to fall just short after so much work is indeed a bitter pill. But ultimately, there simply was no other option. Many thanks to all who had a part in trying to make LDAHPT a valued LDA member benefit.Sincerely,
Lane Eddleman, D.D.S., Chairman
LDA Council on Insurance
Stormy Blair, Vice President, Brown & Brown Association Services ProfessionalsPhone: 1-888-503-5547