Universal Health Care's woes raise question for policyholders

By JOSH BOATWRIGHT | Tribune staff Published: March 24, 2013
Updated: March 24, 2013 - 2:42 PM

ST. PETERSBURG --

Now that the state is moving to shut down Universal Health Care, what happens to the coverage of those 100,000 people who had Medicare Advantage plans?

Health experts don't exactly know, because it's rare for the state to shut down a company this rapidly.

A Leon County judge last week appointed the state Department of Financial Services as the receiver for the financially troubled St. Petersburg insurer and set an April 1 date for liquidating its assets.

What remains of those assets will be used to pay existing claims first, but that doesn't help the patient with the costly prescription drugs or the advanced surgery scheduled for next month.

After Universal shuts down, members can default to regular Medicare plans while searching for another insurer, but that may mean much higher premiums and out-of-pocket costs, said Jay Wolfson, a public health professor at the University of South Florida and associate vice president of health law, policy and safety at USF Health.

"It's like any other tragedy: The people at the bottom of the pyramid are going to get the worst deal, and it's very difficult for anybody — even with good intentions — to help them," he said.

Wolfson can remember only one or two other cases where the government has rapidly shut down an insurer, leaving members scrambling for find comparable coverage.

A similar dilemma happened several years ago when Humana abruptly pulled out of a section of South Florida, increasing costs for many people on fixed incomes with vision, dental and special prescription drug plans.

The state argued that Universal had misled creditors, was deeply in debt and represented a danger to policyholders because it could no longer support them financially.

Several buyers stepped forward with plans to rehabilitate the company with capital investments, but Universal missed court deadlines to make its case, and a judge ruled it financially insolvent after numerous employees quit and health providers cancelled contracts after complaining they hadn't been paid.

Pinellas County-based independent insurance agent Joseph Tedesco said he's fielded numerous calls from Universal members seeking advice about what to do.

Since the state hasn't announced any options, Tedesco suggests policyholders begin weighing other insurance options. But finding comparable care with a new advantage plan could prove challenging.

"If you've got three, four, five different doctors, it may be difficult finding a company that has contracts with all these providers," he said.

Neither the federal government, the state nor other insurers has an affirmative legal obligation to offer policyholders the same coverage they had or help them defray the cost differences, Wolfson said.

But he thinks the state should offer to help.

"The state has a moral obligation, I would say, if they're putting them into receivership and closing them down," he said.

State Department of Financial Services officials have not said what help they will offer to Universal policyholders or what options people have for seeking alternative coverage.

http://www2.tbo.com/news/breaking-news/2013/mar/24/1/universal-health-cares-woes-raise-question-for-pol-ar-667938/