Brandon Fincher

My digital parchment talking about the government. Send inquiries to fincher.freelance@gmail.com.

Alfa, BCBS in battle of insurance titans

“Now the highway’s back open, and we’re leavin’ at the same time. So stay in your lane, boy, and I’ll stay in mine.” – Bronson Diamond and Greta Stanley

My wife’s teaching job requires her to be in her classroom and ready to start receiving her students by 7 a.m. every morning.

No one in our little family has been known to jump out of bed ready to seize the day, so she resorts to setting a thousand alarms every morning on her cell phone. On each alarm she hits the snooze button every five minutes to stay on schedule.

I have been hitting my mental snooze button on this column since February because it deals with insurance. When I am forced to think about insurance, my brain usually hangs a “Back in Five Minutes” sign on the door and slips around back to smoke a cigarette.

Despite my mental hangup, one bill passed by the Alabama Legislature in May is interesting enough to receive an overdue column because it pitted two insurance giants in our state – Alfa and Blue Cross and Blue Shield of Alabama – against each other.

Up until House Bill 477’s introduction, Alfa and BCBS generally stayed in their own insurance lanes. Alfa handled property insurance, and BCBS dealt with healthcare insurance.

Now that the bill has passed, Alfa has maneuvered itself directly over the dividing line with two wheels in the property insurance lane and two wheels in the healthcare insurance lane.

Just be sure not call what Alfa offers health insurance. The legislation itself only refers to the plans Alfa is allowed to sell to consumers as providing “health benefits.” Why? Because these health plans are exempt from many of the regulations that traditional health insurance companies in Alabama, like a BCBS, have to follow.

Calling the plans health insurance might open up Alfa to a raft of regulations with which traditional health insurers have to comply.

The main exemptions provided to Alfa include no requirement to offer a benefits plan to people with pre-existing health conditions and little consumer protection oversight or regulation from Alabama’s Department of Insurance.

However, the health benefits Alfa can offer include coverage for ambulatory patient services, hospitalization, emergency services, laboratory services, prescription drugs and mental health and substance abuse treatment.

So while these plans might look like a health insurance duck and quack like a health insurance duck, take it from Alfa that these plans are definitely not a health insurance duck – any puns involving the Aflac duck not intended.

The law’s requirements for offering a health benefits plan are even written in a manner in which only the Alabama Farmers Federation, which operates Alfa Insurance, can offer it.

Frankly, it sounds a lot like a monopoly on the entire concept of a “health benefits” plan. When asked about these unique requirements, State Sen. Arthur Orr, R-Decatur, seemingly shrugged his shoulders and said monopoly, schmonopoly.

“If there are other organizations that wanted to travel down this road, perhaps they could as well if they brought legislation,” Orr said, as reported by Mary Sell of the Alabama Daily News.

The Farmers Federation says this plan is needed due to the high costs new farmers and entrepreneurs face in providing health coverage for their own families and employees. There is likely some truth to this.

Additionally, there are some limitations that are built into the law. An individual can only be eligible for Alfa’s health benefits if that person does not have the option to participate in an employer-sponsored health plan or if an available employer-sponsored health plan would cost more than 9 percent of that person’s household income.

However, it is still odd for a government to meet a need by empowering one, and only one, nongovernment business to fill the gap.

Without much oversight from the Alabama Department of Insurance, it also is unclear how closely those eligibility requirements will be followed in the future.

While I have a difficult time feeling sorry for BCBS of Alabama, which maintained a stranglehold on health insurance provision in the state for a long time, it is difficult to support special rules that advantage only one company in the health insurance marketplace.

It is like laws being in place requiring Alfa to offer automotive insurance plans to everyone – even people who total one or two vehicles a year – while then making an exception to allow BCBS to offer automotive insurance to only the safest drivers.

We can only hope the Legislature was not asleep at the wheel when this law passed.

Leave a comment