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healthy ones, for those added servic- es. Carriers are also removing choice from health care, he says. Dr. Auer referenced a quote from

“Everybody loves the

patient part, but the business side … it’s just so crazy.”

Marcus Merz, the chief executive of Minnesota-based insurer Preferred One, who said, “We have to break peo- ple away from the choice habit that everyone has.” The New York Times published the quote May 12, 2014, in the article, “More Insured, but the Choices Are Narrowing.” “That is a scary statement from a

health insurance executive,” Dr. Auer said. The government is telling carri- ers what to cover, so carriers are go- ing to compensate for more services by raising fees and cutting consumer choice, he added. “That is just sad,” he said. “And this is not the ACA plans pur- chased through the [federal market- place] website,” he added. “The big insurers are offering such poor plans, they’re ruining their brand.” Dr. Auer told Humana he would

“absolutely not” renew the plan. With help from a broker, he purchased in- dividual coverage through Humana in December, which cost more than he was paying last year but less than the grandfathered group plan would have. But then the carrier threw Dr. Auer

another curve ball. Barely a month into the plan, Humana sent him an- other letter notifying him of a 17-per- cent increase in his individual plan. Under ACA, all individual health

plans cover a calendar year, beginning Jan. 1. So although Dr. Auer had his plan for only a month, the plan was up for renewal Jan. 1, and thus a rate increase. “I’m 30 days in, and I’m getting an-

other bump,” he said. “I don’t know what I’m going to do.” To top it off, Dr. Auer says as of

mid-January, Humana had not sent him a bill to show him exactly how

+ 60 TEXAS MEDICINE March 2015

much the carrier would charge him each month in 2015. “It’s just such chaos,” he said. “You

just can’t win.” Dr. Auer says physicians spend

enough time wrestling with patients’ carriers to get paid for services. To struggle with the same companies over your own health insurance exac- erbates physicians’ frustration, he says. “Everybody loves the patient part,

but the business side … it’s just so cra- zy,” he said.

Help without hassle Physician employers can apply for small-group coverage year-round. In- dividuals, however, are largely limited to the federal open enrollment period running from approximately Nov. 15 through Feb. 15 of each year; Dec. 15 is the deadline for coverage starting Jan. 1.

TMAIT takes the reins for mem-

bers by shopping around for small- group insurance, comparing rates, and coming up with quotes for physician employers within two working days. TMAIT small-group sales representa- tive Kerrie Rodriguez says Dr. Auer’s situation is not uncommon, and she is there to help when physician-employ- ers see a drastic rate hike. “I can’t change the rates, but I can

try to find something more affordable,” she said. Ms. Rodriguez says there’s no catch-all plan for everyone, and TMAIT helps physician practice own- ers find a plan based on their needs and priorities. Plus, after members purchase insurance through TMAIT, the trust continues to act as a liaison between the group and the carrier. “We don’t just sell them something;

we work for them after the sale,” Ms. Rodriguez said. “If they have a claim that won’t get paid, they’ll call us, and we’ll investigate the problem.”

Texas Medical Association Insurance Trust:

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