ACA fees result in Q1 loss for HMSA

HMSA recorded a $30.4 million loss in the first three months of 2016, caused by $59.1 million in Affordable Care Act (ACA) fees. The National Association of Insurance Commissioners requires every health insurer to record a year’s worth of ACA insurer fees in the first quarter of each year. HMSA finished the first quarter of 2016 with a loss of 3.9 percent compared to its revenues.

“ACA fees aside, our first quarter financial results show the financial stability that Hawaii residents and businesses have depended on for 78 years,” said Michael A. Gold, HMSA president and chief executive officer. “As one of Hawaii’s largest health plans, we’re responsible for the health care needs of more than half the people in our state. We carefully manage every dollar from members so they can see doctors and go to hospitals when they need to.”

The health insurer collected $782.6 million in premium revenue for the first quarter. Of that amount, $680.5 million paid for members’ medical and hospital benefits and $73.6 million paid for operating expenses. HMSA reported a small investment gain of $3.2 million.

An increase in HMSA’s operating expenses over the same period last year comes primarily from the transfer of more than 200 health coaches, clinicians, and management personnel from the national well-being company, Healthways, to HMSA. The new HMSA employees work closely with doctors and hospitals to care for the thousands of HMSA members with serious illnesses.

“The work we’ve done with Healthways over the past year has helped improve the health of many HMSA members and we’ll keep collaborating with the company on well-being programs,” said Gold.

HMSA also said that improved management of prescription drugs and a mild flu season over the winter had a positive impact on benefit expenses for the quarter.

About HMSA

Caring for the people of Hawaii is our promise and our privilege. Working together with employers, partners, and physicians and other health care providers, we promote wellness; develop reliable, affordable health plans; and support members with clear, thoughtful guidance.

HMSA is the most experienced health plan in the state, covering more than half of Hawaii’s population. As a recognized leader, we embrace our responsibility to strengthen the health and well-being of our community.

Headquartered on Oahu with centers and offices statewide to serve our members, HMSA is an independent licensee of the Blue Cross and Blue Shield Association.