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Continued cost challenges in the individual market lead to further changes
As you know, Wellmark’s mission is to create affordable health insurance for people to access quality health care. For the majority of the past 75 years, we’ve been able to achieve that. Unfortunately, for the past two years, our members with individual health plans in Iowa under the Affordable Care Act (ACA) have had to endure double-digit increases. In addition, Wellmark has lost approximately $67 million over the last two years in this market in Iowa. We’ve discovered as this year goes on, that we expect these trends to continue unless changes are made at the Federal level. It’s apparent that continuing to offer plans with broad networks, combined with the rich benefits of the ACA, are not consistent with managing continually rising costs.

While we could seek additional premium increases to mitigate rising costs, this is not sustainable for our members’ pocketbook. Therefore, in Iowa, Wellmark will be narrowing product choices to offer plans that are lower priced and encourage health care delivery by Iowa providers. Specifically, this means:
1. We will no longer be offering gold tier plans in Iowa. This affects approximately 7,000 (0.5%) of our 1.66 million Iowa members.
2. We will no longer actively market individual under 65 plans using the Preferred Provider Organization (PPO) network in Iowa. Our individual ACA members with a silver or bronze tier PPO plan today may continue on that plan for 2017.
Both of these changes go into effect for policies with a Jan. 1, 2017, effective date. The above changes do not affect people with grandfathered or grandmothered plans (those that generally purchased their individual health plan prior to Jan. 1, 2014). It also does not affect our members with plans through their employer or those with Medicare supplement plans.
We will continue to:
1. Introduce our new, simplified HMO plan called Blue SimplicitySM. This plan is like no other on the market today and is designed to help consumers understand the true value of care through simple copay plans – providing members with transparency and predictability of cost as they seek and use medical services.
2. Debut our two new health insurance companies – Wellmark Value Health Plan (with Mercy Health Network) and Wellmark Synergy Health (with University of Iowa Health System). These new plans are a result of relationships with trusted provider partners who are committed to managing the care of our members.
3. Participate on the public exchange. Wellmark Value Health Plan and Wellmark Synergy Health will offer individual ACA plans both on and off the public exchange in a total of 40 Iowa counties, providing access to subsidies and cost share reductions to many Iowans when they purchase a plan on the exchange.
Although the ACA has done many positive things, it has also had its challenges. Those challenges vary by state. Fortunately, in 2017, the ACA gives states the ability to begin addressing those challenges with the goal of stabilizing the individual under 65 health insurance market. We look forward to working with Iowa policymakers on those solutions in the near future.
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Jesse Patton and John Dougan holding down the booth at the 2016 IAR convention! ... See MoreSee Less

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Mission Statement

Providing solutions and expertise in healthcare coverage and employee benefits for our clients. To provide these services and products to meet the individual needs of our clients and their best interests, not ours. With this attitude AMGI hopes to achieve a partnership philosophy with our clients and partners.




AMGI is an independent benefits consulting group that uses a variety of carriers to assure our clients get the appropriate program to meet their needs.

AMGI provides expertise in both state and federal laws ensuring that your plan remains in compliance with local and federal issues.

AMGI uses advanced computer automation which aids our ability to serve our clients in a fast, cost effective manner.

AMGI provides expertise in the Medicare Market, providing assistance with Medicare, Medicare Advantage Plans, Supplement Programs and the various options under the New Medicare Prescription Drug benefit, Part D. Whether your needs are for your employees, yourself or protection of your family, AMGI can help!

AMGI specializes in helping association members fulfill their benefit needs. We work closely with the business, it's employees and the association in benefit placement, tracking, and claims assistance when needed. 


Jesse Patton (2nd from left) discusses healthcare with President Bush.
This was at the National Institute of Health in Bethesda, MD on January 26, 2005.




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