A Florida-based health insurer has agreed to halt the sale of new Medicare Advantage plans in Georgia amid state regulators’ concerns over the company’s...

A Florida-based health insurer has agreed to halt the sale of new Medicare Advantage plans in Georgia amid state regulators’ concerns over the company’s finances.

Universal Health Care currently has about 25,000 Georgians in its Advantage plans, which are an alternative to traditional Medicare.

State Insurance Commissioner Ralph Hudgens, who signed a consent order with the company Nov. 15, cited Universal’s net loss of $27 million in 2011 and its loss of $22.1 million in the first six months of this year as triggering his move to halt sales.

“If you extrapolate the first six months, you’re looking at $45 million in losses,’’ Hudgens told GHN on Tuesday.

The St. Petersburg-based insurer could not be reached for comment Tuesday.

According to the company website, Universal offers Medicare Advantage plans in 19 states, as well as a Medicaid plan in Florida.

Universal Health Care’s customers in Georgia do not have to switch to other insurers as a result of the consent order. That customer base represents roughly 40 percent of Universal’s business nationally, Hudgens said.

“The policyholders are receiving the benefits,’’ Hudgens said. But he added that the state is concerned about the company’s financial viability.

Medicare is currently in its annual open enrollment period.

The U.S. Centers for Medicare and Medicaid Services told GHN on Tuesday that the agency also imposed an immediate suspension of enrollment for Universal in Georgia, in the wake of Hudgens’ order. That suspension remains in effect until Hudgens lifts his order, CMS said.

The company has been at the center of a legal fight in Florida involving its chairman and CEO and another prominent physician, Health News Florida reported in April.

 


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Andy Miller

Andy Miller is editor and CEO of Georgia Health News

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