A federal judge denied Oscar Health’s request for a preliminary injunction to stop Florida Blue from enforcing a policy that prevented its insurance agents from selling competing insurers’ coverage.
“The court is unpersuaded by Oscar’s argument that Florida Blue’s exclusivity policy is responsible for the market share obtained in Orlando in the first year of competition,” U.S. District Judge Paul Byron wrote in an order filed Tuesday.
Oscar General Counsel Bruce Gottlieb said in a statement that Oscar will continue to pursue its claims based on the merits. Florida Blue filed a motion this month to dismiss the case.
Oscar argued in a lawsuit filed in November in U.S. District Court in Orlando that Florida Blue’s “exclusivity policy” was anticompetitive because it prevented Oscar from accessing brokers that would enroll people in its Orlando-area insurance plans during the open-enrollment period for 2019 coverage, which ended Dec. 15.
Oscar ended up enrolling 33,251 individuals in individual ACA plans in Orlando—many fewer than the 63,000 it had projected.
But Byron wrote that not only did Oscar not prove that it would suffer irreparable harm without the preliminary injunction, it also didn’t prove that its lower-than-projected enrollment stemmed from Florida Blue’s exclusivity policy, according to the order.
“Oscar’s lower-than-expected performance in Orlando may be due to the differences in available products as opposed to Florida Blue’s exclusivity policy,” the judge wrote.
For instance, Florida Blue offered 77 on-exchange individual plans, while Oscar sold eight; Florida Blue offered plans with no deductible, while Oscar did not; and Florida Blue’s provider networks were bigger than Oscar’s, according to the order.
Byron went on to say that “Florida Blue’s exclusivity agreements occupy a tiny fraction of the available pool of brokers,” in the state, and that nothing prevents Oscar from recruiting more brokers than Florida Blue.
Of the 19,275 licensed brokers in Orlando, Florida Blue has exclusive relationships with 1,724 of them, according to the order. Oscar was able to appoint 1,887 brokers in the area, but less than 40% of them sold Oscar plans during the open-enrollment period.
Source: ModernHealthCare.com
