California Health Benefit Exchange Votes to Not Allow Stand-Alone Vision Plans to Directly Participate


RANCHO CORDOVA, Calif.—The California Health Benefit Exchange voted on Aug. 23 to not allow stand-alone vision plans to directly participate in its insurance program for individuals when it launches in 2014. However, while stand-alone vision plans have been barred from the exchange through which individuals in California will be able to purchase health insurance, stand-alone vision plans will be permitted to participate in a separate exchange being established for small businesses, which will also make its debut in 2014.

In an Op-Ed piece for the Sacramento Business Journal last week, Rob Lynch, president and CEO of VSP Global took exception to this decision. In it, he made the case for why VSP in particular should have been allowed to participate in the California exchange, citing a number of statistics, including the fact that since the company started 57 years ago it has grown into the largest health insurer as ranked by the more than 58 million members covered. He also stated, “What’s even more inconceivable is that in California, VSP is also the largest insurer by membership—larger than Anthem Blue Cross, Kaiser and Blue Shield combined with 14.3 million Californians covered by our company. Department of Managed Health Care data confirms that 93 percent of vision care coverage is provided through stand-alone plans like VSP. As a not-for-profit health plan we provide coverage to Medi-Cal, Medicare, CHIP and Healthy Families participants on a cost-effective and non-discriminatory basis.”

In his editorial, Lynch even hinted that the company would consider moving out of California: “Like other successful California companies, we have been heavily solicited to relocate out of state with incentives and subsidies. Choice is important in the marketplace. California has chosen not to support one of its own home-grown successful businesses, with 2,000 employees in California. Maybe it’s time for us to choose to go where we are wanted.”

A VSP spokesperson told VMail, “While we are disappointed with the California Health Benefits Exchange Board’s vote, we are committed to our doctors and will continue to fight for their access to patients through the state exchanges. Both Maryland and Massachusetts have voted to include stand-alone vision plans directly, recognizing both the value and cost benefits these types of plans provide.” (See “Maryland Approves Stand-Alone Vision Plans in State Health Exchange.”)

Julian Roberts, executive director of the National Association of Vision Care Plans, told VMail, “Essential Health Benefits covering so many more pediatrics is a win for vision care as a whole, but we are disappointed now that in some situations in California that there might not be as much choice or access as if they had opened the exchange to both comprehensive and stand-alone vision care. As we continue down this road, we’re hoping that we can expand coverage and choice to Americans regardless of the structure of these exchanges.”