Oscar Asks Court To Immediately Stop Florida Blue’s Exclusivity Policy

Nov 27, 2018
Originally published on November 27, 2018 8:27 am

A new health insurer in Florida filed a motion to immediately block Florida Blue from contracting exclusively with insurance brokers. 

The request for a preliminary injunction comes on the heels of an antitrust lawsuit that Oscar filed last week against Florida's largest health insurer.

The New York-based company’s lawsuit says Florida Blue's policy of restricting health insurance agents from selling competitors' plans is causing a monopoly.

“Florida Blue’s exclusivity policy has substantially foreclosed Oscar from accessing the brokers necessary to compete for a substantial majority of the individual plan business in Orlando,” the preliminary injunction filing states.

When Oscar entered the Affordable Care Act marketplace in the Orlando market this year, it made agreements with brokers to sell its plans, some of which were cheaper than Florida Blue's. But the lawsuit says nearly 200 of the area's most successful brokers backed out after receiving a memo from Florida Blue that they would be terminated for violating an exclusivity agreement.

According to the memo, “any agent or agency that violates the exclusivity arrangement with Florida Blue will be permanently terminated for cause,” the lawsuit states.

With less than a month left in open enrollment, which runs through Dec. 15, Oscar says it is suffering irreparable harm, which is why it’s asking for immediate action.

To support its claim, Oscar received testimonies from two local brokers and an analysis from antitrust economist Mark Israel, of Compass Lexecon.

Florida Blue has a 91 percent share of the Affordable Care Act individual plan market in the Orlando metro area, Israel said in a release.

“Florida Blue has exploited its market power in an anticompetitive fashion, with effects that include excluding Oscar from effectively entering into Orlando and other Florida metropolitan areas, and that such exclusionary conduct is likely to cause irreparable harm to competition, consumers, and Oscar,” Israel said.

Oscar's lawsuit says the policy is preventing consumers from learning about all of their health insurance options and it may prevent Oscar from expanding into other areas, including Jacksonville and Tampa.

Florida Blue responded with a statement that said Oscar has 1,600 agents in the state that can sell its insurance, which should be enough.

But Klein said Florida Blue has restricted the agents with the most clients.

Oscar, which is known as a patent-centered, technology-driven company, provides free telemedicine to all clients 24-hours a day and a personalized concierge team to connect patients with care.

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