Insurers who exit a state health insuranceexchange are not necessarily throwing in the towel onall individual policy business in a state.

Kaiser Health News reports that company procedure on sellingindividual policies varies from company to company and state tostate. Consumers who worry they won’t have much choice in statesthe insurers abandon may find the same companies still offer plansoff the exchange, KHN advised.

Aetna, KHN said, no longer sells via the Kansas, Utah, andDistrict of Columbia exchanges. But it continues to offerindividual policies in Kansas and Utah, because neither of thosestates require insurers to sell through an exchange if they want tosell off-exchange.

Washington, D.C. is another matter. Aetna can’t offer individualpolicies off exchange because D.C. has the on-off exchangerequirement.

And Aetna is being selective about which exchanges it isabandoning. It said last week that, despite the challenges oftrying to make (or keep from losing) money through exchange policysales, it will continue to offer health insurance on 15 stateexchanges.

UnitedHealth has said that it is exiting “most” of the 34 stateswhere it sells individual polices. But when is an exit not a fulldeparture?

In Colorado, reports the Denver Post, UnitedHealth said it waspulling out of on and off-exchange plan sales. But subsidiaryGolden Rule Insurance will continue to sell individual plans off ofthe exchange. UnitedHealth still will offer small and large groupbusiness plans.

An earlier Kaiser Family Foundation study said that an exit from all state exchanges byUnitedHealth would leave more than 1.1 millionconsumers with just one individual plan option on the exchange.But, the foundation said, the impact would be felt much more inrural and southern regions. Additionally, Kaiser concluded, theeffect on the cost of a plan would not be significant, given thatUnitedHealth “does not generally offer low premium plans in themarketplaces.”

Longer term, the study concluded, the picture becomes murky.Fewer competitors on the exchanges would likely lead to increasedcost to consumers. But because the exchanges are evolving andinsurers are still learning to manage costs and products on them,it’s too early to accurately forecast exchange salestrends.