Delaware experienced a 7.2 point drop in its uninsured rate following the first open enrollment period, which was the third largest decrease recorded in a Gallup survey published in August. The Gallup survey showed Delaware with an uninsured rate of 3.3 percent — the lowest in the nation. While state officials agree Delaware’s uninsured is moving in the right direction, they cautioned that the Gallup survey has a 5.5 point margin of error for state’s with small populations.
Choose Health Delaware strategies
To continuing building on its first-year successes, Choose Health Delaware is planning its marketing and outreach strategies for the second open enrollment period. Key messages on which officials plan to focus include enrollment dates and deadlines, higher penalties for not being insured, the availability of financial assistance, and marketplace guide locations. Choose Health Delaware is also working with the Delaware Hispanic Commission to enhance its Spanish-language marketing and outreach.
The upcoming enrollment period is three months shorter than last year’s session. This year, open enrollment runs Nov. 15, 2014, through Feb. 15, 2015. Consumers must sign up by Dec. 15 to have coverage starting Jan. 1.
Penalties for being uninsured increase for 2015: the greater of $325 per adult and $162.50 per child, or 2 percent of the household income.
Delaware received a $600,000 federal grant to fund in-person assistance with enrollment. Choose Health Delaware plans to make marketplace guides available at more than 70 locations throughout the state, including hospitals and other healthcare facilities, libraries, state service centers, schools and college campuses, community agencies and churches. The exchange website includes a list of organizations that can help consumers schedule an appointment with a marketplace guide.
What to expect: 2015 insurers and rates
Two divisions of Aetna and Highmark Blue Cross Blue Shield will sell individual policies through the exchange for 2015. Plans being sold by Aetna were marketed as Coventry plans in 2014; Coventry was acquired by Aetna in 2013.
Information gathered by PricewaterhouseCoopers puts the average premium increase, covering plans sold both on and off the exchange, at 1.3 percent. October brought news that Delaware’s insurance commissioner blocked requested rate hikes by Highmark Blue Cross Blue Shield. However, the requests applied to grandfathered plans that don’t comply with the ACA and aren’t sold on the marketplace.
Final 2015 rates for policies sold on the exchange will be announced publicly in late October or early November.
How many people signed up in 2014?
According to Choose Health Delaware, 22,787 state residents have enrolled in private insurance or Medicaid between October 2013 and September 2014.
During 2014 open enrollment, 81 percent of those enrolling in QHPs were eligible for premium subsidies. Among those who qualified for subsidies the average post-subsidy monthly premium was $130. That’s the third-highest average among states using the federal marketplace.
Delaware’s SHOP exchange
Delaware is one of five states gaining early access — in late October — to HealthCare.gov’s online SHOP portal. While small businesses have been able to submit paper applications or work through a broker, online SHOP enrollment has not been available in states that use the federal marketplace.
The online portal will go live nationally on Nov. 15
Delaware is delaying the launch of “employee choice” on the SHOP exchange. Employee choice allows employees of small businesses that use the SHOP to select from a range of plans rather than being limited to a single plan selected by their employer. The federal government let states that use the federal marketplace choose if they want to implement employee choice for 2015. Delaware is one of 18 states that is delaying implementation of employee choice.
How Delaware approached launching an exchange
The state’s health insurance marketplace is branded as Choose Health Delaware, and it is operated in partnership with the federal government. Delaware is responsible for plan management and consumer assistance while the federal government handles all other functions.
Several states adopted a partnership exchange as an incremental step toward an eventual state-run exchange. However, Delaware is unlikely to go that route given its small population.
One alternative that may work for Delaware in the future is a regional exchange, whereby the state would partner with one or more other states. A regional partnership would spread administrative cost over a wider population and increase the size of the risk pool.
Delaware health insurance exchange links
Choose Health Delaware
Health Benefit Exchange information
Exchange information from the Delaware Health Care Commission
State Exchange Profile: Delaware
The Henry J. Kaiser Family Foundation overview of Delaware’s progress toward creating a state health insurance exchange.