Washington health insurance exchange
32% of Washington's eligible enroll in private plans through exchange
- By Louise Norris
- healthinsurance.org contributor
- September 15, 2014
Washington Healthplanfinder announced on September 5 that 147,888 people were enrolled in private plans through the exchange as of the end of July. The exchange had enrolled 11,497 people with special enrollment periods triggered by qualifying events since between March 31 and July 31. They had unenrolled a total of 24,072 people because of non-payment, loss of eligibility, or voluntary plan terminations, but that’s an attrition rate of just 6.4 percent. Including Medicaid and private plans, 1,283,670 people were enrolled in plans through Washington Healthplanfinder at the end of July.
Open enrollment for 2015 is just around the corner; it starts on November 15. And it runs for just three months this time, ending on February 15. Washington Healthplanfinder has been hard at work to ensure that their second open enrollment period is even more smooth and successful than their first. The exchange has made significant progress on the back-end functionality of the website, improving the transmittal of enrollment and payment data to insurance carriers, and implementing critical code and data fixes to avoid repeats of the isolated – but very frustrating – billing and invoice issues that arose in 2014. As a result of all the fixes, there will be far fewer billing, enrollment, and submission errors during the 2015 open enrollment.
With all of the improvements, the state Insurance Commissioner Mike Kreidler has said he is “cautiously optimistic” that the technological problems people have faced with enrollment this year will be fully resolved by November 15, but notes that there is “no guarantee.” Because of the glitches that have hampered enrollment for some people, Kreidler’s office has implemented a special open enrollment period running from August 27 to November 14, for people who wish to enroll in a plan outside the exchange because of problems with their exchange enrollment. In order to utilize the special enrollment period, consumers must first contact the Washington Healthplanfinder suppport center at 588-923-4633. Subsidies are not available outside the exchange, and Washington Healthplanfinder notes that they have resolved nearly all of the problems that occurred during the first open enrollment. So it’s unlikely that a large number of people will take advantage of the special enrollment period.
From a consumer interface perspective, Washington Healthplanfinder will be more user friendly this year too. They’ve added screen-sharing functionality with customer support, and additional on-screen definitions to help consumers – especially those who are not familiar with how health insurance works – better understand the enrollment process. They’ve also added new information on the eligibility screen to make it easier to understand eligibility for each member of a household. This page summarizes the improvements Washington Healthplanfinder has made over the last year.
For people who already have a plan through Washington Healthplanfinder, automatic renewal will be possible – assuming their plan will still be available in 2015 – if they checked a box on their initial 2014 application allowing the exchange to verify their subsidy eligibility by checking federal tax data for up to five years. These consumers will receive a letter from the exchange letting them know that their plan is being renewed with the applicable subsidy, but they will also have the option to switch to a new plan during open enrollment.
2015 rates will not be available on Washington Healthplanfinder’s quote system until November 15, but the state Insurance Commissioner has already published rates that have been approved thus far, with a notice that more will be added as they are approved. Their website allows consumers to see rates in PDF format for each region of the state.
By June 1, enrollment in private plans through Washington Healthplanfinder had grown to 156,155, or about 32 percent of the state’s eligible population, making Washington’s exchange one of the most successful in the country. In addition to the private plan enrollments, 909,752 people had enrolled in Medicaid through the Washington exchange by mid-April (nearly half of those people were already enrolled previously, but renewed their Medicaid coverage through the exchange). Also by June 1, another 171,286 people had enrolled in private individual plans outside of the exchange in Washington, making the off-exchange market in Washington even more robust than the exchange market (off-exchange plans are all ACA-compliant, but there are no subsidies available to offset the premiums and cost-sharing for off-exchange plans).
In May, insurance carriers filed rates for 2015 plans in the individual market in Washington, including plans that will be sold in the exchange as well as off-exchange. For carriers that are selling plans in 2014, the average rate increase for 2015 was 8.25 percent, which is the lowest in seven years. But the two highest rate increases (Group Health Options, at 14.2 percent, and Time Insurance – which has few policies in Washington – at 26 percent) are for plans that are only sold off-exchange. If we look at just the plans that are sold in the exchange, the average rate increase is only 5.4 percent, and includes a rate decrease for Molina Healthcare of Washington.
In addition to lower-than-normal rate increases, the filed rates represent a large increase in the number of plans that will be available next year, both on and off-exchange. If approved by the state, there will be 114 plans in the exchange next year (up from 46 this year) and 119 plans outside the exchange (up from 51 this year).
In Washington, enrollees pay their premiums directly to Washington Healthplanfinder and the exchange then sends the premiums out to each insurer. This is different from the standard billing method used in most other states, where insureds pay their premiums to the carriers after enrolling through the exchange. For the most part, this has worked smoothly in Washington, but a technological invoice problem has impacted roughly 25,000 enrollments (about 15 percent of the total) and has resulted in premiums being paid even though the carrier has no record of the enrollee. As of early June, the exchange was working to fix the problem.
Washington Insurance Commissioner Mike Kreidler and Governor Jay Inslee took a strong progressive stance with regards to consumer protections: existing plans that did not meet ACA standards were cancelled at the end of 2013 and needed to be replaced on January 1 with new, ACA-compliant policies. Following President Obama’s announcement that carriers could extend existing plans into 2014 if states allowed it, Kreidler and Inslee were quick to declare that Washington would not allow non-compliant plans to continue into 2014.
Washington was one of the first states to move ahead with a state-run health insurance marketplace as envisioned by the Affordable Care Act. Former Gov. Chris Gregoire signed legislation creating the state exchange in May 2011. In March 2012 Gregoire signed additional legislation, which further defined how the exchange will be governed and operated.
The Washington Health Care Authority (HCA) helped establish the Washington marketplace. HCA transitioned governing authority to an 11-member board of directors in March 2012. The governor appointed eight voting members and a board chairperson who votes only in if needed to break a tie. In addition, the insurance commissioner and the administrator of the Health Care Authority are non-voting members.
In 2014, eight insurers are selling individual policies through the Washington Healthplanfinder:
- Community Health Plan of Washington
- Group Health Cooperative
- Coordinated Care
- Kaiser Foundation Health Plan of the Northwest
- Molina Healthcare of Washington
- Premera Blue Cross
The carriers are offering a total of 46 individual policy options in 2014, but not all options are available in all counties. Pediatric dental-only coverage is being offered by Delta Dental of Washington, Kaiser Foundation Health Plan of the Northwest, LifeWise, and Premera Blue Cross in all 39 counties.
Four more carriers have submitted plans to join Washington Healthplanfinder for 2015: Moda, Columbia United Providers, Health Alliance Northwest Health Plan, and United Healthcare of Washington. The addition of more carriers and plans demonstrates how successful Washington’s exchange has been in its first year, and the new plans should be beneficial in terms of competition, consumer choice, and rate stabilization.
In March, 2014, Washington legislators tried to pass a bill that would have created much more transparency in the state’s health insurance industry, providing consumers with data on how much insurers are paying for services in each region of the state. It had widespread support, but opposition from Premera Blue Cross – the state’s largest insurer – sank the bill and Washington did not join the 11 other states that have all-payer claims databases.
The federal government is funding the Washington Healthplanfinder in 2014. In 2015, marketplace operations will be funded by the state with $21 million that was previously earmarked for the state’s high-risk insurance pool, which will be operated through the exchange, and with a 2 percent tax on premiums on plans sold through the exchange.
According to the U.S. Department of Health and Human Services (HHS), about 835,000 Washington residents are eligible to use the new marketplace. The Washington insurance commissioner’s office estimates that 477,400 residents will qualify for subsidies, and state set a target of enrolling 130,000 people through the marketplace by Jan. 1 and 280,000 people in 2014. Obviously it fell short of that amount, but enrollment will continue throughout 2014 as a result of qualifying events, and the 2015 open enrollment period begins on November 15, 2014.
Contact the Washington exchange
More Washington State health insurance exchange links
Washington Health Benefit Exchange
Information about marketplace planning and development
State Exchange Profile: Washington
The Henry J. Kaiser Family Foundation overview of Washington’s progress toward creating a state health insurance exchange.