Washington health insurance exchange
WA exchange rates up less than 2%; More carriers, more plans for 2015
- By Louise Norris
- healthinsurance.org contributor
- October 15, 2014
2015 rate hike less than 2 percent
Washington Insurance Commissioner Mike Kreidler announced in September that for plans sold through the state-run exchange – Washington Healthplanfinder – average premiums would only be increasing by 1.9 percent for 2015. This represents a significant improvement over the past several years, when premiums in the individual market in Washington increased an average of 8 to 18 percent each year. The state is still finalizing premiums for off-exchange products for 2015, and for two new carriers that applied to join the exchange.
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 they are all 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).
New carriers, more plans
In 2014, eight insurers offered 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
For 2015, they will be joined by Columbia United Providers.
In addition, three new carriers’ plans and rates are still under review by the Insurance Commissioner: Moda Health Plan, Inc., United Healthcare of Washington, Inc. and Health Alliance Northwest Health Plan Inc.
For the carriers that have already been certified to sell 2015 policies, 90 plans have been approved for sale (plan availability varies from one region to another). That’s nearly double the 46 individual policy options that were available in 2014, and it doesn’t yet include plans from United Healthcare and Health Alliance.
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.
Renewing coverage for 2015
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. About 80 percent of the exchange’s 2014 plans will be available again in 2015, and the exchange has reported that roughly 100,000 of their 147,000 private plan enrollees will be eligible for automatic renewal.
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. In Washington, the deadline to enroll or switch plans is December 23 if you want to have a January 1 effective date (this is later than the deadline in most other states).
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.
Washington Healthplanfinder 2014 enrollment
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, and remains one of the country’s most successful exchanges. A quarter of the people who enrolled were in the 25 – 34 “young invincible” age group.
By the end of July, the exchange had disenrolled 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.
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).
Improvements for 2015
Open enrollment for 2015 is just around the corner; it starts on November 15. It runs for just three months this time, ending on February 15, and Washington Healthplanfinder CEO Richard Onizuka is reminding Washington residents to enroll early rather than waiting until the last minute. Applicants who wish to have a January 1 effective date must complete their enrollments by December 23.
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.
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.
Consumers will also have the option to pay premiums to the exchange using paper checks in 2015, as opposed to 2014 when all payments had to be electronic. Although electronic payments are widely considered to be a convenient method, they can be difficult for low-income residents.
Billing and invoices
In Washington, enrollees pay their premiums directly to Washington Healthplanfinder and the exchange then sends the premiums out to each insurer (although the exchange notes that customers do also have the option of paying premiums directly to insurers). 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.
By early October, nearly all of the billing problems had been resolved, but there were still approximately 1,300 customer accounts that continued to have technical issues. Those remaining problems are expected to be fixed by mid-October.
Special off-exchange enrollment period
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.
Washington Heatlthplanfinder history
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 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 could potentially use the new marketplace to purchase private plans (nearly 148.000 had done so by the end of July). The Washington insurance commissioner’s office estimates that 477,400 residents will qualify for subsidies, and state set a target of enrolling 280,000 people in 2014. Obviously it fell short of that amount, but enrollment continues throughout 2014 as a result of qualifying events.
Healthplanfinder Business (SHOP)
The Washington exchange for small businesses will offer 23 plans from two carriers in 2015:
- Moda Health Plan will be available state-wide, and is new to the small business exchange.
- Kaiser Permanent will be available in Clark and Cowlitz counties, where it also offered small group plans in 2014.
No grandmothered plans
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.
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.