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.
In addition to lower-than-normal rate increases, 90 plans are available in 2015 from the ten carriers in the exchange (plan availability varies from one region to another). That’s nearly double the 46 individual policy options that were available in 2014.
Once open enrollment began on November 15, residents were able to easily compare rates and plans in the site’s plan browsing section. It takes less than a minute on the exchange’s shopping system to see quotes with estimated subsidies included.
An early glitch, quickly resolved
Officials at Washington Healthplanfinder learned in 2014 that enrollment errors are difficult to fix once the enrollment is finalized. So when they discovered that the exchange had a slight error in calculating tax credits in the early hours of 2015 open enrollment, they made the decision to shut down the exchange temporarily while they sorted out the issue, viewing this as preferable to letting people continue to enroll with incorrect premium subsidies.
The error was a result of the system still using data from the first open enrollment, instead of updated numbers. Poverty level tables from 2013 were used for people enrolling in 2014 plans, but now that we’re enrolling for 2015, it’s the 2014 poverty level tables that are being used. And the applicable percentage of income that you have to pay for the second-lowest-cost silver plan has been updated for 2015 as well.
About 150 enrollees had finished their application and scheduled premium payments based on the incorrect subsidy amounts before the glitch was noticed, and Washington Healthplanfinder is reaching out to all of them to fix the problem. The exchange shut down within hours of opening on November 15, but was back up and running by the next morning and has been functional ever since.
Within the first three days of 2015 open enrollment, 10,000 people had completed their applications for private health plans, and 14,000 people had renewed or newly-enrolled in Medicaid coverage through the exchange.
New carriers, more plans
In 2014, eight insurers offered individual policies through the Washington Healthplanfinder. That has grown to ten carriers for 2015 (Columbia United Providers and Moda Health Plan are new to the exchange for 2015):
- Columbia United Providers
- Community Health Plan of Washington
- Coordinated Care
- Group Health Cooperative
- Kaiser Foundation Health Plan of the Northwest
- Moda Health Plan Inc.
- Molina Healthcare of Washington
- Premera Blue Cross
Not all carriers offer plans in all areas of the state. Only Lifewise and Moda offer policies in all 39 counties in Washington, and Premera offers policies in 38 counties (all but Clark). The rest of the carriers offer plans in selected areas ranging from a single county to 19 counties.
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 is possible – assuming their plan is still 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 are available again in 2015, and the exchange has reported that roughly 100,000 of their private plan enrollees are 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).
Even though automatic renewal is possible for most Washington Healthplanfinder enrollees, it’s probably not the best option for most people. The benchmark plan (second-lowest-cost silver plan) has decreased in price in most of Washington state for 2015. Enrollees who keep the benchmark plan from last year will see rate increases that range from an average of 2 percent to nearly 11 percent, depending on where they live. But enrollees who shop around and switch to the new benchmark plan could see significant rate decreases instead.
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.
As of October, 139,700 people were enrolled in private plans through Washington Healthplanfinder, indicating that their rate of enrollment due to qualifying events had continued at roughly the same pace throughout the summer and fall.
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 started 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 is 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 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.
The Washington Healthplanfinder has tripled its call center staffing to 500 people, and there are also 2,500 brokers in Washington who are certified to help customers enroll in a plan through the exchange.
Billing and invoices – ongoing problems
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 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.
By early October, according to the exchange, nearly all of the billing problems had been resolved, but there were still approximately 1,300 customer accounts that continued to have technical issues. By the time the 2015 open enrollment began in mid-November, the exchange reported that lingering billing problems from 2014 were still affecting about a thousand customers.
But health insurance carriers had a different story to tell. As of October 30, Premera Blue Cross Blue Shield had 15,000 members whose coverage was in limbo because of billing problems with Washington Healthplanfinder. And the Association of Washington Healthcare Plans estimated that the problems were still impacting about 25,000 insureds state-wide at the end of October.
Special off-exchange enrollment period
With all of the improvements, the state Insurance Commissioner Mike Kreidler said he was “cautiously optimistic” that the technological problems people have faced with enrollment this year would be fully resolved by November 15 (the problems do appear to be fixed, other than the subsidy calculation error that resulted in one day of downtime for the exchange at the start of open enrollment).
Because of the glitches that hampered enrollment for some people in 2014, Kreidler’s office implemented a special open enrollment period running from August 27 to November 14, for people who wanted to enroll in a plan outside the exchange because of problems with their exchange enrollment. Subsidies are not available outside the exchange though.
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 is offering 23 plans from two carriers in 2015:
- Moda Health Plan is available state-wide, and is new to the small business exchange.
- Kaiser Permanent is 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.