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Posted by on Aug 9, 2013 in Washington | 0 comments

Washington Health Benefit Exchange

Washington Healthplanfinder

washington-county-map

Source: Washington State Office of the Insurance Commissioner

The Washington Health Benefit Exchange is an independent organization responsible for implementing the online health insurance marketplace; in Washington, this is the Washington Healthplanfinder.

Will there be many options for health insurance on the exchange?

While nine carriers initially filed individual plans with the Office of the Insurance Commissioner, on August 1, it was announced that only four carriers offering a total 31 plans were approved by the state. The plans will now be reviewed by the board of the Washington Health Benefit Exchange to determine if they meet the standards for Qualified Health Plans. A final announcement is expected August 21. The current individual offerings include Gold, Silver, and Bronze metal level plans, with one carrier offering a Catastrophic plan. No Platinum level plans were filed.

Participation in the Small Business Health Options Program (SHOP) Exchange is limited. Currently, Kaiser has applied to offer plans in Clark and Cowlitz counties.

Which companies will be offering plans on the exchange?

There are four health plans approved by the Office of the Insurance Commissioner (shown below), as well as Dental plans from LifeWise of Washington, Premera BlueCross, Dental Health Services, Delta Dental of Washington, and Williamette Dental.

BridgeSpan is an affiliate of Cambia Health Solutions. The company will be offering plans on the exchange at the gold, silver, and bronze metal levels in 7 counties: King, Kitsap, Pierce, Skagit, Snohomish, Thurston, and Spokane. BridgeSpan will use the Regence RealValue Network and in Spokane County, the company will rent the Asuris Northwest Health SimpleConnect network.

Group Health Cooperative is NOT one of the CO-OPs that received a loan from CMS (Centers for Medicare & Medicaid Services). While many states are seeing new CO-OPs spring up as a result of low-interest loans made possible by the PPACA, this cooperative has a long history dating back to 1947. This CO-OP will be offering plans on the exchange, as well as outside the exchange. On the exchange, Group Health will be offering the only catastrophic plan as well as plans at the gold, silver, and bronze metal levels. The organization will be offering plans in 19 counties: Benton, Columbia, Franklin, Island, King, Kitsap, Kittitas, Lewis, Mason, Pierce, San Juan, Skagit, Snohomish, Spokane, Thurston, Walla Walla, Whatcom, Whitman, and Yakima.

Premera Blue Cross will be offering plans in 38 out of 39 counties; Clark County is the outsider. Premera Blue Cross Preferred plans will be offered at the gold, silver, and bronze metal levels. Premera will be using a network designed to controls costs.

LifeWise is the only carrier offering plans statewide; all 39 counties, at the gold, silver, and bronze metal levels. LifeWise Essential plans will also utilize a provider network that was developed in order to help reduce costs.

Five carriers were not approved by the state to sell plans on the exchange. Several were not able to guarantee access to certain providers and hospitals. The five companies are:

  • Community Health Plan of Washington
  • Coordinated Care
  • Kaiser Permanente NW
  • Molina Healthcare
  • Moda Health (formerly ODS Health)

Will coverage and premiums be the same statewide?

The state of Washington is broken up into five geographic areas; rates can differ in each area. Insurance carriers do not have to offer plans in all the counties in a geographic area.

Area

Counties

1 King
2 Clallam, Cowlitz, Grays Harbor, Island, Jefferson, Mason, Lewis, Kitsap, Pacific, Pierce, San Juan,
Skagit, Snohomish, Thurston, Wahkiakum, and Whatcom
3 Clark, Klickitat, and Skamania
4 Ferry, Lincoln, Pend Oreille, Spokane, and Stevens
5 Adams, Asotin, Benton, Chelan, Columbia, Douglas, Franklin, Garfield, Grant, Kittitas, Okanogan,
Walla Walla, Whitman, and Yakima

Here is a nice summary of carrier offerings provided by the Office of the Insurance Commissioner:

Washington_OIC_Exchange_Approved_Plans

New information is being released every day. Follow this blog to receive updates as new information is released in Washington.

Jillian Carlile
Research Analyst & Health Exchange know-it-all
Strenuus
jcarlile@strenuus.com

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