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Posted by on Aug 13, 2013 in Maryland | 0 comments

Maryland Health Benefit Exchange

Maryland Health Connection

On April 12, 2011, Governor O’Malley signed the Maryland Health Benefit Exchange Act of 2011, which established the Maryland Health Benefit Exchange (MHBE) as a public corporation and independent unit of state government. The Maryland Health Benefit Exchange (MHBE) is responsible for the administration of Maryland Health Connection, Maryland’s health insurance marketplace.

What steps are in place to ensure the quality of the options available through the exchange?

Maryland has a multi-step process in place that carriers must complete in order to offer insurance plans through the state’s exchange. Insurance companies initially submitted a Notice of Intent in the fall of 2012. In May of 2013, the MHBE released a list of 13 insurance companies planning to sell individual and small group health insurance plans through the Maryland Health Connection. Individual premium rates have been approved by the Maryland Insurance Administration; however, only after the administration requested that companies reduce the submitted rates. Plans are now required to pass the Maryland Health Benefit Exchange’s certification process, which is intended to ensure that plans meet the standards established by the PPACA.

Will the plans offered through the Maryland Health Connection have competitive premiums?

According to a report released July 26 by the MHBE, health insurance premiums for individual plans offered through the Maryland Health Connection are among the lowest for 12 states with rates that have been proposed or approved.

Which companies will be offering plans on the exchange?

The carriers seeking certification from MHBE are CareFirst, doing business as CareFirst of Maryland, CareFirst BlueChoice, and Group Hospitalization and Medical Services; Evergreen Health Cooperative; Kaiser Foundation Health Plan of the Mid-Atlantic; and UnitedHealthcare, doing business as All Savers Insurance.

CareFirst will be offering a range of plans through its operating affiliates: CareFirst of Maryland Inc., CareFirst BlueChoice Inc., and Group Hospitalization and Medical Services Inc. CareFirst will have a range of plan offerings which will include their BlueChoice HMO, BlueChoice POS, HealthyBlue POS, Blue Preferred PPO, and a BluePreferred Multistate PPO plan. Currently, it appears CareFirst will be offering individual plans at all metal levels.

New to the Maryland insurance market is Evergreen Health Cooperative Inc., the state’s new CO-OP. This health insurance carrier will be offering HMO network plans with EPO and PPO options.

Kaiser Foundation Health Plan of the Mid-Atlantic will be offering their KPIF HMO individual plan at the gold, silver, bronze, and catastrophic metal levels. The company will also be withdrawing many recently introduced and current plans from the market.

UnitedHealthcare, through All Savers Insurance Co, will be offering individual EPO plans at the gold, silver, bronze, and catastrophic metal levels.

Aetna announced at the beginning of August that they are exiting the Exchange in Maryland due to a request to reduce rates by 29%. Coventry, which was recently acquired by Aetna, will also be withdrawing from the Maryland marketplace.

There should also be a variety of Dental options available through Maryland Health Connection; the following carriers are seeking to offer dental insurance coverage:

  • BEST Life and Health Insurance Co.
  • Delta
  • DentaQuest Mid-Atlantic Inc.
  • Dominion Dental Services Inc.
  • Guardian Life Insurance Co. of America
  • Metropolitan Life Insurance Co.
  • United Concordia

Will coverage and premiums be the same statewide?

The state of Maryland is broken up into groups of counties or geographic rating areas that are used to determine rates. In Maryland, there are four rating areas and premiums can differ in each area. Insurance carriers do not have to offer plans in all the counties in a geographic area. Here are the rating areas in Maryland:

Area

Counties

Area Name

1 Anne Arundel County, Baltimore City,Baltimore County, Harford County, Howard County Baltimore Metropolitan Area
2 Calvert County, Caroline County, Cecil County, Charles County, Dorchester County, Kent County, Queen Anne’s County, St. Mary’s County, Somerset County, Talbot County, Wicomico County, Worcester County Eastern and Southern Maryland
3 Montgomery County, Prince George’s County DC Metropolitan Area
4 Allegany County, Carroll County, Frederick County, Garrett County, Washington County Western Maryland

When can I enroll?

Enrollment through Maryland Health Connection is scheduled to begin in October 2013, with coverage beginning January 1, 2014 for individuals and families. Enrollment through the Small Business Health Options Program (SHOP) opens January 1, 2014.

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

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

About Strenuus

Strenuus® is the industry leader in delivering network competitive intelligence services. We are the largest collector of managed care data in the country. With a singular focus on the managed care industry, we provide services to support payors, brokers, consultants and healthcare IT companies. Whether you represent employer-based coverage, Medicare, Medicaid, dental, work comp or specialty networks, we have the data and insights you need.

Learn more at www.strenuus.com.

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