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Posted by on May 19, 2014 in Arizona, California, Colorado, Highlight, Network News, Rates, Transparency, Virginia, Washington | 0 comments

Weekly Health Insurance Industry Highlights


Catch up on healthcare news and gain insights from our own industry gurus.

HIX network news

New health plans offer consumers access to fewer in-network providers. While these narrow networks are utilized for many public HIX plans, they are becoming more common in employer and Medicare Advantage plans as well.

The New York Times | More insured, but the choices are narrowing

Some consumers are finding that their access to care is limited, even after checking to ensure that their provider was in-network. While many consumers switched plans before the enrollment deadline upon realizing their doctor was not in-network, others are only learning of the situation now.

Insurance agents Craig Gussin in San Diego and Kelly Fristoe in Texas helped dozens of clients switch plans just before the enrollment deadline when clients realized their doctors weren’t covered. 

Everybody I talk to is having the same issue. It’s probably the number one item that we’re seeing right now,” said Gussin, who is petitioning Covered California for special enrollment status to help clients change plans.

ABC News | Consumers losing doctors with new insurance plans

States begin to release 2015 proposed rates

While many insurers are seeking rate increases in plans proposed for 2015, this is not the case for all carriers; we can expect some insurers who offered products priced well above the market to lower 2015 rates to offer more competitive prices.

In Virginia:

  • Kaiser Foundation Health Plan of the Mid-Atlantic States proposed a 3.3% increase
  • CareFirst BlueChoice proposed a 14.9% increase
  • Anthem HealthKeeprs (WellPoint) proposed an average increase of 8.5%

In Washington, the average proposed rate change for individual exchange plans was 8.25%, the lowest average rate increase in seven years:

  • Molina proposed a decrease averaging 6.8%
  • Kaiser Foundation Health Plan of the Northwest proposed a 0.57% increase
  • Group Health Cooperative proposed an 11.2% increase

Washington also saw four new companies submit proposed 2015 HIX plans:

  • Columbia United Providers
  • Health Alliance Northwest Health Plan, Inc.
  • UnitedHealthcare of Washington, Inc.
  • Moda Health Plan, Inc.

In Arizona, only submissions that are public are those that propose a premium increase of more than 10%.

  • Humana proposed a 25.5% increase
  • Cigna proposed a 14.4% increase

The Wall Street Journal | Virginia filings give first look at 2015 health rate increases
The Wall Street Journal | A Washington state health insurer plans to cut rates in 2015
Washington State Office of the Insurance Commissioner | New companies submit proposals to sell health plans in Washington
Modern Healthcare | Reform Update: Significant rate increases ahead for 2015 open enrollment, initial filings show
PRWeb | AIS Newsletter reports on lower-than-expected exchange rate proposals in Wash., Va.


Three major insurers are partnering with a not-for-profit group, the Health Care Cost Institute, to provide consumers greater transparency, including access to price and quality information.

Modern Healthcare | Aetna, Humana, UnitedHealthcare to supply healthcare cost data for new transparency tool

Other news

In Colorado, state regulators are seeking permissions to redefine the state’s geographic rating areas in hopes of bringing down health insurance premiums in high-cost mountain and rural areas. The move would reduce the state’s 11 rating areas to nine by combining four rural areas into two larger areas.

The Denver Post | Colorado proposes fix for high health insurance premiums in mountains

According to a report from the Commonwealth Fund, agents and brokers lost $300 million in commissions in 2012 as a result of the medical loss ratio provision in the ACA.

Insurance Business | Broker commissions slashed by $300 million

The Commonwealth Fund | The federal medical loss ratio rule: Implications for consumers in year 2

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