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Posted by on May 27, 2014 in California, Colorado, Highlight, Indiana, Oregon | 0 comments

Weekly Health Insurance Industry Highlights


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

Subsidies being paid for those who purchased health insurance through the federal marketplace may be incorrect (either larger or smaller than permitted by the ACA) for more than 1 million Americans as a result of income discrepancies. The government has been unable to rectify the discrepancies because the federal computer system responsible for processing proof of income has not yet been built.

The Washington Post | Federal health-care subsidies may be too high or too low for more than 1 million Americans

What worked and what didn’t work for selling health plans through the public exchanges in 2014?

Enroll America learned that messaging was important, making the ads “someone like me,” she notes. While there was power in that, Filipic, previously the White House’s deputy director of public engagement, said Enroll America found it was much powerful to instead provide consumers with tools to provide a customized shopping experience, such as helping to figure out their subsidy. After changing their homepage image from people to tools, the click through rate dramatically increased.

HIX Health Insurance Exchange | Lessons learned from selling the exchanges

A report by S&P Capital IQ Global Markets Intelligence predicts a shift from employer based coverage to the individual marketplace:

Companies could shift 90% of their workers from employer-based healthcare to individual coverage on insurance marketplaces by 2020. If all U.S. companies with 50 or more employees transferred coverage for their employees to the marketplace, they could save $3.25 trillion by 2025

Medical Economics | Most employers could shift healthcare coverage to exchanges by 2020, report says

Public Health Insurance Exchanges

For the 2014 enrollment period, 26 states and the District of Columbia ran their own marketplaces, while 17 states relied on the FFM, and the remaining seven resorted to partnership exchanges. According to CMS, states had until May 1 to declare their intent to switch models – CMS received no such notices according to an agency spokeswoman.

The CMS says it will be flexible with states that need to turn to for the 2015 enrollment period.

Modern Healthcare | States stick to insurance exchange models

The Oregon governor’s office released subpoenas Tuesday from the U.S. attorney’s office seeking state records related to the Cover Oregon site.
Subpoenas were issued to both Cover Oregon and the Oregon Health Authority, which was responsible for the early technology development of the exchange site.

Modern Healthcare | U.S. subpoenas Oregon insurance exchange documents

Nevada’s health-care exchange board voted Tuesday to cut ties with Xerox Corp., which helped build the state’s troubled insurance website, and instead use the federal government’s technology for the next insurance enrollment season.

The Wall Street Journal | Nevada scraps Xerox for health site

Nevada plans to use the software from Connecticut’s exchange beginning in 2016, said Kevin Counihan, CEO of Access Health CT, Connecticut’s exchange. Nevada plans to use the federally run exchange for 2015.

The CT Mirror | Nevada to use Access Health CT’s exchange software in 2016

State News


California is once again a leading indicator of consumer sentiment regarding exchange plan rollout.
As we have seen from well before the initial rollout of the ACA, California has consistently been a focal point for moving exchange principles from theory into practice and testing the understanding of all parties involved.
The latest development centers on consumers’ understanding of the provider network corresponding to their chosen exchange plan. As we have tracked consistently since before the ACA went into effect last year, the availability of accurate provider network data to aid the consumer in important healthcare decisions is critical to the long-term success of the consumer-centric model of purchasing healthcare.
We are encouraged by the increased attention nationwide to this important issue. There are many dimensions to a successful universal provider search solution and growing pains are always present when new processes and technology are implemented.
We’re dedicated to working with all parties who need accurate, timely information about provider networks. The right data coupled with the right decision support process greatly improves a consumer’s experience.

Central Coast News – KION 46 | Dear Jon: Blue Cross customer upset doctor won’t accept health insurance: Many doctors on the Central Coast opted out of the ACA compliant plan

Reuters | California consumers say duped by Blue Shield’s limited Obamacare plans


The state Division of Insurance said that the U.S. Department of Health & Human Services approved its request to reduce the rating areas to nine from 11 by combining four rural areas into two larger rating areas, while retaining seven urban rating areas.
Two Western Slope mountain rating areas consisting of 21 counties will be combined into one rating area and two Eastern Plains rating areas consisting of 26 counties will be combined.

The Denver Post | Feds approve Colorado plan intended to lower rural health premiums


According to filings with the Indiana Department of Insurance, initial 2015 HIX premiums filed by the four health insurers that sold plans on the exchange in 2014, on average ranged from as high as a 46-percent increase to as low as a 9-percent decrease.

  • Anthem Blue Cross and Blue Shield proposed an average increase of 9.7 percent.
  • Physicians Health Plan of Northern Indiana, which proposed the highest average premium increases of 46 percent.
  • Indianapolis-based MDwise Inc. proposed the second-highest increase, 35 percent. MDwise CEO Charlotte MacBeth said even the 35 percent figure is certain to change.
  • Coordinated Care, Centene Corp., filed premium changes that range from a decrease of 15.5 percent to an increase of 53 percent. Its average change is projected to be a decline of 8.8 percent.

The Indiana Department of Insurance must approve rate increases.
There will be new entrants into the Obamacare marketplace in 2015:

  • Indiana University Health Plans
  • SIHO Insurance Services
  • CareSource

Indianapolis Business Journal | Indiana’s Obamacare rates for 2015 all over the map

Indiana Gov. Mike Pence’s new plan to provide health coverage for more of the state’s low-income residents involves applying for a waiver that will allow it to use federal Medicaid expansion funds to purchase coverage for adults earning up to 138% of the federal poverty level.
Not counting Indiana, 23 states have yet to move forward with some form of expansion. Joel Ario, former director of HHS’ Office of Health Insurance Exchanges, the remaining states are unlikely to opt for a traditional Medicaid expansion.
“They’ll likely pursue some sort or privatized option, because they like the idea of personal responsibility,” said Ario, now a managing director at Manatt Health Solutions, speaking at Global Health Care’s Health Insurance Exchange Summit the day before Pence unveiled his plan. “That movement is likely to expand to a number of states.”

Modern Healthcare | Indiana governor offers alternative to Medicaid expansion


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