Weekly Health Insurance Industry Highlights
Catch up on healthcare news and gain insights from our own industry gurus.
2015 Health Insurance Rate Filings
Health insurance rate filings for 2015 exchange plans are shedding light on the carriers who are planning to participate in next year’s HIX marketplace.
For more information about a specific state, click on the state name to be directed to the state’s 2015 HIX Competitors page. These state specific pages will be updated regularly as information becomes available about 2015 insurers and product offerings.
Harvard Pilgrim Health Care to join Anthem Blue Cross Blue Shield and Maine Community Health Options on the state’s HIX in 2015.
- Anthem Healthplans of Maine, Inc.
- Harvard Pilgrim Health Care, Inc. or HPHC Insurance Company, Inc.
- Maine Community Health Options
Co-op here to stay
Maine Community Health Options, MCHO, competing with Anthem Blue Cross in the state’s HIX, ended up writing 80% of the policies in its first year.
“For most Mainers, health insurance is about a lot more than the insurance product. It’s really more about health, and a sense of security and well-being,” CEO Kevin Lewis says in an interview.
“We’re long past the point of where we’re concerned about financial viability,” Lewis says. “We’re here to stay.”
Carriers that have proposed rates for plans:
- Blue Cross Blue Shield of Vermont
- MVP Health Care
- Anthem Health Plans, Inc. dba Anthem Blue Cross and Blue Shield
- ConnectiCare Benefits, Inc. (CBI)
- UnitedHealthcare Insurance Company
New Hampshire – 2015 to bring new competition and broad networks
Consumers shopping for health insurance will have at least five companies to choose from for coverage in 2015, compared to only one company this year.
- Anthem Blue Cross Blue Shield
- Minuteman Health
- Harvard Pilgrim Health
- Maine Community Health Options
- Assurant Health (Time Insurance Company)
Anthem was the sole company to offer health insurance packages on the exchange when it opened in October for coverage starting in January 2014. Since then, Minuteman Health and Harvard-Pilgrim Health Care, both based in Massachusetts, have indicated that they will be offering products for coverage starting in January 2015.
The state Insurance Department announced on Monday that two other companies plan to offer products to New Hampshire consumers — Maine Community Health Options and Assurant Health. Both announced plans to offer the broadest possible provider network. Anthem’s narrow network has been criticized for excluding too many of the state’s hospitals.Maine Community Health Options, established in 2011 in Lewiston, Maine, plans to introduce its products in four New Hampshire counties at first — Rockingham, Strafford, Carroll and Coos — with plans to expand later in the year.
Assurant Health, headquartered in Milwaukee, Wis., has been in business since 1892. The company was already licensed in 41 states, including New Hampshire, but did not offer plans on the New Hampshire exchange this year.
The Insurance Department has until Aug. 7 to review all the proposed plans and recommend them for approval to the federal government.
Health insurers were required to submit their 2015 rate requests Monday to the Oregon Insurance Division.
- ATRIO Health Plans
- BridgeSpan Health Company (Cambia Health Solutions)
- Community Care of Oregon, Inc. (Oregon’s Health CO-OP)
- Health Net Health Plan of Oregon, Inc.
- Health Republic Insurance Company (Freelancer’s CO-OP)
- Kaiser Foundation Health Plan of the Northwest
- LifeWise Health Plan of Oregon
- MODA Health Plan
- PacificSource Health Plans
- Providence Health Plan
- Trillium Community Health Plan
More Virginians than expected enrolled in health plans through the Affordable Care Act’s insurance marketplaces, industry executives say, and average rate hikes proposed for 2015 are comparable to increases in the market before the health law took effect.
Executives with Optima Health and Anthem Blue Cross and Blue Shield in Virginia said they were pleased with participation, though it was a fraction of the Virginia marketplace’s potential customers, estimated at 823,000 by the Kaiser Family Foundation.
“The enrollment exceeded our expectations,” said Steve Cindrich, director of strategic business development for Optima, the insurance arm of Norfolk-based Sentara Healthcare – though he added that “we were disappointed that so many people didn’t pay their first premium.”
About a fifth of the people signing up for an Optima plan through the exchange didn’t pay, leaving 17,000 that fully enrolled.
Open enrollment for marketplace plans ran for six months, ending March 31. But some were allowed an extension into April, with coverage beginning as late as May.
That made it challenging for Virginia insurers to determine rates for 2015, executives said. Their deadline to file requests for premium increases with the Virginia Bureau of Insurance was May 9. Final rates will be set in the fall.
One of the three managed care insurers covering New Hampshire’s Medicaid population is withdrawing from the program.
State officials announced Tuesday that Meridian Health Plan, based in Detroit, Michigan, will continue to provide services to July 31 to give the state time to move its Medicaid clients to one of the two other plans: New Hampshire Healthy Families or Well Sense Health Plan.
New Hampshire began switching from a fee-for-service health care system to managed care on Dec. 1 to save money and try to provide Medicaid clients with better access to health care, especially those with chronic illnesses such as diabetes.
Narrow Networks & Access to Care
Redefining Network Adequacy Standards
Laws governing health insurance vary, but states generally try to ensure that health plans give residents reasonable access to a sufficient number of primary care and specialty physicians, said Tyler Brannen, a health policy analyst for the state of New Hampshire. Yet that aim hasn’t kept up with changes in how and where people access health care, he added.
“There’s going to be an emphasis on types of services, versus types of providers,” he said of the new standards being put in place.
New Hampshire recently began working to revise its 2001 rules, Washington state just implemented new regulations, and discussions are underway in several others, including Arkansas, Minnesota and California.
Narrow Networks: Affordability and Access to Care
Narrow networks contain a smaller number of providers and in-network facilities than traditional provider networks, typically resulting in lower premiums. In this paper researchers assess the benefits and risks of a range of policy and regulatory options available to federal and state policy-makers on these narrow networks.
The development, review and oversight of health plan networks involves trade-offs between premium costs and consumers’ access to and choice of providers. This paper makes clear that there is no current regulatory approach that can satisfy all stakeholders, but with the right balance between consumer choice and cost containment, consumers can receive quality care at an affordable price through narrow networks.
Ascension Health Acquisition of Insurer
Ascension Health moves forward with acquisition of insurer
Ascension Health has signed a non-binding letter of intent to acquire an insurance company.
St. Louis-based Ascension did not name the company in newly released municipal bond documents, but described it as one that “provides life, accident and health-related insurance policies on a group basis and provides benefits processing, payments and other services.”
Ascension’s latest bond documents said the price of the deal is not believed to be material and officials will seek to close the insurance acquisition by October.
Ascension Health is not buying a publicly traded Medicaid plan, as some had speculated last week, Citigroup analyst Carl McDonald stated. Last week Ascension’s CEO reportedly said that it was in talks to acquire an unnamed insurance company that operates in 18 states, leading research firm Leerink to speculate that Ascension was likely looking to buy WellCare or that it may be interested in buying Centene. However, McDonald rejected both scenarios, as he reported that Ascension recently wrote that the purchase price of the insurer it was poised to buy would not be material.
Stifel Nicolaus analyst Thomas Carroll believes St. Louis-based managed care company Centene and Florida-based WellCare are prime targets for acquisition. However, he also said a private company based in Pennsylvania, AmeriHealth Caritas, might be a likely target as well.