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Posted by on Jun 16, 2014 in Highlight, Illinois, Kentucky, Maryland, Michigan, Oregon | 0 comments

Weekly Health Insurance Industry Highlights

StrenuusNow

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


Network Development

Insurers are expanding provider networks

Health insurers in several states are adding to the choices of doctors and hospitals in their health-law plans amid concerns among some consumers and state officials about access to care.
In states including New York, Connecticut and Ohio, insurers have bolstered their health-care provider networks in recent months. In California, three of the biggest insurers—WellPoint Inc’s Anthem Blue Cross, Blue Shield of California and Health Net Inc. have all added substantially to their lists.
CareSource, based in Dayton, Ohio, has added more than a half-dozen hospitals since the start of the year, and it hopes to roughly double the number it currently has to more than 50. Fidelis Care, a New York nonprofit focused largely on Medicaid, has added more than 4,500 providers, including 13 hospitals, since the start of the year. More hospitals and doctors have joined “as we’ve started to get more enrollment, and as we’ve shown that we are paying claims accurately and timely,” said David Thomas, chief operating officer.

THE WALL STREET JOURNAL | INSURERS FILL GAPS IN HEALTH-LAW PLANS

Nearly half of 2014 HIX products were plans with narrow hospital networks
Roughly half of the products sold on exchanges in 2014 were narrow-network plans, according to a study by the McKinsey Center for U.S. Health System Reform. In the largest city in each state, that figure jumped to 60%.
MODERN HEALTHCARE | NEARLY HALF OF EXCHANGE PRODUCTS OFFER NARROW NETWORKS, MCKINSEY STUDY SAYS
MCKINSEY&COMPANY – MCKINSEY CENTER FOR U.S. HEALTH SYSTEM REFORM | HOSPITAL NETWORKS: UPDATED NATIONAL VIEW OF CONFIGURATIONS ON THE EXCHANGES

Health Exchanges

Array Health, a leading provider of private health insurance exchange technology, today released a report which reveals consumer-focused shopping and enrollment is the most valuable capability for a successful private exchange, according to opinions of healthcare industry professionals.
INSURANCE NEWS | SURVEY REVEALS CONSUMER-FOCUSED SHOPPING AND ENROLLMENT IS THE MOST IMPORTANT CAPABILITY FOR A SUCCESSFUL HEALTH EXCHANGE

2015 Rate Filings

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.

Maryland

  • CareFirst BlueCross BlueShield – CareFirst Blue Choice & CareFirst of Maryland
  • Kaiser Foundation Health Plan
  • All Savers Insurance (UHC)
  • Evergreen Health CO-OP
  • UnitedHealthcare of the Mid-Atlantic
  • Cigna Health and Life Insurance Co.

THE BALTIMORE SUN | STATE RELEASES PROPOSED RATES FOR INDIVIDUAL-MARKET, SMALL-BUSINESS HEALTH INSURANCE
THE WASHINGTON POST | CAREFIRST SEEKS PRICE HIKES FOR INDIVIDUAL HEALTH PLANS

Michigan

  • Blue Care Network of Michigan
  • Blue Cross Blue Shield of Michigan
  • Consumers Mutual Insurance of Michigan (CO-OP)
  • Health Alliance Plan (HMO) / Alliance Health and Life Insurance Company (PPO)
  • Humana Medical Plan of Michigan, Inc.
  • McLaren Health Plan
  • Meridian Health Plan of Michigan, Inc. (MHP)
  • Molina Healthcare of Michigan
  • Physicians Health Plan – withdrew in 2014 plan year
  • Priority Health (Insurance Company)
  • Total Health Care USA

New Entrants

  • Harbor Health Plan (currently present in the Medicaid space)
  • Time Insurance Company (Assurant)
  • UnitedHealthcare Community Plan

DEPARTMENT OF INSURANCE AND FINANCIAL SERVICES | INSURANCE COMPANY RATE, RULE, AND FORM SERFF FILING SEARCH
DEPARTMENT OF INSURANCE AND FINANCIAL SERVICES | MORE MICHIGAN INSURERS SUBMTI PLANS FOR SECOND YEAR OF FEDERAL HEALTH INSURANCE MARKETPLACE

Oregon
The division will make decisions on rates by early August and post-consumer-friendly documents that describe the decisions

  • ATRIO Health Plans
  • BridgeSpan Health Company
  • Community Care of Oregon (Oregon’s Health CO-OP)
  • Health Republic (Freelancer’s CO-OP)
  • Kaiser Foundation Health Plan of the Northwest
  • LifeWise Health Plan of Oregon
  • MODA Health Plan (ODS)
  • PacificSource Health Plans
  • Providence Health Plan
  • Trillium Community Health Plans
  • Health Net

OREGON INSURANCE DIVISION | REVIEW OF 2015 HEALTH INSURANCE RATES BEINGS
OREGON INSURANCE DIVISION | PROPOSED RATES FOR 2015 HEALTH PLANS

Illinois

The Illinois Department of Insurance (DOI) today announced that it has received applications from ten health issuers seeking to provide 504 Qualified Health Plans (QHPs) to people seeking health insurance coverage through Get Covered Illinois (GCI) and the Illinois Health Insurance Marketplace.
The 504 submissions include 306 individual plans and 198 plans for the small group insurance market. In the first year, issuers offered 165 plans, including 120 individual plans and 45 small group plans. The plans will be reviewed by DOI to determine whether they provide the required Essential Health Benefits, were developed consistent with acceptable actuarial standards, meet network sufficiency standards and do not discriminate by discouraging purchase by people with health problems. DOI will aggressively scrutinize network adequacy and issuers will be required to provide better disclosure on their websites of the providers in participating networks in the QHPs.
Once the review is completed, DOI will recommend whether or not the plan should be certified as a QHP to HHS onor before August 8, 2014. HHS will announce its decision regarding certification prior to open enrollment.

2015 HIX Participants Include:

UnitedHealthcare confirmed Thursday (June 12, 2014) that it plans to offer policies through the marketplace in 2015.
Blue Cross plans to sell exchange-based plans again for 2015.
Land of Lincoln has said it plans to participate again in 2015.
Health Alliance, the Urbana, Ill.-based insurer that offered plans throughout the state in 2014 outside the Chicago area plans to participate in 2015.
Aetna Inc. and its subsidiary, Coventry Health Care, both participated in 2014 under separate banners. The combined company is expected to again offer plans under both brands in Illinois in 2015.
Humana Inc. has not announced its decision yet, but a spokeswoman said previously the Louisville, Ky.-based company has “no plans to reduce our footprint.”

THURSDAY, JUNE 12, 2014 | ILLINOIS DEPARTMENT OF INSURANCE | DOI ANNOUNCES TEN ISSUERS APPLY TO OFFER 504 QUALIFIED HEALTH PLANS FOR YEAR TWO OF ILLINOIS HEALTH INSURANCE MARKETPLACE

CHICAGO TRIBUNE BUSINESS | MORE HEALTH INSURERS LINE UP FOR 2015 ILLINOIS EXCHANGE

Kentucky

All five insurance companies that sold policies this year on the exchange known as Kynect want to come back for 2015, and at least one other — CareSource — wants to join them.
We are pleased that additional health insurance companies are expressing interest in Kentucky’s market, both on and off the exchange. Consumers benefit from the choices that come with more competition,” state Insurance Commissioner Sharon P. Clark said.
Five insurance companies were on the Kentucky exchange this year: Anthem, Humana, Bluegrass Family Health, United Healthcare of Kentucky, and Kentucky Health Cooperative.
All of them except Humana provided small group market insurance on the exchange, which describes small group market as two to 50 employees. Three — Humana, Anthem and Kentucky Health Cooperative — provided individual coverage.

LEXINGTON HERALD-LEADER | MORE COMPANIES ARE EXPECTED TO SELL HEALTH POLICIES ON KENTUCKY EXCHANGE NEXT YEAR

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