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Posted by on Jun 23, 2014 in Public Exchanges | 0 comments

2015 HIX Update

2015 Health Insurance Exchange Update 


California

2014 California HIX insurer not offering HIX plans in 2015

The Contra Costa Health Plan elected to withdraw from the exchange in 2015 because it could not meet a federal regulation that requires insurers to offer the same plan inside and outside the exchange.
Patricia Tanquary, CEO of the health plan, said that offering the same version of the Contra Costa Health Plan both inside and outside the Covered California exchange is so costly to administer that it will lead to increased rates. The plan serves 138,000 mostly MediCal residents in Contra Costa County.

SAN JOSE MERCURY NEWS | CONTRA COSTA HEALTH PLAN MUST WITHDRAW FROM STATE HEALTH INSURANCE EXCHANGE

Iowa

CoOportunity Health and Coventry Health Care, the two top insurance companies on Iowa’s Obamacare exchange, are planning to increase premium prices for 2015.

MAINE NEWS | 2 TOP INSURANCE COMPANIES TO RAISE PREMIUM PRICES FOR 2015

Wellmark said that it will not join the government’s health care exchange, marking the second year in a row it has declined to go on the exchange.
The insurer said it decided not to go on the exchange in 2015 due in part to challenges the system has faced, such as its rocky rollout that started in October.

THE DES MOINES REGISTER | WELLMARK SEEKS INSURANCE RATE HIKES, WON’T JOIN EXCHANGE

Idaho

The Idaho Department of Insurance on Friday approved Mountain Health CO-OP’s application to sell health insurance in Idaho.
The co-op plans to offer coverage through Idaho’s health insurance exchange this fall. Those plans will become effective Jan. 1.
The Mountain Health CO-OP, is the Idaho branch of Montana Health CO-OP.
Four not-for-profit insurers sold plans in open enrollment last year and early this year through Your Health Idaho, the insurance exchange in Idaho. They were Blue Cross of Idaho, Oregon-based PacificSource, Utah-based Select Health and BridgeSpan, which is a sister company of Regence BlueShield of Idaho.

IDAHO STATESMAN | STATE APPROVES MOUNTAIN HEALTH CO-OP TO SELL INSURANCE IN IDAHO

Indiana & Kentucky – CareSource

CareSource is looking to expand its health insurance product onto marketplaces in Kentucky and Indiana next year.
Company officials say CareSource Just4Me, which debuted last year on the Ohio Health Insurance Marketplace, will grow to the Indiana Health Insurance Marketplace, as well as Kynect, Kentucky’s state-run exchange.

DAYTON BUSINESS JOURNAL | CARESOURCE PLANS EXPANSION INTO KENTUCKY, INDIANA HEALTH INSURANCE MARKETPLACES

Kentucky

At least two additional insurance companies say they want to sell policies on Kentucky’s state-run health exchange.
Ohio-based CareSource and Florida-based WellCare have filed paperwork with state regulators indicating interest in selling policies through kynect. Both provide Medicaid plans in Kentucky but have not sold on the individual market.

THE COURIER-JOURNAL | TWO NEW INSURERS INTERESTED IN JOINING KYNECT

New Hampshire

Harvard Pilgrim Health Care to offer broad and narrow network choices on New Hampshire marketplace
On Monday, Harvard Pilgrim Health Care announced the networks it intends to make available to individuals and small-employer groups through the New Hampshire marketplace.
Marketplace plans will feature a choice of two networks — ElevateHealthSM and Harvard Pilgrim’s New Hampshire provider network, which offers access to virtually all New Hampshire hospitals and affiliated physician groups.
ElevateHealth, a partnership with Dartmouth-Hitchcock and Elliot Health System, is a nonprofit, high-performance, defined-network product offering access to premier hospitals and providers in New Hampshire, according to Roberts. With its emphasis on care coordination within the network, Roberts said ElevateHealth insurance premiums on average offer 10 percent savings compared to Harvard Pilgrim’s similar full-network plans.
“ElevateHealth currently has 12 hospitals that will be in the network and we are negotiating with others,” Roberts said. “Our full-access plan goal is to have all 26 hospitals available to our users. We have 24, and are in active negotiations with Portsmouth Regional Hospital and Parkland Medical Center now, and we are hopeful that we can add them into our full network product soon.”
Harvard Pilgrim intends to offer two gold plans, four silver plans and two bronze plans for individuals in the New Hampshire marketplace. Subscribers will be able to choose either the ElevateHealth or full New Hampshire network and may elect plans with health savings accounts within each of the metal tiers.

SEACOAST ONLINE | MORE CHOICES IN HEALTH CARE COMING IN NOVEMBER

New Jersey

UnitedHealthcare did not participate in the exchange’s first year in 2014, but told NJBIZ on Monday that “UnitedHealthcare intends to file an application for New Jersey’s individual exchange, and look forward to continuing our conversations throughout the approval process.”
The exchange launched this year with three New Jersey health insurers on board: Horizon Blue Cross Blue Shield of New Jersey; AmeriHealth New Jersey; and Health Republic Insurance of New Jersey, a new co-op insurer financed with loans from the ACA.

NJBIZ | N.J. RESIDENTS TO GET ANOTHER HEALTHCARE.GOV OPTION IN 2015

New York

Insurers offering tailored network product to decrease 2015 rates
Proposed 2015 plan rates were due Friday, June 13, 2014. State regulators will review the requested rates and decide by September whether to approve, modify or deny them.
BlueCross BlueShield members who use one of its “align” products could see decreases of as much as 7.5 percent in their premiums for next year. The “align” products, also known as tailored networks, are partnerships with Kaleida Health and a group of doctors that lower premiums for members in exchange for restrictions on physicians and hospitals.
Independent Health has its own tailored network, Choice Plus, in a partnership with Catholic Health System and the Catholic Medical Partners doctors’ group. The Amherst-based insurer, which has the second-largest market share here, said members of that plan would see a rate decrease of nearly 3 percent next year.
Excellus Health Plan of Rochester, which includes Univera, said its proposed rate hikes for 2015 were driven by rising health care costs, federal and state mandated changes to the health insurance market and a higher-than-anticipated movement of members into lower-benefit plans.

THE BUFFALO NEWS | PLAN RATES TO RISE SLOWLY AT 2 AREA HEALTH INSURERS, SHARPLY AT UNIVERA

Rhode Island

On April 15, 2014 and May 15, 2014, Blue Cross Blue Shield of Rhode Island (BCBSRI), Neighborhood Health Plan of Rhode Island (NHPRI), Tufts Health Plan (Tufts), and United Healthcare (United) filed with the State of Rhode Island Office of the Health Insurance Commissioner (OHIC) to request approval for rates to be charged to individuals, small employers, and large employers effective in 2015.
BCBSRI, NHPRI, and United have filed in the individual market. All four commercial health insurers have filed in the small employer market. BCBSRI, Tufts, and United have filed in the large employer market. OHIC has the responsibility of reviewing the rates with the goal of holding the insurers publicly accountable for making health insurance more affordable while ensuring their solvency.

OFFICE OF THE HEALTH INSURANCE COMMISSIONER | 2014 HEALTH INSURANCE RATE REVIEW PROCESS

South Dakota

Two health insurers said they intend to sell plans to South Dakota residents through the federal marketplace during the open-enrollment period that begins in November, but it is unclear whether at least two other companies have filed documents with the state that would allow them to offer plans through the same system.
Representatives for Avera Health Plans and Sanford Health Plan said they have filed policies with the state. Dakotacare, Avera and Sanford were the only insurers selling plans to South Dakota residents during the site’s first run.
Dakotacare spokesmen did not return messages seeking comment on whether the insurer will again offer some or all of the 19 individual and two small-group plans it sold through March.
Wellmark, the largest private insurer in South Dakota, opted to stay out of the marketplace during the past enrollment period. The company hasn’t publicly announced whether it will sell plans on the website starting in November

ASSOCIATED PRESS | TWO S.D. INSURERS PLAN TO SELL DURING OPEN ENROLLMENT

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