Updates for the week of 8/21/14 – 8/28/14

  • The Arkansas Insurance Department announced that insurance policies sold through the Arkansas Health Insurance Marketplace will see a net decrease of 2% in premium costs for 2015. This calculation includes the policies offered through the Arkansas Private Option, which will notice a small decrease in premiums, but will essentially remain flat in comparison to 2014.
    • BCBS is increasing rates by an average of 2%
    • Celtic Insurance is decreasing rates by an average of 12%
    • QualChoice is increasing rates by an average of 5%
  • Executive Director of the Connecticut’s Access Health CT, Kevin Counihan to has been hired to the Department of Health and Human Services as CEO of HealthCare.gov. Counihan will not only manage the federal exchange, but also coordinate with state marketplaces and oversee CCIIO. He’ll report to CMS Administrator Marilynn Tavenner.
  • Hawaii HHHealth Connector staff reported that QSSI (owned by UnitedHealth Group) has been selected to revamp the troubled Hawaii Health Connector, which was built by CGI.  The Connector initially awarded CGI a $53 million, four-year contract to build the exchange and subsequently gave it an additional $20 million for maintenance and operations. But CGI failed to meet the scheduled Oct. 1 launch date due to software problems and Hawaii was last in the country to go live with health plans on Oct. 15. Executive Director Tom Matsuda didn’t say how much the Connector has paid CGI to date. He also didn’t address whether the Connector will be seeking any refunds from CGI for the bungled launch of the exchange.
  • Maryland has released information on final insurance premiums for 2015 by metro area and carrier. Regulators approved lower rates for the Kaiser Foundation Health Plan, Evergreen Health Cooperative and All Savers Insurance; the rates will drop by an average of 14 percent, 10.3 percent and 6.7 percent, respectively.
  • The Mississippi Insurance Department has released some information about 2015 insurance rates. They are not expecting any new carriers in the exchange. On average, Magnolia Health Plan (subsidiary of Centene) premiums are expected to go down by 25% while Humana’s premiums will increase by 6.5%.
  • Montana Commissioner of Securities and Insurance, Monica Lindeen, has made available information on 2015 health insurance rates that would suggest an increase of approx. 1.35% over the individual and small groups. BlueCross BlueShield of Montana, PacificSource, Montana Health CO-OP, and Assurant are expected to participate in the individual marketplace in 2015.
  • At an August 30 board meeting, the Cover Oregon board discussed follow-up from a planning session on FFM transition options. For the long-term reorganization of the marketplace, the state is currently considering the merits of establishing as a ‘Supported State-Based Marketplace’ or a ‘Partnership Marketplace’. The board will make a final decision at their meeting next week on September 4th.
  • The Oregon Department of Justice has filed its long-discussed lawsuit against Oracle America, the company state officials have accused of shoddy work on the Cover Oregon health exchange. The 126-page lawsuit was filed in Marion County Circuit Court on August 22. It accuses Oracle of fraud, false claims, breach of contract and civil racketeering.
  • At an August 30 board meeting, Washington Healthplanfinder staff reviewed the goals of an upcoming system release aimed at fixing some of the EDI transmission issues. They hope this weekend’s release will fix: 1.) Payments not being sent to carriers; 2.) Incorrect grace periods and termination process failing; 3.) Incorrect invoice adjustments; 4.) Invoice balances are not carrying forward to the next invoice; 5.) Multiple active QHP enrollments for the same application.
  • At the same board meeting, Washington exchange staff voted 6-1 to approve a budget proposal (slide 6) for 2015 – 2017. With the chosen budget proposal, exchange staff has decided to forgo a comprehensive physician and clinic / network search tool ($900K) and Rx Formulary Search Tool ($2.4M) for the 2015 open enrollment. However, staff did report that they will plan to introduce a “scaled-down formulary comparison tool” by the end of this year.
  • Washington Insurance Commissioner, Mike Kreidler, has opened a special enrollment period to extend from August 27th to November 14th for people who have had problems paying for their coverage through the exchange. At current, this problem is expected to impact between 3,000 – 5,000 households (averaging 1.2 individuals per household). The number of consumers expected to use the SEP to leave the exchange and enroll in the outside market is unknown.
  • The Washington Office of the Insurance Commissioner approved ninety individual health plans to be sold by ten insurance carriers through the WA HBE (if they also approve these products). There are still two insurance carriers who have yet to be approved by the OIC (Health Alliance Northwest and UnitedHealthcare). The OIC also approved two carriers’ plans (Kaiser and Moda) to be sold in the SHOP, which will now be available state-wide (by Moda).

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