Washington Health Benefit Exchange 2018 Carrier Plan Filings All Committee Meeting August 8, 2017 Molly Voris, Policy Director
Themes of 2018 Exchange Health Plan Filings Reflect the uncertainty at the federal level no decision on CSRs and enforcement of mandate Carriers reacting to the market and cost trend While carriers have filed, plans still in flux HMO models offered by traditional Medicaid MCOs are more dominant Exchange will likely have a greater portion of the individual insurance market Significantly fewer choices of carriers in many counties; several with one choice 2
Summary of Anticipated Exchange Health Plans for 2018 Individual Market 7 issuers offering 2018 QHPs Had 9 issuers in 2017 Regence and CHPW not offering in the Exchange plans for 2018 42 proposed QHPs 98 QHPs in 2017 No bare counties 9 counties with one issuer SHOP Chelan, Douglas, Ferry, Grays Harbor, Island, Pend Oreille, San Juan, Skagit, Skamania No issuers offering SHOP plans for 2018 3
Evolving Market Since Filing Deadline OIC has worked with carriers to cover previously bare counties, Grays Harbor and Klickitat Premera will cover Grays Harbor On Exchange only BridgeSpan and Molina will cover Klickitat Molina on Exchange, BridgeSpan on and off Exchange 4
Coverage Area Changes Inside Exchange Kaiser of WA and Kaiser NW made no changes Coordinated Care added 2 counties to its service area Columbia and Kittitas Counties County exits Premera/LifeWise exited 3 counties Molina exited 6 counties but added Klickitat Regence and CHPW exited Exchange coverage BridgeSpan exited 12 counties and offering in Klickitat only 5
Coverage Area Changes Outside Exchange 10 counties with no carrier offerings off the Exchange All have coverage on Exchange Clallam, Ferry, Grays Harbor, Jefferson, Lincoln, Pacific, Pend Oreille, Skamania, Stevens, Wahkiakum BridgeSpan/Regence withdrew from entire I 5 corridor Remaining only in southeastern Washington in 6 counties 6
2018 Exchange QHPs Metal Level Overview 7 QHP Issuers 42 QHPs Gold Silver Bronze Catastrophic 80% AV 70% AV CSRs available 60% AV Only through the Exchange Under age 30 or hardship No tax credits 7 Issuers 9 Plans 7 Issuers 20 Plans 5 Issuers 11 Plans 2 Issuers 2 Plans 7
Proposed Rate Increases for 2018 in the Exchange* by Metal Level Average Requested Rate Increase Range of Requested Rate Increases Gold 22% 3% 45% Silver 18% 6% 36% Bronze 33% 11% 82% Cheapest plan** 36% 14% 61% *Does not include BridgeSpan plans **Silver is cheapest plan in 16 counties; bronze is cheapest plan in 21 counties (excluding Grays Harbor and Klickitat Counties) 8
Proposed Rate Increases for 2018 in the Exchange by Issuer* Issuer Name Average Requested Rate Increase Range of Requested Rate Increases Coordinated 29.30% 24.80% 41.0% Care Kaiser 12.91% 8.4% 17.89% Northwest Kaiser of 12.9% 0.4% 72.9% Washington Lifewise 21.6% 16.2% 24.2% Molina 38.49% 37% 50.42% Premera 27.7% 18.1% 35.8% * Does not include BridgeSpan plans 9
Proposed Deductibles for 2018 in the Exchange* Gold 2017 2018 Deductible Range $0 $1,540 $0 $3,800 Median Deductible $1,200 $1,250 Silver 2017 2018 Deductible Range $0 $7,150 $1,750 $7,150 Median Deductible $3,000 $4,500 Bronze 2017 2018 Deductible Range $5,000 $7,150 $5,000 $7,150 Median Deductible $6,000 $6,350 * Does not include BridgeSpan plans 10
2018 Proposed Dental Market Summary 6 Issuers Statewide coverage with generally same issuers, plans, and service area as 2017 6 Family Plans Delta Dental, Dental Health Services, Dentegra 3Low 3High 7 Pediatric only Plans 4 Low 3High High= Plan Value of at least 85% Low= Plan Value of at least 70% 11
Addressing 2018 Plan Issues Expect all counties to be covered for 2018 Funding of cost sharing reductions (CSRs) uncertainty continues States approaching CSR uncertainty in different ways CA: asking for carriers to file one set of rates assuming CSRs are not paid; carriers are to load rates onto silver plan RI: asking for carriers opinions on the impact of spreading CSR costs across entire individual market; or filing rate assuming cost of CSRs is built into silver plan OIC directing carriers to file a second set of rates for 2018 to account for termination of CSR payments to issuers 12
Market Stability in 2019 and Beyond Working with OIC on developing risk stabilization program with goals of: stabilizing market, sustaining affordability, and providing access in rural areas Looking at options, such as reinsurance, high risk pool, state as a purchaser, geographical rating areas, etc. Objective to encourage greater county participation Intention to pair with 1332 waiver (ACA waiver) to leverage federal funding for the program Targeting 2019 start date 13
Appendix 14
Proposed Individual QHP Submissions Carrier Gold Silver Bronze Catastrophic Coordinated Care 1 9 0 0 BridgeSpan 1 1 1 0 Kaiser NW 2 2 3 1 Kaiser of WA 1 3 3 1 Lifewise 1 2 1 0 Molina 1 1 0 0 Premera 2 2 3 0 Total 9 20 11 2 15