Clark County has fewest health plans in insurance exchange

Insurance commissioner approves eight plans for Clark County

By Marissa Harshman, Columbian health reporter

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Updated: August 1, 2013, 8:13 PM

 
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Clark County residents looking to purchase health coverage through the state-based insurance exchange will have fewer options than people living in other counties.

LifeWise Health Plan of Washington was the only carrier approved by state Insurance Commissioner Mike Kreidler to provide health plans for individuals and families in Clark County. LifeWise, which currently serves about 6,800 Clark County residents, will offer eight health plans when the exchange opens Oct. 1.

Kaiser Permanente’s application to provide plans in Southwest Washington was denied.

People who purchase insurance through the exchange, part of the Obama administration’s Affordable Care Act, may be eligible for tax credits or subsidies to offset the costs.

The monthly premiums for the LifeWise plans range from $115 to $657 per person for the lowest-level, or bronze, plans, which cover 60 percent of health costs. Monthly premiums for the highest-level — or gold — plans available in Clark County, which cover 80 percent of costs, range from $177 to $924 per person.

Those rates do not include federal subsidies available to individuals and families making up to 400 percent of the federal poverty level.

“We’re now one step closer to giving Washington consumers access to affordable health insurance,” Kreidler said in a news release. “Many of the companies will look the same, but they’re going to sell all-new plans with much better benefits.”

Kreidler’s office announced Thursday the four insurance carriers approved to sell individual health plans on the state exchange, Washington Healthplanfinder, this fall. The four carriers — LifeWise, Premera Blue Cross, Group Health Cooperative and Bridge-Span — will offer 31 plans.

But with only one approved carrier, Clark County has the fewest plan options. Every other county in the state has at least 24 plan options — eight from LifeWise and 16 from Premera. The Premera rates are similar to the LifeWise rates for Southwest Washington, with most varying only $5 to $15.

Seven Washington counties — King, Kitsap, Pierce, Skagit, Snohomish, Spokane and Thurston — will have all 31 plan options.

Nine other insurers — including Kaiser Foundation Health Plan of the Northwest, Community Health Plan of Washington and Molina Healthcare of Washington — submitted applications to provide plans in the exchange but were not approved. Many, Kreidler said, were unable to guarantee access to certain providers and hospitals.

That, however, was not the problem for Kaiser, which applied to provide several plans in Southwest Washington, Kreidler said in a phone interview Thursday.

“Kaiser had several health savings accounts that didn’t meet the federal requirements of health savings accounts,” he said. “Even if they dropped those, then they would have to come back with all-new rates because of the impact on other plans.”

Kreidler said his office “tried our darndest and worked very closely with Kaiser” to get the plans in line with federal requirements.

“We just ran out of time,” he said.

The insurance commissioner’s office faced a July 31 deadline set by the Washington Health Benefit Exchange, the public-private partnership tasked with implementing the health insurance exchange. The exchange board will now review the approved plans and make a final announcement at its Aug. 21 meeting.

Andrew McCulloch, Kaiser Permanente Northwest regional president, issued a statement expressing his disappointment in the decision following Thursday’s announcement.

“We want this new marketplace to be as robust as possible, to ensure that more people have access to the health and care services they need,” he said. “Given our commitment to provide high-quality heath and care services to the communities of Southwest Washington, we’re reaching out to the Washington state insurance commissioner to seek the best path forward.”

Kreidler said his office will begin working with the denied carriers, and others that didn’t apply, this fall in order to get more plans qualified for 2015.

Other options

Even though only one carrier was approved to sell Clark County plans in the 2014 exchange, Kreidler said he anticipates local residents will have additional options outside of the exchange. Health plans purchased outside of the exchange, however, are not eligible for tax subsidies.

Nine carriers have applied to sell insurance plans outside of the exchange. Kreidler has approved three of those carriers’ plans and has until the end of September to review the others.

LifeWise, which provides coverage for more than 100,000 people in Washington, is awaiting approval for its plans outside the exchange. LifeWise’s plans are the same inside and outside of the exchange, with one exception. Plans outside the exchange include pediatric dental coverage and, as a result, have a slightly higher cost, said LifeWise spokeswoman Melanie Coon.

Offering plans inside and outside the exchange gives consumers more options, said LifeWise spokeswoman Nicola King. For example, people who are not eligible for subsidies and have an insurance broker they work with may choose to purchase their plan outside the exchange, she said.

“We wanted to make sure our members had the opportunity to do what was best for them,” King said.

Marissa Harshman: 360-735-4546; http://twitter.com/col_health; http://facebook.com/reporterharshman; marissa.harshman@columbian.com.