Kaiser, Community Health Plan approved to sell on insurance exchange

County residents' options increase from eight plans to 18

By Marissa Harshman, Columbian health reporter

Published:

Updated: August 30, 2013, 6:49 PM

 

The health insurance exchange just got more competitive in Clark County.

State Insurance Commissioner Mike Kreidler announced Friday his office had reached agreements with Kaiser Permanente and Community Health Plan of Washington to add 10 more health plans to the state-based insurance exchange.

Clark County residents will benefit the most from the news.

Of the four insurance carriers approved earlier this month to sell plans on the state-based exchange, only one was approved for Clark County -- leaving local uninsured residents with the fewest options in the state.

LifeWise Health Plan of Washington, which currently serves about 6,800 Clark County residents, was approved to offer eight health plans on the exchange, which is where uninsured individuals will buy coverage for themselves and their families under the federal Affordable Care Act. Every other county in the state had at least two insurers offering 24 plan options.

But Friday's announcement means Clark County residents -- while still having the fewest plan options in the state -- can choose among 18 plans from three insurers.

When the exchange opens for enrollment Oct. 1, Kaiser will offer seven health plans for residents of Clark and Cowlitz counties. Community Health Plan of Washington will offer three plans in 26 Washington counties, including Clark.

The two insurers will add to the exchange three bronze-level plans, which cover 60 percent of health costs; four silver plans, which cover 70 percent of costs; and two gold-level plans, which cover 80 percent of costs. Kaiser will also offer a catastrophic coverage plan.

Kaiser and Community Health Plan had both appealed the insurance commissioner's earlier decision to deny their applications. While the appeal was pending, the commissioner's office met with the health insurers and reached a settlement clearing both companies to participate in the exchange.

"We are pleased to have reached a settlement with the Washington Insurance Commissioner," Kaiser Vice President Sue Hennessy said in a written statement. "This is an important step forward."

The board for the Washington Health Benefit Exchange still has to grant final approval of the 10 plans, as well as the 31 originally approved by the commissioner's office. The board has a meeting Sept. 4 to consider plan approval.

The board was originally scheduled to approve the plans Aug. 21, but members of the board, state legislators and other stakeholders raised concerns about the lack of options. The board asked the insurance commissioner and exchange staff to work with insurers to get more plans cleared for the exchange. The federal government granted the state an extension to its July 31 deadline to submit plan information. The state now has until Sept. 5.

Two more appeals

Two other insurers that were originally denied -- Coordinated Care Corporation and Molina Healthcare of Washington -- also appealed the insurance commissioner's decision. Molina dropped its appeal but resubmitted the appeal Thursday evening.

Once the appeals were filed, Kreidler began settlement discussions with only those companies he believed could make the necessary fixes to their plans before the federal Sept. 5 deadline -- Kaiser and Community Health Plan.

Both insurers had issues to resolve before the commissioner would grant approval.

Kaiser had to correct its rate information so it was complete and matched other information it had filed. Kaiser also had to ensure its plans with health savings accounts met federal standards, according to Kreidler's office.

Community Health Plan of Washington had to drop its proposed two-tier pricing structure. The insurer intended to provide a no co-pay option at community clinics.

"Unfortunately, under Washington state law, charging different co-pays for the same type of provider can look like discrimination, steering lower-income residents to only certain providers," according to Kreidler's office.

An administrative law judge is reviewing the appeals by Coordinated Care and Molina.

"I wish I could have entered settlement talks with all of the companies that appealed," Kreidler said in a news release. "Unfortunately, I believed the substantial issues facing Coordinated Care could not be addressed in time to meet the Sept. 5 deadline."

Gov. Jay Inslee applauded Kreidler's announcement Friday and thanked him for his rigorous review of the plans.

"With enrollment beginning on October 1, I want to recognize all the good work of Mike and everyone involved in setting up this ground-breaking new health care exchange," Inslee said in a news release. "Healthy families lead to a healthier economy. With 1 million more Washingtonians soon gaining access to affordable health care coverage, this is a huge step forward for Washington."


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