This week, states’ Marketplaces are busy preparing for the 2015 Open Enrollment Period. Marketplaces are reviewing projected enrollment and renewal figures and releasing searchable databases for 2015 health plan rates, among other activities. Read on for more details.
STATE HEALTH REFORM ACTIVITY
Colorado: Marketplace Board Reviews SHOP Current and Future Enrollment and Functionalities
The Connect for Health Colorado Board discussed the State's Small Employer Health Options Program (SHOP) Marketplace, reviewing the 176 qualified health plans and 16 dental plans offered in 2015. The presentation noted improved capability to support online change reporting. The presentation also reviewed Year One target enrollment of 1,000 employers and 8,000 covered lives. With actual enrollment in year one totaling 304 employers and 2,519 covered lives, the Year Two targets will remain the same as the Year One targets.
Colorado: Marketplace Board Reviews Open Enrollment Readiness Report
The Connect for Health Colorado Board convened to review a report that indicated operations are on schedule for the beginning of the Open Enrollment Period (OEP) starting November 15. Renewals processing began on October 13, including the basic functions to identify 2014 customers eligible for auto-renewal, redetermine tax credit eligibility and calculate new premiums; the State predicted at least 75% of customers will be eligible for auto-renewal and has sent renewal reports to carriers, brokers and assistance sites. The Readiness Report also discusses OEP sales and marketing strategies and operations and finance.
Iowa: CoOportunity Health Announces Exit from the Iowa Health and Wellness Plan
CoOportunity Health announced it is withdrawing from the "Marketplace Choice Plan," which covers Iowans newly eligible for Medicaid expansion on the Marketplace in qualified health plans (QHPs). At the end of November, CoOportunity Health's 9,700 Marketplace Choice Plan enrollees will begin receiving coverage through the Medicaid MCOs that have been covering Medicaid expansion individuals with incomes less than 100% FPL. The other carrier that has been providing coverage under the Marketplace Choice Plan, Coventry Health Care, will continue offering coverage and will accept all new Marketplace Choice enrollees in December while the State explores other options.
Minnesota: Rates Increase for MNsure and PreferredOne Customers
The State's Department of Commerce announced that premiums for MNsure's four carriers will increase by an average 4.5% in 2015, according to MinnPost. PreferredOne, the State’s largest and least expensive insurer on the Marketplace in 2014 that recently announced its withdrawal from the Marketplace for 2015, announced its individual market subscriber rates will increase by 63% on average off the Marketplace in 2015.
Nevada: Insurance Division Releases Searchable Database for 2015 Health Insurance Plan Rates
The Nevada Division of Insurance released 2015 health plan rates for the individual and small group markets available to consumers during the next open enrollment period both on and off the Silver State Exchange, noting that the number of plans has increased by 34% in the individual market compared to 2014. The Department released a serachable database where plans and rates can be sorted by plan name, carrier name, metal tier, and whether or not the plan is available on the Exchange. The information released also contains drug formularies and provider networks for associated plans.
Rhode Island: Independent Organization Issues Report on Sustainability of Marketplace
The Rhode Island Public Expenditure Council, an independent public policy research organization, released a brief that summarizes the current state of HealthSource Rhode Island (HSRI) and outlines pressing sustainability considerations for State officials and stakeholders. The report highlights that Rhode Island is one of four State-based Marketplaces that has applied to use federal funds through 2015. As the state works to develop a plan to make HSRI self-sustainable, the report recommends that stakeholders determine the goals and functions of HSRI, funding mechanisms to support those functions, and strategies to better integrate HSRI with other healthcare reform activities.
Vermont: Vermont Health Connect Provides Marketplace Consumer Activity Update
Administrators from the Vermont Health Connect provided an update on Marketplace consumer activity to the Vermont Medicaid and Exchange Advisory Board, indicating that since the beginning of 2014, 31,500 Vermonters have enrolled in qualified health plans and 58,464 Vermonters have enrolled in Medicaid through the Marketplace. According to the presentation, the State expects 3,000 to 5,000 new consumers to seek coverage in the 2015 open enrollment period. Finally, the board reviewed Marketplace call center activity; to date, the call center has received 478,700 calls, which, in October, had a less than a 0.5% abandonment rate.
FEDERAL NEWS
Federal SHOP Marketplace Launches Early in Five States
The Federally-Facilitated Small Business Health Options Program (SHOP) Marketplace launched early in five states, giving small businesses, agents, and brokers the opportunity to test pre-enrollment features before the official Open Enrollment begins on November 15. The features allow users to create an account, assign an agent/broker, and obtain an eligibility determination on the SHOP Marketplace. Earlier in October, the five “Early Access” states, which include Delaware, Illinois, Missouri, New Jersey and Ohio, participated in forums with HHS to provide feedback on the features prior to the launch.
CMS Releases Payment Methodology Notice and Other Documents Related to Basic Health Program
The proposed payment methodology used to determine federal funding for the Basic Health Program (BHP) in 2016 mirrors the final methodology used in 2015, according to a proposed notice issued by CMS. Payments will be made to states that elect to implement the BHP to cover individuals with incomes less than 200% of the federal poverty level who are otherwise eligible to purchase coverage through a Marketplace. CMS plans to issue a final payment notice by February 2015. To help calculate these payments to states, the Agency also released a data collection tool to collect State Based Marketplaces' premium information for select Marketplace plans. Finally, CMS released the final BHP Blueprint that requests information from states on program design, operations, and the legal compliance of their BHP programs. States must complete the Blueprint in order to receive federal certification for BHP.