Ritter Insurance Marketing, Craig Ritter

Health Care Marketplace Good News Roundup

Despite a myriad of carrier exits this year, there are still insurers working to offer Americans affordable coverage through the health care exchange. Here are a few recent stories to highlight places where the ACA marketplace has seen success.

Jump to state: Arizona Colorado Maine North Carolina


Maine CO-OP Making a Comeback

Community Health Options, Maine’s health care CO-OP, recently received approval from CMS to offer individual and small-group coverage on and off the exchange for 2017.

As of July, CHO had more than 65,000 Maine beneficiaries and just over 11,400 members in New Hampshire. CHO holds roughly 72 percent of the individual health market in Maine.

CHO expanded their coverage into New Hampshire in 2015, but after suffering significant losses, the CO-OP announced it would not offer plans in the New Hampshire marketplace this enrollment period.

Officials from the Maine Bureau of Insurance say they will continue to closely monitor the CO-OP’s efforts to stabilize its finances. In a recent email with the Portland Press Herald, a CHO spokesman said the company is “well on target” with their 2016 recovery plan.

Moving forward, insurance regulators in New Hampshire say they’re open to the idea of CHO returning to the state marketplace in 2018.

 Back to top

Marketplace Prices Fall in Colorado

Colorado residents who enroll through the marketplace and receive subsidies are in for a pleasant surprise this year. One actuary has predicted that these enrollees will see an average 11% decrease in their monthly premiums for 2017.

If these members choose to shop around for new coverage, they could potentially find even better cost-saving opportunities of about 29 percent.

Plan Type Avg. Premium Change
Silver 5% decrease
Bronze 22% decrease
Gold 4% increase

* No carriers are offering Platinum plans on the Colorado exchange for 2017.

For those without subsidies, plan costs will rise by an average of 24 percent next year. However, many of these consumers could save roughly 9 percent on their premium if they shop around for a new plan.

But the best way for unsubsidized enrollees to save money? Check your eligibility!

According to a government report released on October 4, nearly 80 percent of residents are eligible for federal tax credits, but only about 50 percent know they qualify. On top of that, the report estimates that an additional 50,000 Colorado residents were eligible for exchange subsidies in 2016, but they couldn’t claim them because they didn’t enroll through the state marketplace.

Back to top

North Carolina Retains Major Carrier

Blue Cross Blue Shield of North Carolina, the state’s largest health insurer, will again offer on-exchange coverage in all 100 counties for 2017.

In an op-ed penned for the local newspaper on October 1, BCBSNC President and CEO Brad Wilson expressed a strong sense of personal responsibility to the people of North Carolina in regards to the company’s resolution to stay in the marketplace.

Wilson wrote that, as part of their decision, the company considered the fact that Aetna and UnitedHealthcare had already announced they would not be offering on-exchange coverage for 2017. These carrier exits left more than 250,000 North Carolina residents in need of new plans for next year.

BCBSNC currently insures about 300,000 residents in the state, but the inclusion of new members who lost their Aetna and UHC coverage would nearly double the number of people the company serves. Wilson admitted that a huge influx of new members would be a challenge for the company – but one they’re willing to face. “The risk of not meeting our highest service standards is worth it in order to give people a chance to be insured.”

The CEO wasn’t just posturing. Roughly 85 percent of North Carolina residents will have only one on-exchange carrier to choose from for 2017. Although the limited choice isn’t exactly great, there are still 600,000 health care marketplace enrollees who likely wouldn’t have any coverage without BCBSNC.

In more good news for consumers, more than 90 percent of residents qualify for subsidies. Since subsidies increase proportionally to premiums, roughly 72 percent of enrollees will actually pay the same or less than they did this year if they enroll through HealthCare.gov.

Back to top

Arizona Counties Get a New Option

Missouri-based Centene will offer HMO plans in Maricopa and Pima counties under the name Ambetter for 2017.

Currently, Centene is the only option for Maricopa residents who want to obtain coverage through the health care marketplace. Still, this is welcome news for the more than 150,000 residents of Maricopa – Arizona’s most densely populated county – who will need to find a new plan during open enrollment.

The dwindling competition has even led some carriers to team up for the greater good. In September, Centene announced plans to partner with Cigna to offer an expanded provider network to its members. Cigna will grant Centene beneficiaries in-network access to its roughly 100 doctors and 50 advanced-practice nurses in Arizona.

Centene’s expansion brings good news for job-seekers as well. The insurer is looking to fill more than 100 positions in the Arizona area by November 1.

However, this announcement doesn’t change the fact that another Centene subsidiary, Health Net, will no longer offer its PPO plans in Arizona for 2017.

Regardless of the carrier, enrollees would be wise to look into their federal tax-credit eligibility before choosing a new plan. Even though roughly 85 percent of Arizona residents qualify for subsidies through the exchange, experts report that nearly 30,000 people who qualify didn’t take advantage of the tax credits.

Back to top

Posted by filed under Affordable Care Act, Arizona, Centene Corporation, Colorado, Maine, North Carolina .

© Ritter Insurance Marketing