Plans, rates laid out for health plans under state's new insurance exchange

The exchange is one of the outcomes of the Affordable Care Act.

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OLYMPIA — Washington state's insurance commissioner on Thursday announced that he's approved 31 plans that will be part of the state's new health exchange.

Commissioner Mike Kreidler said that he's authorized the individual health plans and rates of four health companies that will sell the plans in the exchange starting on Oct. 1. Of nine companies that applied to sell health plan in the exchange, the four that were approved are: Bridgespan, Group Health Cooperative, LifeWise and Premera Blue Cross.

“This is a real milestone for us,” Kreidler said during a phone interview after the announcement.

The plans must receive final approval by the board of the Washington Health Benefit Exchange, which is expected to issue a decision at a meeting later this month.

LifeWise is the only company that will offer plans in all 39 counties. Premera Blue Cross will sell in all counties except Clark; Bridgespan will sell in King, Kitsap, Pierce, Skagit, Snohomish, Thurston and Spokane counties; and Group Health Cooperative will offer plans in Benton, Columbia, Franklin, Island, King, Kitsap, Kittitas, Lewis, Mason, Pierce, San Juan, Skagit, Snohomish, Spokane, Thurston, Walla Walla, Whatcom, Whitman, and Yakima counties.

“We're now one step closer to giving Washington consumers access to affordable health insurance,” Kreidler said in an earlier written statement. “Many of the companies will look the same, but they're going to sell all new plans with much better benefits.”

Kreidler said that the approved rates are 1.8 percent lower than what the companies originally requested. Rates very based on factors like age, home county, smoking habits and choice of plan.

For example, under a basic LifeWise plan that covers essentials with a deductible of nearly $2,000, a 40-year-old non-smoker in King County currently pays $247 a month. Under a LifeWise plan with a similar deductible in the exchange, that would increase slightly to $254 a month, though that person would gain coverage for prescription drugs and maternity care and have limits on their out-of-pocket spending. A 21-year-old non-smoker in King County who currently pays $172 under the same LifeWise plan would see an increase in premium rates to $251 a month under the exchange, though state officials say that person would likely be eligible for federal subsidies, based on their income, to offset some or all of that increase.

A 60-year-old smoker in Yakima County with the cheapest Group Health plan would see their monthly premium increase to $517 a month in the exchange from the current $374 a month they pay now, not counting federal subsidies that would lessen the increase. Under the federal health care law, annual out-of-pocket costs including deductibles and copays are capped at $6,350 for an individual and $12,700 for a family.

“You can't really do an apples-to-apples comparison, because these benefits are so different,” said Stephanie Marquis, a spokeswoman for Kreidler.

Group Health Cooperative, LifeWise and Premera also have approved individual plans for outside of the exchange, and six additional insurers have applied for plans outside of the exchange, but Kreidler has until the end of September to approve those plans and rates.

Melanie Coon, a spokeswoman for Premera, said the company is in the process of getting ready to help guide customers through the process.

“Everyone has different needs,” she said. “Each customer's experience is going to be different.”

The companies who applied but were not approved to be part of the exchange were: Moda Health Plan, Inc., Kaiser Foundation Health Plan of the Northwest, Community Health Plan of Washington, Coordinated Care Company and Molina Healthcare of Washington, Inc.

Kreidler said that some of those not approved couldn't guarantee accesses to certain providers and hospitals.

“It's our duty to make sure that if you buy a health plan, you can actually see the doctor or hospital that provides the service you need,” Kreidler wrote in the statement. He said that the state would work with those companies to try and get them approved for sale in 2015.

Kaiser is the only company that has applied to sell small employer plans inside the exchange, and its application is to sell only in Clark and Cowlitz counties. Kreidler is still reviewing that application, and a decision is expected next week.

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