Washington Certifies Plan Offerings for the 2021 Marketplace
On Thursday, September 24, 2020, the Office of the Insurance Commissioner (OIC) and the Washington Health Benefit Exchange Board (HBE) certified 2021 Qualified Health Plans (QHPs). These plans include new Cascade Care products (i.e., public option plans and standardized non-public option plans) that will be offered through Washington Healthplanfinder during the upcoming open enrollment period from November 1, 2020 through January 15, 2021.
Although public option plans for each of the five insurance carriers previously identified as apparently successful bidders (ASBs) were certified, the announcement notes that the Washington State Health Care Authority (HCA) is still working to sign procurement contracts for the plans.
Certified public option offerings differ from those proposed in that there are more counties with no public option plans available, public option plans are offered in fewer counties overall, and monthly premiums are lower.
Analysis
Geographic Availability
There is an overall decline in geographic availability of public option plans between carriers’ proposed offerings and those that have been certified. A public option plan will not be offered in Garfield county, increasing the number of counties with no public option from 19 to 20. Additionally, now only four counties (Adams, Kittitas, Pierce, and Yakima) are able to choose a public option plan from multiple carriers, down from six prior to certification. Kittitas has three carriers offering a public option, while Pierce, Yakima, and Adams each have two carriers.
Three out of the five public option plan sponsors are certified to offer public option plans in two fewer counties than originally proposed. Only LifeWise Health Plan of Washington and UnitedHealthcare of Oregon will offer public option plans in each county they filed rates for. Among those carriers serving fewer counties, Coordinated Care Corporation will not offer its public option plan in Garfield or Whitman counties; Community Health Network of Washington will not offer its public option plan in Cowlitz or Lewis counties; and BridgeSpan Health Company will not offer its public option plan in Adams or Garfield counties.
Premiums
Premium differences between standardized public option plans, standardized non-public option plans, and non-standardized plans narrowed from the time of plan submission to certification, with premiums decreasing an average of $185.57 across all on-exchange silver plans. Monthly premiums for silver-level public option plans, on average, ranged from $558.23 to $680.42 at submission, but are subsequently certified between $392.07 and $490.28. Silver non-standardized plans are certified between an average of $376.27 and $500.02, while non-public option standardized plans are offered, on average, between $385.20 and $528.00 per month.
The range of average monthly premiums is narrowest for silver-level public option plans (difference between high and low is $98.21), followed by non-standardized silver plans ($123.75), with silver standardized non-public option plans having the widest range ($142.80). The table below details the average monthly premiums in the certified rate filings for 2021.
Affordability implications of public option plans vary at the county level. In Cowlitz County where only one standardized non-public option plan will be offered, the monthly premium is certified at $510.16. This stands in contrast to Kittitas County where two standardized non-public option plans and three public option plans will be offered. There, premiums range from $400 to $490 for the public option plans and from $413 to $469 for the standardized non-public option plans.
Public option plans have either the lowest (see, e.g., Chelan, Douglas, Grant, Okanogan, Klickitat, in Appendix A) or second lowest premium when two standardized non-public option plans and one public option plan is offered (see, e.g., Jefferson, Kitsap, Lincoln, Mason). When more than one public option plan and more than one standardized non-public option plan are offered, a public option plan has the lowest premium (see, e.g., Pierce, Kittitas, Yakima). Public option plans are not the most expensive option in any county.
Certification centers on whether or not consumers have access to covered health care services and if the rates are reasonable in relation to the benefits for a particular plan offered in a particular county. In general, it appears the OIC’s certification process for 2021 served to reduce access to the public option geographically, but has improved the affordability of available plans. This means that public option plans may have been unable to satisfy provider access requirements in certain counties, and therefore had to be dropped. Additionally, the OIC’s review of plans’ financial information related to medical claims, administrative expenses, and profit or loss, could have uncovered miscalculations related to risk adjustment or other assumptions in the proposed rate filings. If such errors were identified, correcting them may have contributed to the rate reductions seen in the final rate filings. We want to emphasize that we do not have direct information about the reason for the substantial reductions in the rates certified so we are speculating regarding the cause of these changes.
Please find Appendix A in the PDF version here.
With the Support of Arnold Ventures