Iowa Health Insurance Exchange

[ctg]

From Wellmark this morning...

"Wellmark has decided to participate in the public health insurance exchanges in Iowa and South Dakota beginning with the 2015 open enrollment period. Wellmark is committed to providing quality health insurance for years to come. Although we will not be on the public exchange initially, we have made significant investments in a new information technology platform so we can offer Affordable Care Act (ACA)-compliant plans in 2014, and to prepare for participation in the exchange."

We'll see what they say July 18 at the Agent Forum.

 

[timsip]

He said the decision to delay was not financially motivated, but based on concern that implementing the exchange would be bumpy in year one.

KCCI.com

This is good for me! I don't expect a different position from GR, so it looks like 1-2 players only in Iowa. This will be released soon.
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A grand total of six companies have applied for the Iowa Marketplace. Of these six, only two are applying for state-wide coverage those two being Coventry and the new Co-Op which is also offering small group state-wide; two are applying for regional IFP and small group while the last two of the six are only applying for regional small group.

Two of the companies, Coventry Health Care of Iowa, Inc. and CoOportunity Health, are expected to offer statewide coverage for individual health care coverage, while CoOportunity Health also applied to offer statewide small group plans. Two insurers applied to offer individual and small employer group plans for smaller regional markets. Those companies are Avera Health Plans and Gunderson Health Plan, Inc. Two companies; Sanford Health and Health Alliance Midwest, Inc., have applied to offer small group plans only.

The companies:
Coventry
CoOportunity Health
Avera Health Plans
Gunderson Health Plan, Inc.
Sanford Health
Health Alliance Midwest, Inc.

I am noticing that these smaller regional plans are heavily Medicare companies. A growing trend across many states.

 

[anonymous1]

Should be interesting. Coventry and the co op only two state wide players. Avera and Sanford are hospital networks Haven't heard of the other two. This could almost be fun here in iowa. I would like a price check please

 

[timsip]

Should be interesting. Coventry and the co op only two state wide players. Avera and Sanford are hospital networks Haven't heard of the other two. This could almost be fun here in iowa. I would like a price check please

Good luck with that price check. You can expect that info right before commissions, but only a day or two I am sure. I think the consensus for when commissions being released is somewhere no earlier than September 30th.

I know we aren't the only three agents in Iowa, but I haven't seen or heard much from anyone else around Central Iowa. Life could be getting better for us over the next twelve months.

 

[Yagents]

Iowa's largest insurance provider delays participation in health exchange



DES MOINES, Iowa — The chairman of Iowa's leading health insurer says the company will not participate in the state's health exchange during 2014.
Wellmark Blue Cross and Blue Shield CEO John Forsyth said Monday that the insurer will enter the online insurance marketplace in 2015. He said the decision to delay was based on concern that implementation would be bumpy in year one.
Sunday was the deadline for insurance carriers to file for inclusion in the Iowa exchange next year. Iowa's insurance commissioner announced Monday that six companies applied. Two will offer statewide plans for individuals, while the other four will offer plans with regional limits or that apply to group insurance.

 

[ctg]

The only reason I even know of Gunderson is that they have the only 5 star MA plan in Iowa. And I believe they are only in NE Iowa and SW Wisconsin.
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I know that Wellmark says that they are delaying until 2015 because of implementation concerns, and I suspect it will be bumpy in year one, but is there another reason? Do they expect to keep their clients through 2014 by allowing them to renew through December and let the other carriers be the guinea pigs in this grand experiment?

 

[timsip]

I was suspecting Gunderson to just cover a few NE counties around Dubuque. Too far for me to drive, it's all yours!

With Wellmark, I actually think this is where they (and GR for that matter) is wanting to dump their high risk clients. They haven't had to send out rebates to date yet they continue to have 9-12% increases annually. The only way this can happen is if they are full of unhealthy clients. These unhealthy clients are with Wellmark because they can't get approved with another carrier today, but that doesn't mean they are happy with paying the high rates they are. As soon as this segment sees their subsidy eligibility, I predict they will jump ship. In fact I am going to bank on that and use it in my marketing. This could provide them with an opportunity in 2015 to come in with lower rates as Coventry and CoOpportunity either bow out or drive their prices up to recoup all their losses from year 1. In comes Wellmark and Golden Rule with rates in 2015 that are similar to what Coventry was charging in 2014 while Coventry has to increase their rates another 50% in 2015. Now everyone that jumped to Coventry is seeing another big increase, they are going to take their subsidy and find a similar plan, but for half the price. If they have 15k in subsidies, they can find the lowest priced plan in the coverage level they want and it probably will be with Wellmark or Golden Rule. Don't rule out Assurant, they too will be in play in 2015. I am thinking 2015 will be just as good as 2014 if not better.

 

[AllenChicago]

Because many parts of Iowa have hospitals that are more than 50 miles distant from each other, let's hope for the people's sake that the participating companies have comprehensive Networks where they operate.

Twelve thousand dollars Out-of-Pocket potential will already be a turn-off to most families. If the closest hospital is out-of-network, that $12,000 is doubled! I have the suspicion that "ObamaCare" will generate lots of honest-to-goodness ANGER in rural America.
-ac

 

[timsip]

There is a lot of truth to that, Allen. Every state I think is going to see this problem. Most rural areas will probably be very limited in their options. These are also the ones that have the most limited income and will be impacted the most.

 

[Yagents]

National Underwriter - July 2013

Article on Iowa carriers, or lack there of