Reprinted from HEALTH PLAN WEEK, the most reliable source of
objective business, financial and regulatory news of the health insurance
industry.
By Patrick
Connole, Managing Editor
September 29,
2014Volume 24Issue 33
Last time out was a disaster. This time
will be different. That is the hope of health insurers as they prepare to
implement strategies for the second public exchange open-enrollment period
beginning on Nov. 15 and running to Feb. 15, 2015. What health plans and
strategists expect this time around is a more nuanced, knowledgeable approach
to how things work, from how plans are priced and marketed to consumers to how
education efforts are conducted. The disaster of last year’s open-enrollment
period was technical in nature, out of the control of health insurers; this
year’s focus will be on “normal” business issues, market watchers say.
Part of that new normal will be more
insurers. HHS has said that a full 25% jump is expected in insurer
participation, which is simply “amazing,” according to Paul Lambdin, national
leader of exchanges and retail practice leader for Deloitte Consulting LLP.
“That’s a big increase,” he tells HPW, saying the jump in players is
indicative of the growing stability of the marketplaces, in part validated by
UnitedHealth Group’s strategy to increase its entries from just five exchanges
in 2014 to two dozen in 2015. “United decided to jump in this year in a much bigger
way,” Lambin says.
In raw numbers, HHS said participation
in the 36 federally facilitated states is expected to increase from a combined
191 insurers in the 2014 enrollment period to 248 in 2015. Eight of the states
managing their own exchanges will have a combined 67 insurers next year versus
the 61 active in 2014. Those numbers do not include counts for state-run
marketplaces in Hawaii, Kentucky, Massachusetts, Minnesota and Vermont, along
with Nevada and Oregon. The final two states plan to join HealthCare.gov after
suffering debilitating technical problems during the 2014 open-enrollment
period.
Exchange Plans Are Finalized
More intense insurer interest should
help contain prices, considering that HHS has estimated that every new insurer
participating equates to 4% lower premiums for people in that region.
Insurers Consider New Strategies
Since this is the second time around
for most insurers, this open-enrollment period will feature plan offerings
designed to appeal to consumers’ tastes as indicated by their 2014 selections.
BlueCross BlueShield of Tennessee, for instance, says it will be throwing out
some plans and replacing them with others. “The plans themselves are not
dramatically different. But we took a dozen off that didn’t seem to sell as well
and added back a dozen or so we think might do better. Overall, it is pretty
much the same portfolio, but we learned people like zero-premium type things
[for instance],” Henry Smith, senior vice president and chief marketing officer
for BlueCross BlueShield of Tennessee, tells HPW. There will also be
renewed efforts to market coverage options to younger people and to Hispanics,
he adds.
Rosemarie Day, president of Day Health
Strategies, tells HPW that she expects most returning plans to stay the
course in 2015, and agrees that new entrants increase competition and could
help lower prices. But she cautions that some markets could get to the edge of
overwhelming consumers with too many choices. Day also points to new
Medicaid-oriented insurers coming to exchanges as a possible avenue for
enrollees to find more affordable options. As for returning enrollees, price
will likely determine their decision-making. “As long as there is not price
shock, they should re-up….[Consumers] generally take the path of least resistance,”
Day says.
Lambdin expects insurers to put a
“little more force behind outreach” this open-enrollment season, having learned
that exchange customers are sometimes hard to reach, need plenty of education
about health insurance and, despite being in an online marketplace, want
in-person help. “[Plans were] somewhat surprised last year, since it became
very important to have that personal touch. So I think there is a new
appreciation to not be overly reliant on social media and online, and instead pay
attention to broker networks, for example,” he says.
Indeed, Smith says the Tennessee Blues
plan is making face-to-face marketing a big part of its efforts, driving a
mobile van across the state to educate and explain exchange offerings and
health insurance in general, as well as operating a consumer information center
designed for outreach purposes. Even though many consumers are tech savvy, they
still want that in-person experience, Smith adds.
Lambin says plan designs seem pretty
stable for 2015, with insurers focused mainly on getting networks in place.
“For plan designs, there is not much new going on there, with talk broadly
still about creating the right price point to compete without really knowing
where other plans will be. It really comes back to the right network
design….Plans are laser-beam focused on getting the geography right,” he says.
The way insurers have looked at
exchanges is over a three-year window, Lambdin says. “They set first-year
prices not knowing anything in a brand-new market, making a lot of assumptions
on small group or individuals,” he says. “And they are really making
second-year rates on another set of assumptions. So there will be enough noise
out of the process in the third year, and insurers can say, ‘we feel good, we priced
to break even, and did so to the best of our ability.’”
Tweaks, Not Major Changes Are Coming
Anna Nielsen, spokesperson for
SelectHealth, the insurance arm of Intermountain HealthCare, tells HPW
that she expects the low-cost service areas of Idaho and Utah in which the
carrier operates to remain so for 2015. “Overall, SelectHealth is offering an
array of plans designed to meet the needs of our community. To help consumers
to compare plans, we offer consistency between plan benefits wherever possible.
In addition, pediatric dental benefits are embedded into plans offered in
Utah,” she says.
Alex Kepnes, a spokesperson for Humana
Inc., says the insurer intends to participate in exchanges in 15 states for
2015. “There is still a strong need for basic information and education on
health coverage. The more knowledgeable people are about health coverage, the
more empowered they are to make smart choices about their unique health needs,”
he says.
In Nebraska and Iowa, CoOportunity
Health says pricing is always a factor for consumers, regardless of the number
of competitors available. “In Nebraska, there is one new player that is priced
highest in the market and one who has come off the marketplace (Health
Alliance) so we don’t expect much change,” says Leigh McGivern, spokesperson
for the insurer. CoOportunity, a Consumer Operated and Oriented Plan (CO-OP)
created under the Affordable Care Act, bested its initial business projections
in its two markets (HPW 2/24/14, p. 1).
http://aishealth.com/archive/nhpw092914-01?utm_source=Real%20Magnet&utm_medium=Email&utm_campaign=53975469
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