Peninsula Daily News
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Peninsula Daily News
OLYMPIA — State residents struggling with their 2014 insurance plans because of billing problems with the state’s health exchange can try again during a special enrollment period announced last week by the office of Insurance Commissioner Mike Kreidler.
The limited enrollment period is now underway and runs through Nov. 14.
It allows those with unresolved problems with payments, claims or billings for their current health plan to “reset” their coverage by signing up for a different plan or with a different company for the remainder of this year.
Only people who signed up under the previous enrollment period are eligible. And they will still have to go through the normal open enrollment period from Nov. 15-Feb. 15 to purchase coverage for 2015.
“It’s not a perfect solution,” Kreidler said. “But it’s an option.”
Though it has fared better than most exchanges nationwide, Washington Healthplanfinder has hardly been without bugs and outages.
Officials at the exchange have estimated at least 6,000 accounts are affected by the billing problems.
Some people aren’t being properly credited by the exchange for their insurance payments.
Others were told by their doctors that the insurance company has no record of their coverage.
Exchange officials said the problems are a combination of software issues and human error and promised that major fixes will be made to the system.
A list of answers to questions about this temporary special enrollment period is available on the insurance commissioner’s website, www.insurance.wa.gov.
The state Office of the Insurance Commissioner and Washington’s Health Benefit Exchange Board have approved 10 insurers to sell 90 individual health plans across the state in next year’s exchange.
Three of those insurers will offer a total of 29 individual health plans in Jefferson and Clallam counties.
Another insurer will offer an additional nine plans, but only in Jefferson County.
This year — the first year of the state’s Washington Healthplanfinder exchange set up under the federal Affordable Care Act — Jefferson and Clallam residents had to choose from 24 plans offered by two insurers.
The two were Premera Blue Cross and its subsidiary, Lifewise Health Plan of America.
Now Clallam residents have three providers, and Jefferson has four.
Statewide, there were eight insurers offering 46 plans in various counties for 2014.
“I take the increased interest from health insurers this year as a clear sign that health reform is working,” Insurance Commissioner Mike Kreidler said in a news release.
“Consumers will have two more insurers to choose from next year, nearly double the number of health plans and a record low rate change.”
The insurance commissioner’s office also approved an overall average rate increase of 1.9 percent for 2015 — significantly lower than what the exchange’s insurers requested, which averaged 8.6 percent.
The exchange is where individuals who do not have employer-provided insurance and don’t qualify for the state Medicaid program can purchase coverage for themselves and their families.
Plans purchased inside the health exchange are eligible for federal tax credits to help pay for the cost of coverage.
The new plans will be available for purchase through Washington Healthplanfinder, www.wahealthplanfinder.org, during the upcoming open enrollment, which runs from Nov. 15 to Feb. 15.
Coverage for plans purchased before the end of the year begins Jan. 1.
For 2015, Premera Blue Cross is offering the same 16 health plans they provided this year.
Premera proposed a 8.1 percent rate increase for the plans. The insurance commissioner approved a 2.6 percent hike.
LifeWise will have the same eight plans it had for 2014.
It proposed an average rate jump of 8.9 percent. The insurance commissioner approved a 2.3 percent increase.
Moda Health Plan, Inc. — new to the health exchange — will offer five plans in Jefferson and Clallam counties.
Coordinated Care Corp. added Jefferson County to its now 16-county service area for 2015 and will offer nine plans.
Coordinated Care wanted a 11.2 percent rate hike; it got 2.5 percent.
The health plans fall under three “metal levels” — gold, silver and bronze. The metal levels represent different cost-sharing levels.
With bronze plans, the insurer pays 60 percent of costs, and the enrollee pays 40 percent.
Insurers cover 70 percent of health costs for silver plans, 80 percent for gold plans.
There is a fourth level — platinum — that covers 90 percent. But there are no platinum plans offered in Jefferson or Clallam counties.
■ Premera Blue Cross’ average silver plan for 2014 was $300.94 monthly. It will go to $308.76 in 2015.
■ LifeWise will go from $301.07 to $307.99 monthly for a similar plan.
■ Coordinated Care will go from $253.92 to $260.27 monthly.
The insurance commissioner is still reviewing applications from five health insurers that applied to sell plans outside of the exchange, one that applied to sell plans inside the exchange and one that applied to sell plans both inside and outside the exchange.
Decisions on those plans will come at a later date.
More than 3,400 North Olympic Peninsula residents signed up for a private health plan for 2014 through the insurance exchange during the first open enrollment period, Washington Healthplanfinder reported last spring.
Another 7,309 in Clallam and Jefferson counties became newly covered under Medicaid, the federal-state program for the poor and disabled, and 5,848 who were already on Medicaid had their status converted, redetermined or renewed though the exchange during the six-month enrollment period that ended March 31.
In Clallam County, 2,072 purchased a qualified private plan, 4,838 became newly covered under Medicaid and 4,437 had their Medicaid status changed.
In Jefferson County, 1,332 purchased a private plan, 2,471 became newly covered under Medicaid and 1,411 had their Medicaid status converted, redetermined or renewed through Washington Healthplanfinder.
Statewide, more than 600,000 Washington residents obtained new health insurance coverage during the first open enrollment period. A total of 164,062 signed up for a private plan; abut 450,000 adults obtained new coverage under Medicaid.