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Health care exchanges look more appealing to insurers the 2nd time around

Health care exchanges look more appealing to insurers the 2nd time around

Health insurers appear to be increasingly bullish on the fledgling state and federal exchanges, in spite of disastrous rollouts in many of the online marketplaces last fall. Mounting evidence suggests more health plans are poised to compete for exchange business during the 2015 open-enrollment period.

In most states, insurers don't have to submit products until May or June, and in most cases, they have until September to withdraw coverage offerings. Insurers are currently scrutinizing the emerging enrollment data for 2014 to determine market opportunities and offer competitive products. The next open-enrollment period is scheduled to begin Nov. 15.

UnitedHealth Group Inc. executives indicated on a Thursday call discussing their first-quarter financial results that the company expects to be more active in the exchanges in 2015. The Minnetonka-Minn.-based insurer took a more cautious approach to the exchanges this year than some of its competitors, particularly WellPoint Inc.

UnitedHealth to expand exchange presence as profits dip “We do have a bias to increase that participation in 2015,” Gail Boudreaux, executive vice president of UnitedHealth Group said. “The size of the overall market is positive.”

Cigna Corp. has expressed similar willingness to expand its offerings for 2015. The Bloomfield, Conn.-based company was active in five exchanges this year. "We have a bias to extend, but it's (to be determined) right now,” David Cordani, Cigna's president and CEO, said earlier this month, according to Reuters. “There is a lot of work to be done over the next couple of months.”


In addition, Wellmark Blue Cross and Blue Shield plans to compete in insurance exchanges in South Dakota and Iowa in 2015, after sitting out the initial enrollment period. The company cited risk-adjustment protections included in the federal health care law as one of the reasons for its willingness to take a chance on the emerging markets.

Some start-up nonprofit insurers have plans to expand into neighboring states in 2015. The marketplaces in West Virginia, Idaho and New Hampshire will all have new not-for-profit competitors seeded with grants or loans under the reform law's Consumer-Operated and Oriented Plan program.

Several other states have indicated that they expect more competing plans in 2015, but aren't yet naming firms. Among those are Washington, Rhode Island, Kentucky, Michigan and California.

“We have seen interest from at least two companies that would like to come into the marketplace and are working very diligently to be prepared to do that,” Bill Nold, deputy executive director of the Office of the Kentucky Health Benefit Exchange, said on a call with reporters last week organized by Families USA, a consumer-advocacy group that has championed the health care law.

Officials in other states said that it's still too early to know whether there will be more competition in 2015. David Gonzales, executive director of the Texas Association of Health Plans, said that 12 companies sold products in the state in 2014, with an average of three to five competitors in each market. But he doesn't know how the next enrollment period will compare.


“I know there are deadlines quickly approaching,” Mr. Gonzales said. “Our plans have not given me any indication, nor do I think they've given anybody else any indication, about how they plan to approach 2015.”

There has been considerable speculation that premiums could increase by double digits next year. But research from the Society of Actuaries suggests that increases in the realm of 6% to 8.5% are more likely—which is in line with rate hikes in recent years.

Paul Demko writes for Modern Healthcare, a sister publication of Business Insurance.