State certifies health, dental plans for sale next year

The board that oversees the state’s new online health-insurance marketplace has finally certified health and dental plans that can be sold through the exchange in 2014.

At a special meeting Wednesday in Seattle, the Washington Health Benefit Exchange Board voted for certification, an action it had been expected to take in August but twice postponed.

In the end, the board unanimously approved 35 health plans for the individual insurance market, one health plan for the small-business market and four pediatric dental plans.

Certification was a key step leading up to the state’s implementation of the Affordable Care Act, also known as Obamacare.

The certified plans now can be sold through the health-benefits exchange, called Washington Healthplanfinder, which opens for enrollment Oct. 1 and is a core component of Obamacare.

The federal Office of Personnel Management (OPM) is expected to certify eight additional health plans for the individual market in Washington. Altogether, there will be at least 43 individual health plans sold through the state exchange.

Wednesday’s vote restarted a process that had temporarily stalled. The board had been expected to certify plans for the exchange Aug. 21, but panel members at the time said they did not want to certify plans state Insurance Commissioner Mike Kreidler approved Aug. 1 until more insurers had an opportunity to get their plans reviewed again.

Kreidler had approved plans offered by four insurance carriers but rejected plans from five other carriers.

Four of the rejected carriers appealed Kreidler’s decision to an administrative-law judge.

In the past week, Kreidler reached settlement agreements with three of the carriers: Kaiser Foundation Health Plan of the Northwest, Community Health Plan of Washington, and Molina Healthcare of Washington.

The board Wednesday certified the plans offered by all three, as well as those from the four Kreidler had approved earlier: Premera Blue Cross; LifeWise Health Plan of Washington (a subsidiary of Premera); Group Health Cooperative; and BridgeSpan, a subsidiary of Cambia Health Solutions, which is the parent company of Regence Blue Shield.

In general, premiums for the plans from the three additional insurers came in somewhat higher than plans from the four companies previously approved by the state’s Office of the Insurance Commissioner.

Meanwhile, a fourth rejected carrier, Coordinated Care, is in talks with the commissioner’s staff.

During the public-comment period of Wednesday’s board meeting, Coordinated Care President and CEO Jay Fathi said the administrative-law judge ruled Tuesday night that the Office of the Insurance Commissioner should give “prompt, reasonable guidance” to the company to assist its staff in getting its health plans through the approval process.

The exchange board has scheduled a special meeting Friday, when it may vote on certifying Coordinated Care’s health plans.

In the small-business market, the board certified one insurer — Kaiser Foundation Health Plan of the Northwest — to offer health plans in Clark and Cowlitz counties, where the insurer will also offer plans for the individual market.

Kaiser was the only insurer that submitted plans to be sold for the small-business market through the exchange.

Four insurers have been certified to offer pediatric dental plans through the exchange: Delta Dental of Washington, Kaiser, LifeWise and Premera.

After the vote, board member Teresa Mosqueda said the panel’s decision to certify the plans should reassure the public that “we are moving forward.”

“We are going to be ready for open enrollment come Oct. 1, and we are going to have robust plan choices in every corner of this state for all of the population at all incomes,” said Mosqueda, who is legislative and policy director for the Washington State Labor Council and chairwoman of the Healthy Washington Coalition.



Source: Seattle Times


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