The Washington Health Benefit Exchange reached a milestone last week when its board provided final certification of health plans to be offered through Washington Healthplanfinder, the new online marketplace that opens Oct 1.
Following initial approval by the state Office of the Insurance Commissioner, the Exchange's board certified seven health insurance carriers at a special meeting held Sept. 4 to offer 35 qualified health plans (QHPs) for individuals and families through Washington Healthplanfinder. Additionally, four insurance carriers will offer pediatric qualified dental plans (QDPs), and one insurance carrier will offer plans in the small business market.
Eight additional multistate plans, which must be certified by the U.S. Office of Personnel Management (OPM) before they can be offered through Washington Healthplanfinder, could boost the total number of qualified health plans in the state to 43. Multistate plans are being provided by that federal agency and private insurance carriers to drive additional competition in health insurance marketplaces across the country.
"This is the first time that many Washingtonians will be able to shop for quality health care coverage," asserts Richard Onizuka, Washington Healthplanfinder's CEO. "These brand new coverage options will enable residents to find the important health care services they need at costs that best fit their budget."
Last week's special meeting decision came after the Exchange board voted to forego certification of QHPs and QDPs at its regular Aug. 21 meeting and at a special meeting on Aug. 29. The Exchange scheduled the special meetings to allow health plans in the appeals process with the state insurance commissioner's office to complete the process.
The insurance commissioner's office has reached appeal settlements with Community Health Plan of Washington, Kaiser Foundation Health Plan of the Northwest, and Molina Healthcare of Washington Inc., approving 12 additional plans.
Another special board meeting was held Friday, Sept. 6, to allow Coordinated Care, Dental Health Services, and Willamette Dental Group additional time to continue the appeals process with the insurance commissioner's office and potentially to receive certification from the board.
The federal Department of Health & Human Services (HHS) had agreed to provide the Washington Health Benefit Exchange with operational flexibility until Sept. 6. HHS had required all state-based exchanges to submit health plan information by Aug. 31. That flexibility doesn't affect the open enrollment start date of Oct. 1.
"Our goal was to offer as many plans to consumers as possible," says Margaret Stanley, chairwoman of the Washington Health Benefit Exchange board. "By allowing these health plans time to complete the appeals process, we were able to ensure that all offerings that met the requirements this year could participate in Washington Healthplanfinder."
The following insurance carriers, listed with the counties they will serve, were approved to sell health and pediatric dental plans through Washington Healthplanfinder:
•Premera Blue Cross—All counties except Clark.
•Group Health Cooperative—Spokane, Columbia, Franklin, Island, King, Kitsap, Kittitas, Lewis, Mason, Pierce, San Juan, Skagit, Snohomish, Thurston, Walla Walla, Whatcom, Whitman, and Yakima.
•LifeWise All 39 counties in Wash-ington state.
•Molina Healthcare of Washington, Inc.—Spokane, King, and Pierce.
•BridgeSpan—Spokane, King, Kitsap, Pierce, Skagit, Snohomish, and Thurston.
•Community Health Plan of Washington—Spokane, Adams, Benton, Chelan, Clark, Cowlitz, Douglas, Ferry, Franklin, Grant, Grays Harbor, King, Kitsap, Lewis, Okanogan, Pacific, Pend Oreille, Pierce, Skagit, Snohomish, Stevens, Thurston, Wahkiakum, Walla Walla, Whatcom, and Yakima counties.
•Kaiser Foundation Health Plan of the Northwest—Clark and Cowlitz (small business and individual markets).
The four carriers offering pediatric dental plans are Delta Dental of Washington, Kaiser Foundation Health Plan of the Northwest, LifeWise, and Premera Blue Cross.
The board certification ensures that each plan meets the requirements for qualified health plans and the 10 essential health benefits under the Affordable Care Act, including regular doctor's visits, maternity care, and hospital stays.
"Residents can rest assured that the health plans available on Washington Healthplanfinder will provide all of the important benefits for them and their family," Onizuka says. "Financial help will also be available to help cover the cost of monthly insurance premiums."
Kaiser Foundation Health Plan of the Northwest was the only insurance carrier that applied to sell health plans through Washington Healthplanfinder Business, which is intended to offer small employers added convenience and cost savings. Plans will be available for small businesses in Clark and Cowlitz counties with up to 50 employees. A more robust business marketplace is expected next year, the exchange said in a press release.
As has been reported previously, Washington Healthplanfinder is designed to enable shoppers to find a plan that fits their needs and their budget by offering side-by-side comparisons of health plans based on a variety of factors, such as cost and physician networks. Plan options will be broken down into metal tiers, including gold, silver, and bronze, based on the level of coverage they provide.
The Washington Health Benefit Exchange is a public-private partnership established in accordance with the Patient Protection and Affordable Care Act of 2010, also referred to as Obamacare. The exchange is separate from state government and is governed by an independent 11-member board.