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Washington Healthplanfinder

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Washington Healthplanfinder

Washington Healthpathfinder
Agency overview
Jurisdiction Health insurance marketplace for U.S. state of Washington
Agency executive
  • Richard Onizuka, CEO
Website .orgwahealthplanfinder

Washington Healthplanfinder is the online health insurance marketplace in the state of Washington, created in accordance with the Patient Protection and Affordable Care Act. It operates together with the Washington Benefit Exchange. In 2013 it received approval for more than $150 million in federal funding.[1] $26.3 million in funding from the American federal government has been for advertising and promotion.[2] The marketplace web site also allows people to sign up for Apple Health.

The marketplace operates a web site and a call center and is a resource for families and small business to compare and enroll in health insurance plans. It also provides enrollees with access to tax credits. Enrollment started on October 1, 2013. During the first month of operation 7,091 people enrolled through Washington healthplanfinder.[3] It is estimated that there are one million medically uninsured individuals living in Washington state.[4]

In November 2013 the exchange board voted to increase the CEO’s pay by 13%. [5]

Overview

There are three basic plans with varying levels of coverage available for Washington residents: Bronze (60 percent), Silver (70 percent) and Gold (80 percent). Plans with a lower percentage have lower premiums, and higher costs to the individuals (out-of-pocket costs, deductibles and co-payments). A catastrophic plan is available and designed for younger individuals (under the age of 30) and these plans will have a high deductible and a lower premium.

In 2013 no Platinum plans were not available in Washington.[6][7]

Goals

Marketplace administrators hope to sign up 130,000 people by the end of 2013, and a further 280,000 people in 2014. The ultimate goal is to have all of Washington's 6.5 million residents consult the exchange website to see what healthcare opportunities are available to them.[2]

GMMB,[8] a market research firm with offices in Washington D.C. and Seattle which will be receiving $19 million of the federal funds, said that many uninsured Washington residents are skeptical about finding an affordable health insurance plan. Washington Healthplanfinder is working with community groups to try to overcome this obstacle.

History

Timeline

  • Regular updates posted on Facebook (YouTube is under consideration)
  • August 20, 2013 first radio ads
  • August 21, 2013 first online ads
  • week after Labor day first print ads[2]
  • August 31 deadline for submitting plan information[9]
  • mid September TV commercials
  • mid September TV commercials
  • October 1, 2013 website available to the public to:

Choice of healthcare insurance companies

The announcement of the companies to be included in the Washington healthcare exchange was announced on August 1, 2013. Mike Kreidler, Washington State Insurance Commissioner said his office had approved four different companies offering 31 different plans. He rejected five other companies that also applied.[9]

On September 4, 2013 the Washington Health Benefit Exchange Board approved six health insurance companies (plus one affiliate company) approved earlier by the State Insurance Commissioner.[11] On September 5, 2013 the State Insurance Commissioner approved[12] the earlier rejected Coordinated Care Company after a judge ruling on September 2, 2013 ordering the Insurance Commissioner to iron out issues that prevented the addition of Coordinated Care to the list.

The Washington Health Benefit Exchange Board approved a total of five (plus one affiliate company) non-Medicaid companies, two Medicaid companies, and 38 health plans just hours before the federal deadline for approvals expired. (The federal Office of Personnel Management is expected to approve eight additional health plans available in all states.)[11][12]

October 1, 2013 exchange opens to the public

During the first week of enrollment 9,452 people were enrolled in insurance plans offered through the marketplace, and a further 10,000 completed applications. 165,000 people visited the website 837,000 times and 39,000 accounts were set up according to marketplace spokesman Michael Marchand. The call center kept the average caller waiting for an average of 10 minutes.[13]

On October 22, 2013, the Seattle Times reported that 35,500 Washington residents had already enrolled though the web site, but of those only 4,500 had enrolled in private insurance and the other 31,000 enrolled in Medicaid. 70,000 additional residents had completed applications.[14]

2014 enrollment

In its February 2014 final report the Washington Health Benefit Exchange provided the following statistics for 2014 enrollment:

  • Total enrollment was 105,404
  • Medicaid Newly Eligible Adults 214,688
  • 35% of exchange (non-Medicaid) enrollees were aged 55–64
  • The total number of enrollees in both Medicaid and the exchange is 768,027
  • 25% of Exchange enrollees located in King County
  • 55% of Exchange Enrollees were women
  • Slightly less than 55% of Medicaid Enrollees were women

2015

Open enrollment

Enrollment for 2015 will start on November 15, 2014 and end on February 15, 2015.[15]

  • Individuals enrolled in the exchange in the previous year must re-enroll if they want to maintain marketplace insurance plans or Premium tax credits
  • The individual mandate penalties administered through the IRS will increase to the greater of 2% of adjusted household income, or $325 per person and $162.50 per child to a maximum of $975 per family in the 2015 tax year
  • Businesses with 50 or less employees can obtain health plans and tax credits on the exchange for the first time
  • The number of health plans offered has doubled from the previous year to 230
  • Rates have increased by an average 1.5%
  • A Platinum plan is available for the first time on the exchange
  • Call center help personnel has tripled to 500 individuals
  • There are 2,500 insurance brokers in Washington licensed to enroll consumers in the marketplace[16]

2015 1095-A forms mailout

On February 9, 2015, Lisa Stiffler wrote in the Seattle Times that Form 1095-As were mailed out to most 130,000 clients accounts. But, not everyone was able to view the forms through Washington Healthplanfinder website. Some tax forms have not been mailed because of problems with the data, including the need for information from the IRS. [17]

Change in billing

In September of 2015, Washington Health Benefit Exchange (WHBE) made a change to premium payments. Instead of users paying WHBE, they were asked to pay directly to their insurance company. This change affected all one hundred fifty five thousand people enrolled with WHBE. The aim of the change was to free WHBE from the billing portion of the system and alowl it to concentrate on providing comparisons of health plans. [18]

Approved companies

[19]

On Sept 25, 2013, the Seattle Times said there were 46 health care plans in the marketplace.[20]

Approved companies by county

[21]

Approved Medicaid companies

Advertising in other states

Oregon and Colorado have been running TV commercials since the beginning of summer 2013. [23]

Governance

A nine-member board oversees the Washington Health Exchange, led by chief executive officer Richard Onizuka.

Washington Health Exchange Board

Management team

  • Richard Onizuka, Chief Executive Officer
  • Pam MacEwan, Chief of Staff
  • Bob Nakahara, Chief Financial Officer
  • Molly Voris, Director of Policy
  • Beth Walter, Director of Operations
  • Curt Kwak, Chief Information Officer
  • Michael Marchand, Director of Communications
  • Keith Bell, Director of SHOP
  • Brian Peyton, Director of Legal Services

Customer support program

A toll-free customer support call center operated by Faneuil has been operating in Spokane since September 3, 2013. It offers assistance in 175 languages by phone and through email during weekdays.

The center employees are trained to answer questions about health insurance options, financial help available for both Insurance premiums and copayments and how to enroll in plans available to the public.[4]

Criticism and controversy

Children’s hospital sues

On October 5, 2013 the Seattle Times reported that Seattle Children's hospital has filed a lawsuit for "failure to ensure adequate network coverage".[25]

Overly generous tax subsidies

On October 25, 2013, the Seattle Times reported that a miscalculation effects thousands of individuals who used the website to enroll in a health plan. The problem was the calculation of a too-generous tax credit since monthly income was assumed to be annual income.[26]

Challenges with the first Open Enrollment period

On November 25, 2013, the Seattle Times reported that less than a third of the calls to Healthplanfinder's customer support center were handled in October 2013. The call center received 167,000 calls during "office hours" of which 67,000 were throttled, and 44,000 were abandoned.[27]

In addition to the volume of customer calls the Exchange continued to struggle with system issues (both perceived and actual issues). The Staff continued to report incremental fixes via hot fixes & code updates, but even with these incremental fixes, the call centers continued to struggle to handle the volume that consistently exceed the projected volumes by many fold.

At the April 2014 Board Meeting, the staff reported that 95% of the applications are getting through the system electronically on the first try and also that the system availability was at 98%. The Operations staff reported that even with 450 customer service representatives, the wait times were still very high, but also cited that 50% of the calls that are not getting handled are duplicate calls. The board asked for better future projections and expected improved call handling for the second open enrollment period.

The Technology QA group then reported that the Exchange hired a PM to help streamline processes across the organization to help convert the implementation culture to a more sustaining, operational culture. The QA group also reported that the stability of the system continues to improve and that the data issues created by Healthplanfinder have lessened.

At the May board meeting in Spokane, Rom Sims was officially introduced as the incoming Chair for the WA HBE Board.

The staff reported the following metrics:

Qualified Health Plans = 167,221 Medicaid Newly Eligible/Coverage Jan 1. - 318,136 Medicaid Previously Eligible but not Enrolled - 163,447 Medicaid re-determinations - 496,750

References

  1. ^
  2. ^ a b c d e
  3. ^
  4. ^ a b [1]
  5. ^ a b
  6. ^
  7. ^ http://www.spokesman.com/stories/2013/may/15/washington-insurance-exchange-to-cut-health-care/
  8. ^
  9. ^ a b c
  10. ^
  11. ^ a b c
  12. ^ a b
  13. ^
  14. ^
  15. ^
  16. ^
  17. ^ http://blogs.seattletimes.com/healthcarecheckup/2015/02/09/tax-forms-mean-new-troubles-for-health-care-exchange/
  18. ^ http://www.seattletimes.com/seattle-news/health/big-switch-health-exchange-customers-to-pay-insurers-now/
  19. ^ [2]
  20. ^
  21. ^ [3]
  22. ^
  23. ^
  24. ^
  25. ^
  26. ^
  27. ^

External links

  • Washington Healthplanfinder (official website)
  • Insurance commissioner
  • Washington Benefit Exchange press release
  • Washington Benefit Exchange Annual report
  • February 2014 Washington Benefit Exchange enrollment report
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