Washington Healthplanfinder

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

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]

The open enrollment period for 2016 coverage runs from October 1, 2015 to January 31, 2016. For the 2016 year, fifteen health insurers are selling 210 health plans in Washington state. The insurance commissioner for the state of Washington warns consumers that, while the plans include the same essential health benefits, they differ in deductible amounts and which medical providers are included in their health insurance networks.[6]

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.[7][8]

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,[9] 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

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.[10]

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.[12] On September 5, 2013 the State Insurance Commissioner approved[13] 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.)[12][13]

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.[14]

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.[15]

2014 enrollment

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

2015

Open enrollment

Enrollment for 2015 will start on November 15, 2014 and end on February 15, 2015.[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. [18]

Change in billing

In September 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. [19]

Approved companies

[20]

On Sept 25, 2013, the Seattle Times said there were 46 health care plans in the marketplace.[21]

Approved companies by county

[22]

Approved Medicaid companies

Advertising in other states

Oregon and Colorado have been running TV commercials since the beginning of summer 2013. [2]

Governance

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

Washington Health Exchange Board

Management team

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. ↑ "New name and logo for Washington's health benefit exchange". Puget Sound Business Journal. Retrieved 2013-09-20.
  2. 1 2 3 4 5 6 Snow Landa, Amy (August 21, 2013). "State’s ad blitz promotes health-insurance exchange". The Seattle Times. Retrieved August 21, 2013.
  3. ↑ "State-Run Exchanges Signed Up More Than Healthcare.gov". Govtech.com. Retrieved 17 November 2014.
  4. 1 2
  5. 1 2 "Exchange board votes to raise CEO’s salary". The Seattle Times. Retrieved 17 November 2014.
  6. ↑ http://www.insurance.wa.gov/about-oic/newsroom/
  7. ↑ "Health Plans Overview". Washington Health Benefit Exchange. Retrieved 17 November 2014.
  8. ↑ http://www.spokesman.com/stories/2013/may/15/washington-insurance-exchange-to-cut-health-care/
  9. ↑ "Advertising, Political Consulting, Advocacy - DC-Seattle". GMMB. Retrieved 17 November 2014.
  10. 1 2 3 Snow, Amy. "State Health Exchange Board wants more insurance choices". The Seattle Times. Retrieved 2013-09-20.
  11. ↑ "Washington announces plans, rates, in health exchange". King5.com. 2013-08-01. Retrieved 2013-09-20.
  12. 1 2 3 "Washington State Panel OKs 7 Insurers For Exchange". The Washington Post. 2013-09-05. Retrieved 2013-09-20.
  13. 1 2 Snow, Amy (2013-09-06). "Exchange board certifies Coordinated Care health plans | HealthCare Checkup". The Seattle Times. Retrieved 2013-09-20.
  14. ↑ "In first week, 9,452 in state sign up for health insurance". The Seattle Times. Retrieved 17 November 2014.
  15. ↑ "Washington Healthplanfinder: more than 35,000 have enrolled in 3 weeks". The Seattle Times. Retrieved 17 November 2014.
  16. ↑ "Higher bar for health law in 2nd sign-up season". CBS News. Retrieved 17 November 2014.
  17. ↑ "Improved health insurance website ready for signups". The Daily Herald. Retrieved 17 November 2014.
  18. ↑ http://blogs.seattletimes.com/healthcarecheckup/2015/02/09/tax-forms-mean-new-troubles-for-health-care-exchange/
  19. ↑ http://www.seattletimes.com/seattle-news/health/big-switch-health-exchange-customers-to-pay-insurers-now/
  20. ↑
  21. ↑ "Premiums unveiled show wide range for health overhaul plans". The Seattle Times. Retrieved 17 November 2014.
  22. ↑ https://web.archive.org/20151208062718/http://www.insurance.wa.gov/your-insurance/health-insurance/individuals-families/health-plans-rates/index.html. Archived from the original on December 8, 2015. Retrieved February 4, 2016. Missing or empty |title= (help)
  23. ↑ "Community Health Plan of Washington". Community Health Plan of Washington. Retrieved 17 November 2014.
  24. ↑ Richard K. Onizuka (October 17, 2012). "Washington Health Benefit Exchange : Joint Select Committee on Health Reform Implementation" (PDF). Leg.wa.gov. Retrieved 17 November 2014.
  25. ↑ "Left off many networks, Seattle Children’s sues". The Seattle Times. Retrieved 17 November 2014.
  26. ↑ "Thousands get wrong subsidies data from state health exchange". The Seattle Times. Retrieved 17 November 2014.
  27. ↑ "Thousands of calls to state health exchange go unanswered". The Seattle Times. Retrieved 17 November 2014.

External links

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