As a U.S. citizen, I am looking forward to tomorrow and the entire weekend full of 4th of July and Sequim Centennial events here in Sequim. Tomorrow I will celebrate my 27th anniversary as a U.S. citizen, and for my wife Sharon it will be her 12th anniversary. We celebrate our citizenship rather than the fact that the U.S. declared its independence from our native homeland. So, if you happen to see us about town at the various events wearing patriotic clothing, please make sure you say “Hi” to us.
As promised I will be giving a monthly update on the Affordable Care Act, which is now less than three months away from accepting applications.
Last month I gave an update of the various plans submitted to the state for approval. The Office of the Insurance Commissioner (OIC) website has been updated (www.insurance.wa.gov) and several companies have submitted plans since last month. These companies are Time Insurance, which does most of its business under the Assurant brand name; Molina Healthcare, which specializes in Medicaid and low-income plans; Coordinated Care Corporation, which is the new carrier to the state and is an HMO that likewise specializes in the Medicaid and low-income arena; and finally MODA, which is part of Oregon Dental Group.
In reviewing the filings, the one that caught my attention was the filing from MODA. The entire filing was a scant 28 pages, minuscule when compared to the 373 pages in the Time Insurance filing. MODA has filed the same premium rate for the entire state, whereas most carriers have dissected the state into six different rating areas. In addition, the MODA Plan will charge smokers and nonsmokers the same premiums.
MODA is not planning on being a major player in the Washington market as it only is anticipating a total of 2,000 members for the year, and its plan will be available both in and out of network. My assumption is that, as MODA is a part of the Oregon Dental Group, most of the PPO providers will be in the Vancouver area in southwest Washington.
The following companies were previously “not approved” by the OIC but have all refiled their products and are now in the “under review” status:
• Time Insurance will be offering plans only outside of the Exchange and it is anticipating annualized premiums of around $21 million, which roughly translates to about 5,000 clients statewide.
• Molina has filed an Exchange-only offering, for only three counties in the state (King, Pierce and Spokane) and anticipates an enrollment of just under 27,000 members.
• Coordinated Care Corporation surprised me for two reasons: It is an HMO and I was under the impression that the OIC was not going to approve any additional provider networks this year. But the greater surprise is that it only is anticipating member premiums of $2 million, which would mean about 500 members. It seems like an awful lot of regulatory filings and paperwork to build a network and then only anticipate enrolling 500 members.
The bottom line is that as far as Clallam County is concerned nothing has changed since last month’s column.
That column is still available for your review on the Sequim Gazette website under the columnists tab, www.sequimgazette.com/castell.
Where do we go from here? More and more of the operational details are being worked out on an ongoing basis and next month I will answer a number of questions that have been posed to me.
Next Tuesday, July 9, the Sequim-Dungeness Valley Chamber of Commerce is pleased to have as guest speaker Mike Jackling of the Washington Health Benefit Exchange. These are the folks who are doing a wonderful job putting this whole program together for the entire state. The luncheon meeting is open to the public starting at 11:45 a.m. at Sunland Golf and Country Club. For costs and details, contact the chamber directly at 683-6197. Reservations for lunch are required by 5 p.m. Friday, July 5, so pick up the phone and call today.
During September I will be making a number of presentations to various groups in the community. If you would like to be kept informed as to the schedule, please shoot me an e-mail and I will keep you updated.
And finally for those loyal readers who are on Medicare, we are not anticipating many drastic changes for 2013. Medicare Supplement premiums appear to be relatively stable.
Advantage plans have had an increase in funding from CMS of over 4 percent, so that also bodes well for premium stability. I have heard of another carrier possibly planning to offer an Advantage plan for 2014 in Clallam County. The prescription drug plans offerings change annually and I do not anticipate any fewer changes for 2014. We already know that Aetna has purchased Coventry Health, which offered the popular First Health Part D plans. We shall have to wait and see if Aetna will rebrand that plan under its own name or continue with the First Health name.
Phil Castell is an independent insurance agent in Sequim. He can be reached at 683-9284 or PhilCastell@msn.com.
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An update on insurance exchange
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Looking at long-term care
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Medicare Plans for 2013
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Medicaid expansion, explained
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The Medicare voucher system
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