Analysis Finds WellPoint, Blues Plans Captured Largest Market Shares in 2014

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By Sara Hansard

Sept. 11 — In 12 of 15 Affordable Care Act marketplaces where complete data on market share are available, WellPoint or independent Blue Cross Blue Shield plans captured the greatest percentage of customers in 2014, according to an analysis released Sept. 10 by Avalere Health LLC.

WellPoint Inc., based in Indianapolis, leads enrollment in California, Colorado, Connecticut, Indiana and Virginia, and Blues plans have captured the greatest portion of customers in the District of Columbia, Florida, Maryland, Michigan, Rhode Island, Vermont and Washington, the analysis said. CO-OPs—Consumer Operated and Oriented Plans—have attracted a sizable share of customers in Maine and New York, it said. In Oregon, Moda Health Plan Inc., based in Portland, captured the largest market share.

According to proposed and final rates in the 15 marketplaces analyzed, nine of the issuers that captured the most enrollment requested rate increases of 9 percent or more for the 2015 plan year, the analysis said. Rates are final in Florida, Maryland, New York, Oregon, Rhode Island and Washington.

“Because proposed 2015 rates were filed when exchange plans had little experience with their new members, rates may reflect that early enrollees may have been older or had higher health needs,” Avalere Vice President Caroline Pearson said in the analysis. “It's important to pay attention to the premium increases among the highest-enrollment plans in 2014 because current enrollees who renew their coverage will be directly impacted,” she said.

Consider Shopping for Lower Premiums

“Consumers should look at their plan premiums carefully and consider whether they should shop for a lower premium option in 2015 rather than re-enroll, especially if they qualify for federal premium subsidies,” Pearson said.

The Centers for Medicare & Medicaid Services released a final rule Sept. 2 under which 2014 enrollees who don't take action to change plans will be automatically renewed for 2015.

Researchers have warned that many consumers who are automatically re-enrolled in plans for 2015 may receive lower subsidies than they would if they went through a redetermination process.

The premium increases proposed by the dominant exchange carriers are consistent with historical growth, the analysis said. It cited a report by Jonathan Gruber, a Massachusetts Institute of Technology economics professor, released June 5 by the Commonwealth Fund, finding that premiums in the individual market grew by 10 percent or more per year prior to the launch of the ACA marketplaces.

Premiums analyzed were for 40-year-old nonsmokers based on rate filings available as of Sept. 5. Rate filings are proposed in many states and may change, the analysis said.

McKinsey Report on Marketplace Filings

Consultant McKinsey & Co. also released a report Sept. 10 on 2015 marketplace filings that found the lowest-priced plans have proposed rates varying from a 27 percent increase to a 28 percent decrease, compared with the equivalent product in 2014. The report is based on individual marketplace filings through June 23.

Seventy-eight percent of marketplace enrollees who are eligible for subsidies will see net premium increases in the lowest-price silver tier plan, which covers an average of 70 percent of medical claims, McKinsey said. Twenty-two percent will see premium decreases in the lowest-price silver plan, it said.

According to the Department of Health and Human Services, 85 percent of the approximately 8 million marketplace enrollees for 2014 received financial assistance to buy the plans, and more than 63 percent chose either the lowest or second-lowest premium plans.

There are 1.8 times more plans being offered in 2015 than in 2014, McKinsey said. Sixty-eight out of 69 health plans that filed for 2014 filed again for 2015 with only one incumbent exiting, and 18 new entrants plan to participate, it said.

To contact the reporter on this story: Sara Hansard in Washington at shansard@bna.com

To contact the editor responsible for this story: Janey Cohen at jcohen@bna.com