For coverage starting next year, Arkansas Blue Cross will offer a new low-cost, silver-level plan on the state health insurance exchange that won't be available to people on the state's Medicaid-funded private-option program, a company spokesman said Friday.
That's because the plan, known as Silver 1500, will offer benefits beyond those considered essential under the federal health care overhaul law.
According to state officials, plans that cover such extra benefits won't be available to private-option enrollees after Dec. 31.
"I think it's just another option for people" who don't qualify for the private option, Blue Cross spokesman Max Greenwood said.
Blue Cross also will continue to offer two other silver-level plans, both with higher premiums as well as higher deductibles than those of the Silver 1500 plan.
Greenwood said she didn't have details about the extra benefits that will be offered through the Silver 1500 plan and didn't know whether private-option participants who are enrolled in the other Blue Cross plans will be able to stay in those plans next year.
Under the private option, the Medicaid program pays insurance companies the full premium for a plan on the exchange on behalf of low-income adults.
Additional subsidies also eliminate the plan's deductible and reduce the enrollee's other out-of-pocket expenses for medical care.
Private-option enrollees are limited to enrolling in silver-level plans. Before subsidies are applied, those plans are designed to cover 70 percent of a typical patient's annual medical expenses.
The expected rates for the Silver 1500 plan were released Friday by the Arkansas Insurance Department along with those of the other plans that will be offered on the state's insurance exchange next year.
The list of the plans and rates is available on an Insurance Department website ahc.arkansas.gov.
The open-enrollment period on the exchange for coverage that begins next year is Nov. 15-Feb. 15.
Those who qualify for Medicaid can sign up at any time, but are limited to changing plans during open enrollment, Amy Webb, a spokesman for the state Department of Human Services, said.
The Insurance Department said in August that it projected an overall 2.2 percent drop in premiums, including an average increase of 2 percent for plans offered by Arkansas Blue Cross and Blue Shield and the national Blue Cross and Blue Shield Association, a 12 percent decrease for St. Louis-based Centene Corp. plans and a 5 percent increase for QualChoice Health Insurance plans.
The department had been planning to release information about the rates for individual plans after the plans were approved by the U.S. Health and Human Services Department's Centers for Medicare and Medicaid Services, which is expected to happen by Nov. 3, but expedited the release at the direction of Gov. Mike Beebe.
U.S. Rep. Tim Griffin, R-Little Rock, who joined the state's other House members in calling last month for the rates to be released, said in an email Friday that he was pleased they had been released "so that Arkansans may make informed decisions on health care for their families."
The figures that were released Friday show the Silver 1500 plan, which will have a $1,500 annual deductible, will be Blue Cross' lowest-cost silver plan in each of the state's seven rating areas.
For instance, in the central Arkansas rating area, a 35-year-old would pay a monthly premium of $280.93 for the Silver 1500 plan.
A person the same age would pay $285.87 for the next cheapest Blue Cross plan, Silver 3500, which has a $3,500 annual deductible.
For the Silver 2500 plan, which has a $2,500 annual deductible, the 35-year-old would pay a monthly premium of $297.34.
Sen. David Sanders, R-Little Rock, a sponsor of the law creating the private option, said he didn't have an opinion Friday on the Silver 1500 plan.
He did credit the private option with helping lower premiums and encouraging insurance companies to expand the areas in which they are offering plans.
The four companies offering plans on the exchange are offering them in every rating area for coverage starting next year. This year only Arkansas Blue Cross and the national Blue Cross and Blue Shield Association offered plans in every rating area.
"Competition is important, and expanding choice for consumers is important and seeing negative price pressure is also important," Sanders said.
Assistance under the private option is available to most Arkansans who became eligible for Medicaid under the expansion of the program approved by the Legislature last year.
The expansion extended eligibility to adults with incomes of up to 138 percent of the poverty level: $16,105 for an individual, for instance, or $32,913 for a family of four.
Tax-credit subsidies are available to those who don't qualify for Medicaid but have incomes below 400 percent of the poverty level: for example, $45,960 for an individual or $94,200 for a family of four.
Additional subsidies that reduce deductibles and other out-of-pocket expenses are available to those who qualify for the tax credits and have incomes below 250 percent of the poverty level. Like the private option, those subsidies are only available through a silver plan.
As of March 31, 67 percent of the more than 43,000 Arkansans who had signed up for a non-Medicaid plan on the exchange chose a silver plan, according to a report released earlier this year by the U.S. Department of Health and Human Services.
Bronze-level plans, designed to cover 60 percent of medical expenses, were the next most popular choice, chosen by 19 percent of enrollees, while 13 percent chose gold plans, designed to cover 80 percent of expected expenses.
One percent chose catastrophic coverage plans, which offer less coverage than bronze plans and are available only to people under age 30 or who would otherwise have to pay more than 8 percent of their incomes for insurance. Subsidies cannot be used to buy catastrophic plans.
This year, Arkansas Blue Cross is charging the lowest premium for a silver plan in each rating area. For coverage starting next year, St. Louis-based Centene Corp. will offer cheaper silver plans in the southeastern and southwestern coverage areas, according to the data released Friday.
This year, Centene is offering plans only in the central, northwestern and west-central areas.
For bronze-level coverage, Arkansas Blue Cross will offer the cheapest plans in those three areas, with Centene offering the cheapest plan in the other four areas.
This year, Arkansas Blue Cross is offering the cheapest bronze plan in every area except the northwestern one.
For gold-level coverage, Arkansas Blue Cross will offer the cheapest plan in five areas, down from six areas this year. Centene will offer the cheapest gold plan in the southeastern and southwestern areas.
Arkansas Blue Cross and Little Rock-based QualChoice Health Insurance are the only companies offering catastrophic plans. QualChoice will have the cheapest catastrophic plan in every rating area.
"I think we're very pleased that we're once again one of the lowest cost plans statewide," Greenwood said. "We've been consistent about trying to offer an affordable plan to the people of the state."
As of Aug. 31, more than 211,000 people were enrolled in plans on Arkansas' exchange, including more than 172,000 in private-option plans.
Greenwood said about 94,000 Arkansans were enrolled in her companies' plans as of late September, including more than 70,000 in private-option plans.
An additional 58,700 Arkansans were in national Blue Cross and Blue Shield Association plans, including 56,000 in the private option.
Michael Stock, chief executive of QualChoice, acknowledged, "our rates are a bit higher than the other carriers" for plans other than catastrophic coverage plans.
But he said he's not concerned about that because most of those enrolled in the exchange qualify for the private option, and most of the others qualify for tax credits to help reduce their premiums.
He said his company focused on the most popular plans -- silver and bronze.
"We didn't necessarily try to make all plans across all metallic tiers equally positioned in the marketplace," Stock said.
Stock said about 17,000 people are enrolled in his company's plans on the exchange, most of whom are in private-option plans.
John Ryan, chief executive of Centene's Arkansas Health and Wellness Solutions, didn't return a call seeking comment about his company's offerings for next year.
A Section on 10/04/2014