Proposed rates for health insurance market offers mostly good news for Adams County

Two health insurance companies will be offering plans inside the Washington Health Benefit Exchange in Adams County for the 2020 individual health insurance market, it was announced earlier this month by the Washington state Office of the Insurance Commissioner.

The two companies, Coordinated Care Corporation and Lifewise Health Plan, also offered plans in the county for the 2019 health insurance market.

In addition, Lifewise Health Plan and Asuris Northwest Health will be offering plans in the county outside of the Exchange. Asuris Northwest Health offered plans outside of the Exchange for the 2019 individual health insurance market, but Lifewise Health Plan previously had not.

In all, 13 health insurers in the state of Washington filed with the Office of the Insurance Commissioner to offer plans for the 2020 individual health insurance market. The individual market exists for those who do not receive health insurance coverage from an employer, which affects about 248,000 people.

The proposed average rate increase among the 13 health insurers compared to the previous year is just 0.96%, a record-low since the Exchange was created in 2011 as a public-private partnership.

For the health insurance companies offering plans in Adams County, the proposed rate changes carry both good and not-so-good news.

LifeWise Health Plan of Washington has requested an average rate change of -5.89%, and Asuris Northwest Health has requested an average rate change of -4.43%. Those are two of the lower requested rate changes among health insurers. But Coordinated Care Corporation has proposed a requested average rate change of 10.16%, the highest requested average rate change by far among health insurers.

Insurance Commissioner Mike Kreidler and his office will review all of the proposed health plans and proposed rate changes over the next few months, and final decisions on the proposed plans and rates will be made in the fall.

To determine whether a health insurer’s requested rate change is reasonable, the Office of the Insurance Commissioner examines information that includes:

-If the rates, claims and administrative costs are consistent with what the company reported in its financial statement.

-The actual vs. projected medical prescription-drug costs.

-The assumptions used to project the medical and prescription-drug costs, which includes changes in the costs and in the benefit design.

If Kreidler and his office believe the rate request is justified after examining the data, state laws requires them to approve the increase. If they don’t believe the rate request is justified, they will deny the increase. The insurer would then either revise its rate request or request a hearing.

Seven of the 13 health insurers offering plans in the 2020 individual market proposed rate decreases, four proposed rate increases, and two are new to the Exchange.

“... This year’s filings are evidence that our full adoption of the law and the steps we’ve taken to defend and preserve it are stabilizing our market,” said Kreidler in a news release. “We have more work to do to lower the cost of health care and to help lower out-of-pocket costs, but these proposed rates are welcome news.”

The Exchange also offers the opportunity for eligible people to enroll in Washington Apple Health (Medicaid), which offers free or low-cost health coverage. Visit washingtonhealthplanfinder.org/apple.php to find out if you are eligible for Washington Apple Health.