Transcript Delaware's Health Insurance Marketplace: Update on Activity April 2016

Delaware’s Health Insurance
Marketplace: Update on Activity
Delaware Health Care Commission
April 7, 2016
Secretary Rita Landgraf
Department of Health and Social Services
Agenda
• Enrollment Update
• Marketplace Enrollment
• Medicaid Expansion Enrollment
• Stories from the Ground
• Tax Reminder
• Plan Management
• Key Dates and Reminders
• Questions/Comments
2
Enrollment Update
3
Marketplace and Medicaid Enrollment Update
As of Jan. 31, 2016, 38,152 Delawareans have
enrolled in health care coverage through
Medicaid expansion and the Health Insurance
Marketplace.
4
Marketplace and Medicaid Enrollment Update
Enrollment as of Jan. 31, 2016:
Total Number of
Enrollees
Increase from
previous year
Marketplace*
28,256
13%
Medicaid
9,896
3%
Total
38,152
10%
*This number represents Delawareans who have selected a Marketplace plan,
either through Healthcare.gov or through direct enrollment with an issuer (with
or without the first premium payment having been received directly by the
Insurance Company.)
5
Marketplace Enrollment
6
Delaware Enrollment at a Glance
• Number enrolled: 28,256
• Number who completed applications:
39,361
• Percentage who received tax credit: 82%
• Average monthly premium before tax
credit: $477
• Average monthly tax credit: $328
• Average monthly premium after tax credit:
$150
• Average percentage reduction in premium
after tax credit: 69%
7
7
Growth in Covered Lives
Increase Each Enrollment Season
Enrolment (in thousands)
38,746
34,729
28,256
25,036
Marketplace
18,614
14,397
9,693
9.896
2015
2016
4,217
2014
8
8
Medicaid
Expansion
Total
Delaware’s Uninsured Rate
• Delaware Behavioral Risk Factor
Surveillance System (adults age 1864): 9.7% in 2015. In 2014, the rate was
10.8% and in 2013, 14.3%.
• Gallup-Healthways Well Being Index
(adults 18 and older): 7.4% in 2015. In
2014, the rate was 9.6% and in 2013, it
was 10.5%.
• CDC – National Health Interview
Survey (ages 0-64): 5.4% in 2014,
down from 10.7% in 2013. No results yet
for 2015.
9
99
Enrollment Type
Used HealthCare.gov for Enrollment
Total
Selecting
2016 Plan
New
Total
Active
Consumers Reenrollees Enrollees
AutoRenewals
Delaware
28,256
33%
67%
42%
25%
All FFM
States
9.6 million
42%
58%
41%
17%
10
Reenrollee Status
Used HealthCare.gov for 2015 and 2016 Coverage Years
%
% Active Chose
Renewals New
Plan
Avg
Monthly
Premium
Savings of
Switchers
% of
Reenrollees
% AutoRenewed
Delaware
70%
38%
32%
30%
$25
All FFM
States
57%
30%
27%
43%
$40
11
Premium Tax Credit
Delaware (2015)
Delaware (2016)
All FFM States
(2016)
Total Enrollment
25,036
28,256
9.6 million
% with Tax Credit
84%
82%
85%
Monthly Premium
(before Tax Credit)
$404
$477
$396
Avg Monthly Tax
Credit
$264
$328
$290
Avg Monthly
Premium (after Tax
Credit)
$140
$150
$106
Avg % Reduction
in Premium (after
Tax Credit)
65%
69%
73%
Description
12
Financial Assistance
Delaware
All FFM States
Total Enrollment
28,256
9.6 million
% with Financial
Assistance
82%
85%
% with Premium Tax
Credit
82%
85%
% with Cost-Sharing
Reduction
43%
59%
Description
13
Comparison by Age
Enrollees
% Enrolled
0 -17
3,673
13%
18 – 25
2,260
8%
26 – 34
4,521
16%
35 – 44
4,238
15%
45 – 54
5,934
21%
55 – 64
7,347
26%
65+
283
1%
Total
28,256
100%
Marketplace Enrollment by Age
1.00%
Age
Groups
13%
26%
8%
16%
21%
15%
14
Ages 0 - 17
Ages 18 - 25
Ages 26 - 34
Ages 45 - 54
Ages 55 - 64
Ages 65+
Ages 35 - 44
Enrollment Update:
Comparison by Gender
All FFM
States
Delaware
Marketplace
Delaware
Medicaid
Expansion
Total
Enrollment
9.6 million
28,256
9,896
% Female
54%
54%
63%
% Male
46%
46%
37%
Description
15
Metal Level Comparisons
Metal Level
Delaware
All FFM States
Bronze
22%
21%
Silver*
61%
71%
Gold
13%
6%
Platinum
3%
1%
Catastrophic
0%
1%
Total Enrollment
28,256
9.6 million
*Only silver plans are eligible for a cost-sharing reduction.
16
Self-Reported Race/Ethnicity
% Delaware
Marketplace
Delaware
Population
(all ages)*
% from
FFM
States
U.S.
Population
(all ages)
White
68%
70.8%
63%
77.4%
AfricanAmerican
13%
22.2%
12%
13.2%
Asian
9%
3.8%
9%
5.4%
Latino
8%
8.9%
15%
17.4%
American Indian
0%
0.7%
0%
1.2%
Native
Hawaiian/Pacific
Islander
0%
0.1%
0%
0.2%
Multi-Racial
2%
2.5%
1%
2.5%
Total
20,307
935,614
6.1M
318.8M
Self-Reported
Race/Ethnicity
* Total Delaware and U.S. population
breakdowns from U.S. Census (2014).
17
Household Income
% from Delaware
% from FFM
States
< 100%
2%
3%
100%-149%
15%
38%*
150%-199%
27%
25%
200%-249%
21%
15%
250%-299%
14%
9%
300%-399%
16%
8%
> 400%
4%
2%
Total Enrollment
with Data
25,547
8.9 million
Household Income
(% of FPL)
*18 of the 19 states that have not
expanded Medicaid are part of the FFM.
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Medicaid Expansion Enrollment
19
Medicaid Enrollment: January 2016
• As of the end of January, 9,896 Delawareans ages 19-64
qualified for Medicaid under the expanded eligibility
requirements (income between 100% and 138% of the
Federal Poverty Level).
• Of those:
 63% were female, 37% male
 54% New Castle County, 19% Kent, 26% Sussex
 24% ages 19-25
 24% ages 26-34
 21% ages 35-44
 18% ages 45-54
 13% ages 55-64
20
Medicaid Enrollment by Age: 2014-2016
Percentage of Delawareans ages 19-64 who qualified for Medicaid under
the expanded eligibility requirements from 2014 to 2016.
Age
Jan. 2014
Jan. 2015
Jan. 2016
19-25
15%
20%
24%
26-34
34%
26%
24%
35-44
27%
22%
21%
45-54
12%
18%
18%
55-64
12%
13%
13%
21
Medicaid Enrollment by Gender: 2014-2016
Percentage of adult Delawareans ages 19-64 who qualified for Medicaid
under the expanded eligibility requirements from 2014 to 2016.
Jan. 2014
Jan. 2015
Jan. 2016
Female
74%
64%
63%
Male
26%
36%
37%
22
Stories from the Ground
23
Stories from the Ground
• A 47-year-old single mother from Dover who also cares for
her grandchildren re-enrolled with Westside. She was
eligible for a tax credit of $395 a month plus cost sharing,
choosing a silver Highmark plan for $37.14 a month.
• During a Coverage to Care Workshop on Palm Sunday at
Iglesia De Dios Maranatha in Seaford, a Chatman
navigator was able to enroll two parishioners through a
Special Enrollment Period. The church’s pastor wants
Chatman to come back for a full-day workshop.
• A 30-year-old man and his wife from Claymont enrolled
through an SEP with Westside. They qualified for a $566
tax credit and chose a silver Aetna plan with a monthly
premium of $107.87. They were very happy because the
QHP has no deductible and a low monthly premium.
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24
National Update
25
Tax Reminder
Make sure you use your health insurance tax form to file
your 2015 federal income taxes.
• Marketplace: Use Form 1095-A, Health Insurance
Marketplace Statement. If you received a tax credit, you
will use this form to reconcile your credit with your final
income for 2015.
• Employer-based, retiree plan, SHOP or COBRA:
Use Form 1095-B, Health Coverage, or Form 1095-C,
Employer-Provided Health Insurance Offer and
Coverage.
• Other coverage, including Medicare, Medicaid or
CHIP: Use Form 1095-B, Health Coverage.
• No coverage: Either pay the penalty with your federal
return or you must claim a health coverage exemption.
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26
Plan Management Updates
27
Insurer Letters of Intent for Plan Year 2017
• In January the Department of Insurance (DOI) invited
insurance companies to submit a letter of intent to
apply for QHP certification for Plan Year 2017
• The following companies submitted letters of intent:
Medical Plans
Stand Alone Dental Plans
Aetna
Delta Dental
Highmark BCBSDE
Dentegra
Dominion
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QHP Review for Plan Year 2017
• The DOI is working with insurance companies to
prepare for the review of Qualified Health Plans
(QHPs) for Plan Year 2017.
• The DOI has released state-specific standards,
guidance and templates to insurers to support their
QHP applications.
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29
Marketplace QHP Review Timeline
Activity
Issuers submit QHP applications including
initial rate and form filings
DOI reviews plans for compliance with state
and federal laws and standards
Proposed Timeline
April – May 2016
DOI conducts public information sessions and
accepts written comments
June – July 2016
May – September 2016
DOI completes review of QHP applications and August – September 2016
rates and makes recommendations to CMS
CMS sends final list of certified QHPs to state October 2016
DOI posts final premium rates
Mid-October 2016
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Key Dates
Date
Milestone
Nov. 1, 2016
Open enrollment begins for Plan Year 2017
Jan. 31, 2017
End of open enrollment for Plan Year 2017
 Consumers who experience qualifying life events such as
birth/adoption of a child; marriage or divorce; loss of minimum
essential coverage; denial of Medicaid; aging out of parents’
insurance at age 26; or domestic violence eligibility may enroll
outside of open enrollment.
 Navigators, assisters and agents and brokers are available to help
with enrollments outside open enrollment.
 Visit www.ChooseHealthDE.com to find free assistance.
 Enrollment in Medicaid and in the SHOP marketplace for small
businesses is open year-round.
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Questions/Comments
 Health Care Commission
 Public
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