Washington Health Benefit Exchange Lowers Carrier Assessment Rate By 55 Percent

Fee reduced to $3.36 for 2019 health plans sold through the state’s online health marketplace OLYMPIA, Wash.

The Washington Health Benefit Exchange today announced it is lowering its carrier assessment rate by 55 percent, from $7.46 to $3.36 per member per month, on all 2019 health plans purchased through Washington Healthplanfinder – a reduction passed on directly to consumers through lowered premium prices.

The Exchange Board acted to reduce the assessment for carriers offering Qualified Health Plans (QHP) through the state’s online health marketplace during a special meeting.

“The financial burden of purchasing health insurance is being felt by many Washingtonians,” said Pam MacEwan, CEO of the Washington Health Benefit Exchange. “The ultimate goal in reducing the carrier assessment on 2019 health plans sold on Washington Healthplanfinder is to lower the overall cost of premiums and help make coverage more affordable for our customers.”

Each spring, the Board evaluates and sets the carrier assessment rate, as directed in state law. The Exchange’s performance during the most recent open enrollment period, which saw a record number of residents use the state’s online health marketplace to purchase a QHP for 2018 coverage, along with current and projected premium prices, operational improvements, and effective fiscal management, all factor into the outcome of the proscribed assessment calculation.

“We welcome the lower carrier assessment for the upcoming coverage year as a result of increased Exchange enrollment for 2018,” said Meg Jones, executive director of the Association of Washington Healthcare Plans. “Washington’s carriers serving the individual market are pleased that Washington families and individuals are using the Exchange as the portal to purchase their coverage. Because the assessment level is tied to the Exchange’s need for additional operating funds beyond their legislative appropriation, we also want to recognize that the assessment reduction is due to improved Exchange operating efficiencies, and applaud them for that.”

Premium prices increased significantly for those purchasing 2018 health coverage. Those increases were due to factors including underlying cost trends, the decision by the federal government to no longer fund cost-sharing subsidies, and uncertainty surrounding the future of the Affordable Care Act. A lower carrier assessment will cushion customers from some of the impact these factors might have on premium prices for 2019 coverage.

Prior to this decrease, the assessment has remained constant since 2016. The Exchange is funded through the state’s premium tax on health insurance carriers, reimbursement for providing Medicaid-related services, and this assessment on insurance carriers.

The timing of the decision is intended to better accommodate health insurance carriers seeking to file 2019 rates by the May 24 deadline. Once carriers take that action, the Office of the Insurance Commissioner (OIC) will review each filed rate and approve them based on their prices, network adequacy, benefits, and correspondence with federal and state laws that govern their operation. The Exchange board will then meet to review and certify OIC-approved health insurance plans for sale on Washington Healthplanfinder.

In its first five years since going live in 2013, Washington Healthplanfinder has connected more than 1.72 million Washingtonians with health coverage. More individuals than ever used the marketplace to connect with health coverage this year, including the nearly 210,000 individuals who purchased a QHP and the 1.5 million residents who enrolled in free or low-cost coverage through Washington Apple Health.

Reminders: Enrollment is offered year-round to individuals and families through Washington Apple Health (Medicaid). Customers enrolled in Apple Health will receive a notice of 60 days before the month they enrolled in or renewed their coverage last year.

About Washington Healthplanfinder

Washington Healthplanfinder is an online marketplace for individuals and families in Washington to compare and enroll in health insurance coverage and gain access to tax credits, reduced cost sharing and public programs such as Medicaid. The next open enrollment period for Washington Healthplanfinder begins on Nov. 1.

About Washington Apple Health

In Washington, Medicaid is called Washington Apple Health. Free or low-cost coverage is available year-round for those who qualify. Since the Affordable Care Act launched in October 2013, more people have access to preventive care, like cancer screenings, treatment for diabetes and high blood pressure, and many other health care services they need to stay healthy. Apple Health clients enroll and renew online using Washington Healthplanfinder. Apple Health is administered by the Washington State Health Care Authority: www.hca.wa.gov

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