HEALTH COVERAGE ENROLLMENT REPORT

Transcription

1 WASHINGTON HEALTH BENEFIT EXCHANGE WAhealthplanfinder.org HEALTH COVERAGE ENROLLMENT REPORT Published December 218

2 Table of Contents Total Enrollees... 1 Enrollees Qualified Health Plan Enrollees Subsidized/Non-Subsidized by Month QHP Enrollees... 2 Metal Level Percent of Federal Poverty Level (FPL) Enrollees by FPL/Metal Level QHP Enrollees... 3 By FPL Level/Age By FPL QHP Disenrollment Disenrollment Metal Level FPL/Metal Level Enrollees by County... 5 QHP by County WAH by County QHP Enrollees Data... 6 Age Under 19 Race/Ethnicity U.S. Citizenship Gender Carrier Language Data... 7 Limited English Proficient Applicants Spanish Language Top Language Requests By Applicants Language Data... 8 Customer Service Dental Enrollees... 9 Plan Type QHP with Dental Age Gender Carrier WAH Enrollees... 1 Age Under 19 Race/Ethnicity Medicaid Plan Selection Additional Data Special Enrollment Period (SEP) Churn Additional Household Data Partnered Households Households Additional Financial Data This in an excel spreadsheet with additional data is also available online at: Health Plans (QHP) data; Author: WAHBE/Thuy Ha, Data Source: Washington Healthplanfinder as of September 218 Washington Apple Health - Medicaid MAGI/CHIP population:magi/chip Population Characteristics; Author: HCA/OMSD ; Data Source: ProviderOne ODS Data Warehouse as of September 218

3 Total Enrollees Enrollees Qualified Health Plan Enrollees QHPs Total: (12%) Non-Subsidized Total: 68,632 (35%) 1,677,254 WAH Total: 1,483,397 (88%) Subsidized Total: 125,225 (65%) Note: Qualified Health Plans (QHP). Washington Apple Health (WAH) is comprised of Medicaid MAGI and CHIP enrollees through Aug 218 QHP - Non-Subsidized: Includes individuals who selected a qualified health plan that either did not qualify for a tax credit or did not apply for financial help QHP - Subsidized: Includes individuals who selected a qualified health plan and are eligible for a tax credit to lower their monthly premiums All subsidized counts now include all individuals eligible for Advanced Premium Tax Credit (APTC). Subsidized/Non-Subsidized by Month 25K 2K 15K 1K 5K 1/1/17 11/1/17 12/1/17 1/1/18 2/1/18 3/1/18 4/1/18 5/1/18 6/1/18 7/1/18 8/1/18 9/1/18 Non-Sub Subsidized Total 52,69...5, , , , , , , , , , ,67 125, , , , , , , , , , , , , , , , , , , , , , , ,858 1

4 QHP Enrollees Metal Level Percent of Federal Poverty Level (FPL) Silver Total: 11,35 (52%) 4K 35K 4,33 39,577 Bronze Total: 66,217 (34%) 3K 25K 2K 26,224 18,159 24,795 2,229 15K 14,421 Gold Total: 24,25 (12%) 1K 6,997 Catastrophic Total: 2,58 (1%) 5K 3,422 <1% 1%-138% 139%-15% 151%-2% 21%-25% 251%-3% 31%-4% >4% Other* *Chose not to apply for tax credit. Bronze Plans cover 6% of the cost of essential health benefits, while the patient pays 4% ; Silver Plans cover 7%, while the patient pays 3%; Gold Plans cover 8%, while the patient pays 2%; Catastrophic Plans are type of health care plan only available through Washington Healthplanfinder for certain populations, such as individuals under age 3. This type of plan generally offers the least coverage. Tax credits and cost sharing reductions cannot be used to purchase a catastrophic plan. FPL/Metal Level 5K 4K 4,33 39,577 3K 26,224 24,795 2K 18,159 2,229 14,421 1K 6,997 3,422 <1% 1%-138% 139%-15% 151%-2% 21%-25% 251%-3% 31%-4% >4% Other* Total Gold Silver Bronze 6, , , , , , , , , , , , , , ,43 6, , , , , , , , , , , , , , , ,47 Catastrophic *Chose not to apply for tax credit. 2

5 QHP Enrollees By FPL & Age 2K 15K 1K 5K <138% 139%-15% 151%-2% 21%-25% 251%-3% 31%-4% >4% Other* 3, , , , ,59...8, , ,49 3, , ,2... 9, ,75...8, , ,746 3,5... 4, , , , , , ,341 By FPL 5K 4K 3K 2K 1K Total <138% 139%-15% 151%-2% 21%-25% 251%-3% 31%-4% >4% Other* 1, , , , , , , ,577 *Chose not to apply for tax credit. 3

6 QHP Disenrollment 218 Disenrollment Metal Level Voluntary Total: 24,917 (51%) 3K 25K 25,442 48,788 Non-Payment Total: 18,523 (38%) 2K 15K 16,578 1K 5,69 Other Total: 5,351 (11%) 5K 1,162 Catastrophic Bronze Silver Gold Notes: Enrollees who moved to WAH are excluded. FPL/Metal Level 15K 13,93 12K 9K 11,895 6K 6,88 5,626 5,564 4,447 3K 2,64 1, <1% 1%-138% 139%-15% 151%-2% 21%-25% 251%-3% 31%-4% >4% Other* Total Gold Silver Bronze 1, ,64...8, ,88...4, , , , ,47 1, , , , ,93...2, , , , , , , ,69...5,97 Catastrophic *Chose not to apply for tax credit. 4

7 Enrollees by County QHP by County 1,213 2,39 8,42 3,315 1, , Top 1 KING...73,677 SNOHOMISH...19,48 2,769 1,73 6,721 19,48 73,677 2, ,747 PIERCE...16,862 CLARK...12,373 SPOKANE...11,747 1,615 1,328 5,822 16, , WHATCOM...8,42 KITSAP...6, ,331 2,27 12, , ,241 1, , ,+ Enrollees (5 Counties) 2, - 9,999 Enrollees (1 Counties) THURSTON...5,822 SKAGIT...3,315 BENTON...3,241 1, - 1,999 Enrollees (1 Counties) Enrollees (14 Counties) WAH by County 17,36 5,84 2,956 12,22 42,243 44,617 29, , ,675 2,421 13,718 11,6 1,913 3,512 11,533 2, ,656 Top 1 KING...318,675 PIERCE...182,386 SNOHOMISH...132,748 SPOKANE...129,656 CLARK...97,911 2,758 15,1 53, ,386 8,13 31,425 8,423 6,797 YAKIMA...94,747 THURSTON...53,286 5, ,58 29,523 97,911 1,861 94,747 5,267 48,7 3, , ,438 1,+ Enrollees (4 Counties) BENTON...48,7 WHATCOM...44,617 KITSAP...42,243 96,316 4,99 3, - 99,999 Enrollees (8 Counties) 1, - 29,999 Enrollees (12 Counties) 1-9,999 Enrollees (15 Counties) 5

8 QHP Enrollees Data Age Under Total: 1,943 (1%) Total: 59,874 (31%) Total: 38,47 (2%) Total: 31,92 (16%) Total: 31,184 (16%) Total: 14,925 (8%) <18 Total: 15,541 (8%) 16,422 Infant <1 Total: 93 (6%) Toddler 1-5 Total: 3,88 (24%) School Age 6-12 Total: 5,944 (36%) Adolescent Total: 5,695 (35%) Race/Ethnicity *Reporting race/ethnicity is not required U.S. Citizenship American Indian/Alaska Native Total: 1,188 (1%) Asian Total: 2,712 (11%) African American Total: 2,835 (1%) Hawaiian: Not Provided Total: 11 Total: 36,151 (18%) Multi-Race: Other Total: 699 Total: 36,968 (19%) Lawfully Present Total: 25,388 (13%) Pacific Islander Total: 3,49 (2%) White Total: 92,145 (48%) Citizen Total: 168,469 (87%) Note: Additional FPL data available online. Gender Carrier Female Total: 16,716 (55%) Male Total: 87,141 (45%) Coordinated Care Total: 51,376 (27%) Kaiser Northwest Total: 9,731 (5%) Kaiser Permanente WA Total: 66,92 (35%) LifeWise Total: 12,139 (6%) Molina Total: 23,945 (12%) Premera Total: 29,245 (15%) BridgeSpan Total: 519 6

9 Language Data Limited English Proficient Applicants 18,479 QHPs Total: 17,361 (16%) WAH Total: 91,118 (84%) Note: Includes applicants as Sep 218 who indicated in Washington Healthplanfinder they do not speak and/or read English Spanish Language Spanish Language Requests By Washington Healthplanfinder Applicants Interpreter QHP... 1,996 (3%) WAH... 64,129 (97%) TOTAL... 66,125 Translation QHP... 1,946 (3%) WAH... 65,6 (97%) TOTAL... 67,6 Top Language Requests By Washington Healthplanfinder Applicants 6K QHP WAH QHP WAH 5K Interpreter Translation 4K 3K 2K 1K QHP WAH Chinese Vietnamese Korean Russian Arabic Somali 2, ,59. 1, , , ,855. 3, ,853 1, ,137 3, ,625 1, , Note: Excludes Spanish, the top language requested (see above). Includes applicants as of Sep 218 who indicated in Washington Healthplanfinder they do not speak and/or read English and requested an interpreter or translation. 7

10 Language Data Customer Service NON-ENGLISH CALLS ANSWERED Language Count Spanish... 2,738 Language Count Language Count Language Count Vietnamese... 3,126 Korean Somali Russian... 3,28 Madarin Cantonese... 2 Cambodian Note: Includes calls answered by bilingual and multilingual Customer Service Representatives (CSRs) at the Washington Healthplanfinder Customer Support Center from April 1, Sept. 3, 218. Additional language data provided online. Top Language Requests Through Telephonic Interpretation Services SPANISH (2,984) VIETNAMESE (2,48) RUSSIAN (1,79) ARABIC (82) MANDARIN (796) SOMALI (67) KOREAn (515) FARSI (483) AMHARIC (419) CANTONESE (26) Note: Includes total calls from Oct Sept Telephonic interpretation services in over 175 languages are available to Exchange staff and the Customer Support Center through Language Line Solutions. Additional language data provided online. 8

11 Dental Enrollees Plan Type Pediatric Dental Total: 3,193 (8%) QHP with Dental Enrolled in QHP and also in QDP Total: 35,126 (15%) 39,335 Family Dental Total: 36,142 (92%) Enrolled in QHP Only Total: 158,731 (85%) Note: QDP - Qualified Dental Plans Age Gender <18 Total: 9,359 (24%) Total: 2,591 (7%) Female Total: 21,389 (54%) 39, Total: Total: 6,32 (16%) Total: 5,77 (15%) Total: 6,372 (16%) Total: 8,733 (22%) 39,335 Male Total: 17,946 (46%) Carrier Delta Dental of Washington...33,69 Dentegra Insurance Company...4,14 Premera Blue Cross...1,237 LifeWise Health Plan of Washington KaiserNorthwest Total...39,335 9

12 WAH Enrollees Age Under 19 <18 Total: 742,94 (5%) Total: 18,44 (12%) Total: 26,312 (14%) 65+ 1,483,397 Total: Total: 151,271 (1%) Total: 11,524 (8%) Total: 91,339 (6%) 776,194 Infant <1 Total: 4,372 (5%) Toddler 1-5 Total: 22,473 (28%) School Age 6-12 Total: 31,639 (39%) Adolescent Total: 213,71 (28%) Race/Ethnicity Medicaid Plan Selection 1,483,397 American Indian /Alaska Native Total: 58,782 (4%) Asian Total: 67,432 (5%) African American Total: 118,286 (8%) Not Provided Total: 134,71 (9%) Hawaiian: Total: 3,75 363,375 CHPW Total: 56,961 (16%) Amerigroup Washington Inc Total: 32,898(9%) United HealthCare Total: 6,612 (17%) Other Total: 217,898 (15%) Pacific Islander Total: 44,591 (3%) White Total: 837,993 (56%) Coordinated Care Total: 33,252 (9%) Molina Total: 179,652 (49%) By FPL 1.2M FPL CHIP MAGI Total 1M Medicaid MAGI CHIP <1%...3, ,92, ,95, % , , % , ,899 8K 151-2% , ,396 6K 21-25%...29, , , %...22, , ,58 4K 31-4%...4, , ,448 2K >4% ,11 Total...61, ,454, ,515,978 1

13 Additional Data Special Enrollment Period (SEP)* Loss of MEC Total: 1,39 (44%) 3,14 Changes in household size Total: 48 (2%) Change in program eligibility Total: 1,494 (48%) Change in residence Total: 167 (5%) Other Total: 41 (1%) There are circumstances that trigger a special enrollment period for an individual or a family outside of open enrollment. These circumstances include, but are not limited to: loss of minimum essential health coverage (MEC); changes in household size (e.g., marriage, death, birth or adoption); change in program eligibility (e.g, change in income); and change in residence (e.g., moved to WA). Enrollment is offered year-round for Washington Apple Health, SHOP, and American Indians and Alaska Natives. *Data shows total SEP enrollments during September 218 Churn QHP - WAH WAH - QHP Oct. 1, Sept. 1, 218 Avg. Monthly Churn Percentage: 1.29% Avg. Monthly Churn Total: 2,427 Highest Month Churn Percentage: Dec. 1, % Highest Month Churn Total: Dec. 1, 217-5,736 QHP - WAH: Enrollees who were enrolled in a QHP in a given month and the next month are enrolled in WAH. Percentage is calculated by dividing the total number of enrollees who moved to WAH by the total number of QHP enrollees the previous month. Oct. 1, Sept. 1, 218 Avg. Monthly Churn Percentage:.7% Avg. Monthly Churn Total: 1,83 Highest Month Churn Percentage: Jan. 1, % Highest Month Churn Total: Jan. 1, 218-2,968 WAH - QHP: Enrollees who were enrolled in a WAH in a given month and the next month are enrolled in QHP. Percentage is calculated by dividing the total number of enrollees who moved to QHP by the total number of WAH enrollees the previous month. 11

14 Additional Household Data Partnered Households QHP Households WAH Households Households Totals Broker Total: 48,618 Broker Total: 33,975 QHP Households Total: 138,229 QHP Navigator Total: 14,58 Navigator Total: 189,73 Mixed Households Total: 19,652 Note: Household account partnered to a Navigator and/or Broker in Washington Healthplanfinder Mixed households have family members enrolled in both QHP and WA Apple Health Additional Financial Data 218 Premiums and Financial Assistance Average monthly premium per person: $59 $128 h from 217 Average monthly tax credit per person: $23 $9 h from 217 Average monthly net premium per person (after tax credit): $279 $37 h from 217 Average monthly net premium per person (after tax credit) by FPL <1% 1%-138% 139%-15% 151%-2% 21%-25% 251%-3% 31%-4% >4% Other* $57 $64 $59 $64 $1 $16 $135 $14 $21 $199 $259 $254 $285 $281 $356 $458 $353 $ Note: Individuals >4% FPL or Other (choose not to apply for tax credit) do not receive federal subsidies 12

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