HEALTH COVERAGE ENROLLMENT REPORT
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1 WASHINGTON HEALTH BENEFIT EXCHANGE wahealthplanfinder.org HEALTH COVERAGE ENROLLMENT REPORT Released October 22, 205
2 Table of contents Total Enrollees... Enrollees QHP Enrollees Subsidized/Non-Subsidized by Month Distribution of QHP Enrollees... 2 By Metal Level By Federal Poverty Level (FPL) By Metal Level/FPL Enrollees Disenrollments Disenrollments Disenrollments by Metal Level Disenrollments by FPL/Metal Level Enrollees by Month... 4 QHP Enrollees MAGI Medicaid Enrollees Dental Enrollees Enrollees by County... 5 QHP by County MAGI Medicaid Enrollees by County QHP Enrollees Data... 6 QHP Enrollees by Age QHP Enrollees by Gender QHP Enrollees by Language QHP Enrollees by Race/Ethnicity QHP by U.S. Citizenship QHP by U.S. Citizenship/FPL MAGI Medicaid Enrollees Data... 7 MAGI Medicaid Enrollees by Age MAGI Medicaid Under 9 Years of Age MAGI Medicaid Enrollees by Race/Ethnicity MAGI Medicaid Enrollees by FPL Medicaid Plan Selection Additional Data... 8 QHP Enrollees by Carriers Carriers Churn Additional Data... 9 Assisted Enrollees Families Premiums, Financial Assistance, and Cost-Sharing Reductions SHOP... 0 SHOP Data County Count of Employers Employers by Metal Level Employees and Dependents by Metal Level Qualified Health Plans (QHP) data, ; Author: WAHBE/Seema Gupta, Data Source: Healthplanfinder Reporting Database as of September 23, 205 More detailed data on the information presented in this report is available at Medicaid MAGI population data, ; Author: HCA/BIS/Thuy Ha; Data Source: ProviderOne ODS Data Warehouse as of October 5, 205
3 Total Enrollees Enrollees QHP Enrollees Total:,599,8 0% QHP 2% Non-Subsidized Total: 32,548 90% MAGI Medicaid Total:,447,294 79% Subsidized Total: 9,969 QHP - No Tax Credit (Non-Subsidized): Includes individuals who purchased a Qualified Health Plan (QHP) that either did not qualify for a tax credit or did not apply for financial help. QHP - Tax Credit (Subsidized): Includes individuals who have purchased a Qualified Health Plan (QHP) and are eligible for a tax credit to lower their monthly premiums. MAGI Medicaid: Includes individuals who have qualified and enrolled in a Medicaid plan under the expansion, caretaker, family, children, and pregnant women Medicaid programs. This report excludes the Children s Health Insurance Program (CHIP) population. Subsidized/Non-Subsidized by Month 50k 00k 50k 0/4 /4 2/4 /5 2/5 3/5 4/5 5/5 6/5 7/5 8/5 9/5 Non- Subsidized Subsidized Total 25,887 24,993 22,29 23,68 28,33 34,707 34,424 35,90 34,476 33,204 32,552 32,548 08,069 05,306 00,830 75,467 95,434 9,54 2,447 22,447 2,053 9,674 9,858 9,969 33,956 30,299 23,049 98,635 23,567 54,22 55,87 57,637 55,529 52,878 52,40 52,57
4 Distribution of QHP Enrollees By Metal Level By Federal Poverty Level (FPL) 8% 56% 36% Platinum Total: 659 Gold Total:,607 Bronze Total: 54,600 Catastrophic Total: 752 Silver Total: 84,899 Did not report Total: 8,86 (6%) >400% Total: 0,677 (7%) % Total: 2,637 (4%) % Total: 8,328 (2%) < Total: 4,875 (3%) 39-50% Total: 2,422 (8%) % Total: 28,246 (9%) 00-38% Total: 2,708 (2%) 5-200% Total: 44,808 (29%) Bronze Plans cover 60% of the cost of Essential Health Benefits, while the patient pays 40%; Silver Plans cover 70%, while the patient pays 30%; Gold Plans cover 80%, while the patient pays 20%; Platinum Plans cover 90%, while the patient pays 0%; Catastrophic Plans are a type of health care plan only available through Washington Healthplanfinder for certain individuals under age 30. This type of plan generally offers the least coverage. Tax credits and cost-sharing reductions cannot be used to purchase a catastrophic plan. By Metal Level/FPL 40k 30k 20k 0k < 0-38% 39-50% 5-200% % % % >400% Did not report Bronze Silver,07 3, ,27,736 0,44 9,33 34,327 0,80 5,682 0,063 6,59 2,249 6,835 5,686 3,048 4,06 2,594 Gold ,240 2,86,872 2,26,656,99 Platinum* Catastrophic* Total 4,875 2,708 2,422 44,808 28,246 8,328 2,637 0,677 8,86 * Not graphed 2
5 Enrollee Disenrollments 205 Disenrollments Disenrollments by Metal Level 44% Voluntary Total: 3,437 7% Gold Total: 2,244 Total: 30,604 Total: 30,604 40% Platinum Total: 74 (%) Bronze Total: 2,34 Catastrophic Total: 407 (%) 56% Non-payment Total: 7,67 5% Silver Total: 5,465 Disenrollments by FPL/Metal Level 2,000 0,000 8,000 6,000 4,000 2,000 < >400 Did not report Bronze Silver Gold Total ,229,430,43, , ,33 3,889, , ,402 5,283 3,699 2,434 2,829,593,804 3
6 Enrollees by Month QHP Enrollees 80k 52,57 35k 90k 45k 0/4 /4 2/4 /5 2/5 3/5 4/5 5/5 6/5 7/5 8/5 9/5 33,956 30,299 23,049 98,635 23,567 54,22 55,87 57,637 55,529 52,878 52,40 52,57 MAGI Medicaid Enrollees.8M,447,294.5M.2M 900k 0/4 /4 2/4 /5 2/5 3/5 4/5 5/5 6/5 7/5 8/5 9/5,38,003,336,739,37,25,38,748,4,444,43,609,425,756,43,504,437,74,44,424,446,652,447,294 Dental Enrollees 8k 5,85 6k 4k 2k 0/4 /4 2/4 /5 2/5 3/5 4/5 5/5 6/5 7/5 8/5 9/5 4,932 4,839 4,402 4,059 4,873 5,784 5,852 6,06 5,978 5,759 5,770 5,85 4
7 Enrollees by County QHPs by County 4,898,248 2,04 2,294,329,480,70 4,968 7,036 2,969 5,757 50,09 2,770 2, ,56 845, , Top 0 KING...50,09 SNOHOMISH...5,757 PIERCE...2,770 SPOKANE...0,367 CLARK...9,707 WHATCOM...7,036 THURSTON...4,968 KITSAP...4, ,579, ,678 2,895,27, YAKIMA...3,678 SKAGIT...2,969 9, MAGI Medicaid Enrollees by County 4,87 2,894,568 6,545 5,95 9,830 3,927 50,783 42,425 28,893 27, ,447 75,89 20,93 8,06 3,090 0,528 29,258 3,265,774 0,975 2,458 23,25 7,902 6,344 Top 0 KING...325,447 PIERCE...75,89 SNOHOMISH...27,893 SPOKANE...23,25 CLARK...96,36 YAKIMA...93,07 THURSTON...50,783 BENTON...45,86 4, ,462 28,45,847 93,07 45,86 29,6 3, ,07 WHATCOM...42,425 KITSAP...4,87 96,36 4,990 *,34 Medicaid enrollees listed Other under county, while 408 enrollees listed Border under county 5
8 QHP Enrollee Data QHP Enrollees by Age QHP Enrollees by Gender <8 Total: 5,523 (4%) 8-25 Total: 0,850 (7%) 65+ Total:,5 (%) 45% Male Total: 69, Total: 23,54 (5%) Total: 24,775 (6%) Total: 53,667 (35%) Total: 32,677 (2%) 55% Female Total: 83,233 QHP Enrollees by Language Chinese Total:,294 (%) Spanish Total: 3,67 (2%) Vietnamese Total:,32 (%) Other Total:,580 (%) QHP by U.S. Citizenship No Total: 20,53 (3%) English Total: 45,344 (95%) Yes Total: 32,364 (87%) QHP Enrollees by Race/Ethnicity American Indian Total:,93 (%) Asian Total: 5,82 (0%) Black Total: 2,875 (2%) Not Provided Total: 33,70 (22%) Alaskan Native Total: 42 (0.%) Hawaiian Total: 9 (0.%) Other Total: 5,03 (3%) Pacific Islander Total: 2,566 (2%) White Total: 9,078 (60%) *Number of enrollees who marked Hispanic indicator on their ethnicity: 9,427 QHP by U.S. Citizenship/FPL FPL < >40 Did not report 7% 7% 87% 88% 9% 93% 95% 94% 9% (TOTAL) (4,875) (2,709) (2,420) (44,803) (28,248) (8,33) (2,639) (0,677) (8,85) Citizen Lawfully Present 93% 83% 3% 2% 9% 7% 5% 6% 9% 6
9 MAGI Medicaid Enrollee Data MAGI Medicaid by Age Under 9 Years of Age Total:,447,294 < Total: 692,245 (48%) Total: 86,972 (3%) Total: 23,388 (5%) 65+ Total: 306 Total: 72,823 < Infant Total: 40,70 (6%) -5 Toddler Total: 2,927 (29%) 6-2 School Age Total: 278,78 (39%) Total: 47,47 (0%) Total: 20,272 (8%) Total: 86,640 (6%) 3-8 Adolescent Total: 9,008 (26%) MAGI Medicaid by Race/Ethnicity MAGI Medicaid by FPL American Indian Total: 42,335 (3%) Asian Total: 67,257 (5%) Black Total: 0,403 (8%) < Total:,08,5 (75%) 00-38% Total: 236,33 (6% 39-50% Total: 30,224 (2%) Total:,447,294 Not Provided Total: 34,678 (9%) Alaskan Native Total:,550 Total:,447, %Total: 80,379 (6%) % Total: 5,749 (%) Hawaiian Total: 3, % Total:,906 Other Total: 224,773 (6%) >300% Total:,554 Pacific Islander Total: 40,288 (3%) White Total: 822,33 (57%) *Number of enrollees who marked Hispanic indicator on their ethnicity: 33,296 Medicaid Plan Selection (MPS) 25,000 20,000 5,000 Total: 76,0 UnitedHealthcare Community Plan Total: 3,200 (8%) Amerigroup Washington Inc Total: 6,997 (9%) Columbia United Providers Total: 3,585 (5%) Community Health Plan of Washington Total: 4,74 (9%) 0,000 5, /5 7/5 8/5 9/5 Coordinated Care of Washington Total: 6,07 (8%) Molina Healthcare of Washington Inc Total: 3,56 (4%) MPS Enrollment, June - Sept. 205 Cumulative MPS Enrollment, as of Sept
10 Additional Data QHP Enrollees by Carriers Churn Molina Total: 4,663 (3%) MODA Total: 7,949 (5%) BridgeSpan Total: 0,603 (7%) LifeWise Total: 3,959 (9%) Kaiser Northwest Total: 2,750 (2%) Premera Total: 33,223 (22%) Coordinated Care Total: 3,536 (2%) CHPW Total:,30 (%) QHP - MEDICAID Oct Sept. 205 Avg. Monthly Churn Percentage:.7% Group Health Total: 2,29 (4%) CUP Total: 82 Premera Multi-State Plan Total: 25,5 (7%) Avg. Monthly Churn Total:,582 Highest Churn Month Percentage: Dec %: Carriers BridgeSpan King, Kitsap, Pierce, Skagit, Snohomish, Thurston, Spokane Columbia United Providers (CUP) Clark Community Health Plan of Washington (CHPW) Adams, Benton, Chelan, Clark, Cowlitz, Douglas, Ferry, Franklin, Grant, Grays Harbor, King, Kitsap, Lewis, Okanogan, Pacific, Pend Oreille, Pierce, Skagit, Snohomish, Spokane, Stevens, Thurston, Wahkiakum, Walla Walla, Whatcom, Yakima Coordinated Care Adams, Benton, Chelan, Douglas, Franklin, Grant, Grays Harbor, King, Skagit, Snohomish, Spokane, Thurston, Walla Walla, Yakima Group Health Cooperative Benton, Columbia, Franklin, Island, King, Kitsap, Kittitas, Lewis, Mason, Pierce, San Juan, Skagit, Snohomish, Spokane, Thurston, Walla Walla, Whatcom, Whitman, Yakima LifeWise Health Plan of Washington All 39 counties MODA Health All 39 counties Molina Health Care of Washington Chelan, Douglas, Grant, King, Mason, Okanogan, Pierce, Spokane, Thurston Premera Blue Cross All counties except Clark Kaiser Foundation Health Plan of the Northwest Clark and Cowlitz (Small Business and Individual Market) Delta Dental of Washington, Kaiser Foundation Health Plan of the Northwest, LifeWise, Premera Blue Cross All 39 counties (Pediatric Dental Only) Dental Health Services Benton, Chelan, Clark, Cowlitz, Douglas, Franklin, Grays Harbor, Island, Jefferson, King, Kitsap, Kittitas, Lewis, Mason, Pierce, San Juan, Skagit, Snohomish, Spokane, Thurston, Wahkiakum,Whatcom, Yakima (Pediatric Dental Only) Highest Churn Month: Dec ,426 QHP Medicaid: Enrollees who were enrolled in a QHP in a given month and the next month they are enrolled in Medicaid. Monthly percentage is calculated by dividing the total number of enrollees who moved to Medicaid by the total number of QHP enrollees the previous month. MEDICAID - QHP Oct Sept. 205 Avg. Monthly Churn Percentage: 0.08% Avg. Monthly Churn Total:,38 Highest Churn Month Percentage: Jan % Highest Churn Month: Jan ,085 Medicaid QHP: Enrollees who were enrolled in Medicaid in a given month and the next month they are enrolled in QHP. Monthly percentage is calculated by dividing the total number of enrollees who moved to QHP by the total number of Medicaid enrollees the previous month. 8
11 Additional Data Assisted Enrollees Total 205 assisted QHP enrollees through Sept. 205 Total 205 assisted Medicaid enrollees through Sept. 205 Families In the month of Broker Total: 29,65 Broker Total: 23,08 QHP Households Enrolled Total:,026 QHP Navigator Total: 5,737 Navigator Total: 278,008 Mixed Households Total: 2,30 Mixed households are the total families enrolled both in QHP and Medicaid in. Premiums, Financial Assistance, and Cost-Sharing Reductions Amounts for Total monthly premium per person Cost-sharing reductions (CSR) QHP premiums Total: $58,73,02 Without FA Total: $38.5/month CSR for Sept. 205 Total: $5,2,635 APTC amounts Total: $3,632,90 With FA Total: $73.89/month Enrollees receiving CSR Total: 66,055 *For FA - Financial Assistance APTC - Advanced Premium Tax Credits, a tax credit subsidy to lower the monthly premium cost. 9
12 SHOP SHOP Data County Count of Employers Enrollments 3 2 Employers Total: 2 Employees Total: Dependents Total: Total: 2 Employers by Metal Level 7% Bronze Total: 2 Employees and Dependents by Metal Level Total: 2 32% Gold Total: % Silver Total: 62 Bronze Dependent Employee Employee + Dependent Gold Silver Total
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