HEALTH COVERAGE ENROLLMENT REPORT

Transcription

1 WASHINGTON HEALTH BENEFIT EXCHANGE WAhealthplanfinder.org HEALTH COVERAGE ENROLLMENT REPORT Open Enrollment 5: Nov. 1, Jan. 15, 2018 Published March 2018

2 Table of Contents Total Enrollees... 1 Enrollees Qualified Health Plan Enrollees Subsidized/Non-Subsidized by Month QHP Enrollees... 2 By Metal Level By Percent of Federal Poverty Level (FPL) Enrollees by FPL/Metal Level New QHP Enrollees... 3 Total New By FPL By Metal/FPL Level QHP Renewals... 4 Renewals By FPL By Metal Levels By Carrier QHP Disenrollment Disenrollment By Metal Level By FPL/Metal Level Enrollees by County... 6 QHP by County Washington Apple Health by County QHP Enrollees Data... 7 Age Under 19 Race/Ethnicity U.S. Citizenship Gender By Carriers Language Data... 8 Limited English Proficient Applicants Spanish Languages Top Language Requests By Applicants Language Enrollees... 9 Customer Service Top Language Requests Through Telephonic Interpretation Services Dental Enrollees By Plan Type QHP with Dental By Age By Gender By Carrier Washington Apple Health Enrollees Age Under 19 Race/Ethnicity Medicaid Plan Selection By FPL 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 Feb. 23, 2018 Washington Apple Health - Medicaid MAGI/CHIP population:magi/chip Population Characteristics; Author: HCA/OMSD ; Data Source: ProviderOne ODS Data Warehouse as of Feb. 6, 2018

3 Total Enrollees Enrollees Qualified Health Plan Enrollees QHPs Total: 209,802 (12%) Non-Subsidized Total: 77,219 (37%) 1,725, ,802 WA Apple Health Total: 1,515,978 (88%) Subsidized Total: 132,589 (63%) * Qualified Health Plans (QHP) * Washington Apple Health is comprised of Medicaid MAGI (1,454,392) and CHIP (61,586) enrollees through Jan 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 have 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 APTC. Subsidized/Non-Subsidized by Month 250K 200K 150K 100K 50K 0 Non-Sub Subsidized Total 3/1/17 4/1/17 5/1/17 6/1/17 7/1/17 8/1/17 9/1/17 10/1/17 11/1/17 12/1/17 1/1/18 2/1/18 55, , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , ,802 1

4 QHP Enrollees By Metal Level By Percent of Federal Poverty Level (FPL) Silver Total: 108,159 (51%) Other* Total: 44,592 (21%) <100% Total: 7,387 (4%) 100%-138% Total: 3,843 (2%) 209,812 Bronze Total: 72,669 (35%) Gold Total: 25,734 (12%) Catastrophic Total: 3,250 (2%) >400% Total: 21,732 (10%) 301%-400% Total: 26,069 (12%) 251%-300% Total: 19,521 (9%) 209, %-150% Total: 15,586 (8%) 151%-200% Total: 42,857 (20%) 201%-250% Total: 28,225 (14%) *Chose not to apply for tax credit. 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%; Catastrophic Plans are type of health care plan only available through Washington Healthplanfinder for certain populations, such as 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 FPL/Metal Level 50K 40K 42,857 44,592 30K 28,225 26,069 20K 15,586 19,521 21,732 10K 7,387 3,843 0 <100% 100%-138% 139%-150% 151%-200% 201%-250% 251%-300% 301%-400% >400% Other* Total Gold Silver Bronze 7, , , , , , , , , , , , , , ,294 6, , , , , , , , , , , , , , , ,959 Catastrophic *Chose not to apply for tax credit. 2

5 New QHP Enrollees Total New By FPL Level 70,842 New Non-Subsidized Total: 35,458 (50%) Other* Total: 25,443 (36%) 70,842 <100% Total: 2,469 (3%) 100%-138% Total: 1,125 (2%) 139%-150% Total: 4,330 (6%) 151%-200% Total: 11,796 (17%) New Subsidized Total: 35,384 (50%) >400% Total: 6,808 (10%) 301%-400% Total: 6,916 (10%) 201%-250% Total: 7,130 (10%) 251%-300% Total: 4,825 (7%) *Chose not to apply for tax credit. * Washington Apple Health is comprised of Medicaid MAGI (1,454,392) and CHIP (61,586) enrollees through Jan 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 have 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 APTC. By Metal/FPL Level 30K 25K 25,449 20K 15K 11,796 10K 5K 0 2,469 1,125 4,330 7,130 4,825 6,916 6,810 <100% 100%-138% 139%-150% 151%-200% 201%-250% 251%-300% 301%-400% >400% Other* Total Gold Silver Bronze 2, , , , , , , , , , , , , ,933 2, , , , , , , , , , , , , , ,188 Catastrophic *Chose not to apply for tax credit. 3

6 QHP Renewals Renewals By FPL Did not renew: Total: 34,094 (20%) <100% 100%-138% 4,746 4,987 2,593 2, Dec QHP Enrollees: Total: 167,101 Renewals: Total: 133,007 (80%) Paid till Feb. 2018: Total: 214, %-150% 151%-200% 201%-250% 251%-300% 301%-400% >400% 10,892 9,412 29,967 30,609 20,182 20,163 13,972 13,528 18,222 16,887 14,034 11,654 No Other* APTC 18,399 23, K 10K 15K 20K 25K 30K 35K *Chose not to apply for tax credit. Movement by Metal Levels Bronze Silver GOLD 2017 Renewals: 38,746 Remained With Metal Total: 28,379 (73%) 2017 Renewals: 82,696 Remained With Metal Total: 65,255 (79%) 2017 Renewals: 10,588 Remained With Metal Total: 8,017 (76%) Movement by Carrier 2017 Enrollees: 28,363 Coordinated Care Continued coverage with the carrier: Total: 25,748 (91%) Enrollees: 4,954 Kaiser Northwest Continued coverage with the carrier: Total: 4,925 (99%) 2017 Enrollees: 29,997 Kaiser Permanente WA Continued coverage with the carrier: Total: 28,816 (96%) 2017 Enrollees: 14,389 LifeWise Continued coverage with the carrier: Total: 6,153 (43%) 2017 Enrollees: 31,277 Molina Continued coverage with the carrier: Total: 16,194 (52%) 2017 Enrollees: 15,148 Premera Continued coverage with the carrier: Total: 10,771 (71%) 4

7 QHP Disenrollment 2017 Disenrollment By Metal Level Non-Payment Total: 28,268 (46%) Gold Total: 4,988 (8%) Catastrophic Total: 1,003 (2%) 62,006 62,006 Bronze Total: 20,907 (34%) Voluntary Total: 33,738 (54%) Silver Total: 35,108 (57%) Notes: Includes 2017 enrollees whose coverage ended before Dec Excludes enrollees who moved to Medicaid (17,703) or reported other changes impacting their eligibility. By FPL/Metal Level 15K 13,296 12K 11,895 9K 6K 9,048 6,444 7,784 7,419 3,439 3K 1, <100% 100%-138% 139%-150% 151%-200% 201%-250% 251%-300% 301%-400% >400% Other* Total Gold Silver Bronze 1, , , , , , , , ,863 1, , , , , , , , , , , , , ,374 Catastrophic *Chose not to apply for tax credit. 5

8 Enrollees by County QHP by County 1,260 2,470 8,790 3,402 1, , Top 10 KING... 81,525 SNOHOMISH... 21,122 2,929 1,834 7,173 21,122 81,525 2,617 1, ,457 PIERCE... 18,257 CLARK... 12,666 SPOKANE... 12,457 1,741 1,375 6,263 18,257 1,069 1, WHATCOM... 8,790 KITSAP... 7, ,483 2,325 12, , ,458 1, , ,000+ Enrollees (5 Counties) 2,000-9,999 Enrollees (10 Counties) THURSTON... 6,263 BENTON... 3,458 SKAGIT... 3,402 1,000-1,999 Enrollees (12 Counties) Enrollees (12 Counties) Washington Apple Health by County 17,434 6,021 3,059 12,335 43,204 45,698 29, , ,903 20,785 13,919 11,100 1,963 3,511 11,677 2, ,174 Top 10 KING ,903 PIERCE ,091 SNOHOMISH ,284 SPOKANE ,174 CLARK ,182 21,061 15,245 54, ,091 8,298 31,260 8,649 7,006 YAKIMA... 95,965 THURSTON... 54,646 5, ,967 29, ,182 1,931 95,965 5,311 4,990 *Washington Apple Health enrollees 96,316 consist of Medicaid MAGI (1,454,392) and CHIP (61,586). A total of 606 Washington Apple Health enrollees listed Other under county, while 209 enrollees listed Border under county. 49,438 30,741 BENTON... 49, WHATCOM... 45, ,901 5,282 KITSAP... 43, ,000+ Enrollees (5 Counties) 30,000-99,999 Enrollees (7 Counties) 10,000-29,999 Enrollees (12 Counties) 1-9,999 Enrollees (15 Counties) 6

9 QHP Enrollees Data Age Under Total: 2,193 (1%) Total: 65,200 (31%) Total: 40,789 (19%) ,802 Total: 35,218 (17%) Total: 34,567 (16%) Total: 15,870 (8%) <18 Total: 15,965 (8%) 16,909 Infant <1 Total: 608 (4%) Toddler 1-5 Total: 4,097 (24%) School Age 6-12 Total: 6,286 (37%) Adolescent Total: 5,918 (35%) Race/Ethnicity *Reporting race/ethnicity is not required U.S. Citizenship 209,802 American Indian/Alaska Native Total: 1,219 (1%) Asian Total: 21,864 (10%) African American Total: 3,302 (1%) Hawaiian: Not Provided Total: 144 Total: 74,074 (35%) 209,802 Lawfully Present Total: 27,148 (13%) Other Total: 5,682 (3%) Pacific Islander Total: 3,456 (2%) White Total: 100,061 (48%) Citizen Total: 182,654 (87%) 10,005 marked Hispanic with their ethnicity, while 145,504 did not declare. Note: Additional FPL data available online. Gender By Carrier 209,802 Female Total: 114,846 (55%) Male Total: 94,956 (45%) 209,802 Coordinated Care Total: 54,516 (26%) Kaiser Northwest Total: 9,800 (5%) Kaiser Permanente WA Total: 73,289 (35%) LifeWise Total: 12,895 (6%) Molina Total: 25,437 (12%) Premera Total: 33,297 (16%) BridgeSpan Total: 568 7

10 Language Data Limited English Proficient Applicants 117,469 QHPs Total: 11,001 (9%) WA Apple Health Total: 106,468 (91%) Note: Includes applicants as of February 2018 who indicated in Washington Healthplanfinder they do not speak and/or read English. Spanish Language Spanish Language Requests By Washington Healthplanfinder Applicants Interpreter QHP... 3,789 (5%) WAH... 70,708 (95%) TOTAL... 74,497 Translation QHP... 3,672 (5%) WAH... 71,664 (95%) TOTAL... 75,336 Top Language Requests By Washington Healthplanfinder Applicants 10K 8K Interpreter QHP Washington Apple Health Translation QHP Washington Apple Health 6K 4K 2K QHP WAH Total Chinese Vietnamese Russian Korean Arabic Somali 3, ,662. 2, ,671 1, , ,776. 5, ,619 4, ,189 1, ,724 1, ,425 1, , ,438 8, ,290 5, ,184 2, ,579 1, ,528 1, ,149 *WAH: Washington Apple Health Note: Excludes Spanish, the top language requested (see above). Includes applicants as of Feb 2018 who indicated in Washington Healthplanfinder they do not speak and/or read English and requested an interpreter or translation. 8

11 Language Data Customer Service NON-ENGLISH CALLS ANSWERED Language Count Spanish... 26,011 Language Count Language Count Language Count Russian... 4,695 Korean Somali Vietnamese... 6,169 Madarin... 1,727 Cambodian Laotian Note: Includes calls answered by bilingual and multilingual Customer Service Representatives (CSRs) at the Washington Healthplanfinder Customer Support Center from Oct Feb Additional language data provided online. Top Language Requests Through Telephonic Interpretation Services VIETNAMESE 1,375 SPANISH 497 MANDARIN 363 ARABIC 323 SOMALI 276 KOREAN 225 RUSSIAN 218 FARSI 215 AMHARIC 187 PUNJABI Note: Includes total calls from Oct Jan 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. 9

12 Dental Enrollees By Plan Type Pediatric Dental Total: 1,430 (4%) QHP with Dental Enrolled in QHP and also in QDP Total: 31,342 (15%) 33,324 Family Dental Total: 31,894 (96%) 209,802 By Age By Gender 33,324 <18 Total: 6,686 (20%) Total: 2,391 (7%) 65+ Total: Total: 5,803 (17%) Total: 5,250 (16%) Total: 5,687 (17%) Total: 7,249 (22%) 33,324 Female Total: 17,973 (54%) Male Total: 15,351 (46%) By Carrier Delta Dental of Washington...28,085 Dentegra Insurance Company...4,009 Premera Blue Cross KaiserNorthwest LifeWise Health Plan of Washington Total...33,324 10

13 WA Apple Health Enrollees Age Under 19 <18 Total: 752,373 (50%) Total: 187,669 (12%) Total: 213,417 (14%) 65+ 1,515,978 Total: Total: 153,137 (8%) Total: 115,195 (8%) Total: (6%) 785,694 Infant <1 Total: 41,854 (5%) Toddler 1-5 Total: 224,552 (29%) School Age 6-12 Total: 304,798 (39%) Adolescent Total: 214,490 (27%) Race/Ethnicity Medicaid Plan Selection 1,515,978 American Indian /Alaska Native Total: 56,487 (4%) Asian Total: 69,515 (5%) African American Total: 118,570 (8%) Not Provided Total: 142,762 (9%) Hawaiian: Total: 3, ,811 CHPW Total: 56,253 (16%) Amerigroup Washington Inc Total: 32,725 (9%) United HealthCare Total: 60,993 (17%) Other Total: 225,243 (15%) Pacific Islander Total: 44,739 (3%) White Total: 854,779 (56%) Coordinated Care Total: 31,520 (9%) Molina Total: 170,320 (49%) 341,364 marked Hispanic with their ethnicity, while 345,860 did not declare. By FPL 1.2M 1M 800K 600K Medicaid MAGI CHIP FPL CHIP MAGI Total <100%...3, ,092, ,095, % , , % , , % , , %...29, , , K 200K %...22, , , %...4, , ,448 >400% ,011 0 <100% 100%-138% 139%-150% 151%-200% 201%-250% 251%-300% 301%-400% >400% Total...61, ,454, ,515,978 11

14 Additional Data Special Enrollment Period (SEP) Loss of MEC Total: 1,912 (59%) 3,323 Changes in household size Total: 57 (2%) Change in program eligibility Total: 914 (28%) Change in residence Total: 221 (7%) Other Total: 119 (4%) There are special circumstances that trigger a special enrollment period for an individual or a family outside of open enrollment. These exceptions 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 February 2018 Churn QHP - WA APPLE HEALTH WA APPLE HEALTH - QHP March 1, Feb. 1, 2018 Avg. Monthly Churn Percentage: 0.846% Avg. Monthly Churn Total: 1,549 Highest Month Churn Percentage: Dec. 1, % Highest Month Churn Total: Dec. 1, ,987 QHP Medicaid: Enrollees who were enrolled in a QHP in a given month and the next month they are enrolled in Medicaid. Percentage is calculated by dividing the total number of enrollees who moved to Medicaid by the total number of QHP enrollees the previous month. March 1, Feb. 1, 2018 Avg. Monthly Churn Percentage: 0.13% Avg. Monthly Churn Total: 2,175 Highest Month Churn Percentage: Jan. 1, % Highest Month Churn Total: Jan. 1, ,887 Medicaid QHP: Enrollees who were enrolled in Medicaid in a given month and the next month they are enrolled in QHP. Percentage is calculated by dividing the total number of enrollees who moved to QHP by the total number of Medicaid enrollees the previous month. 12

15 Additional Household Data Partnered Households QHP Households Medicaid Households Households Totals Broker Total: 52,176 (25%) Broker Total: 33,812 (2%) QHP Households Total: 150,179 QHP Navigator Total: 15,606 (7%) Navigator Total: 186,569 (12%) Mixed Households Total: 23,230 (11%) *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 2018 Premiums and Financial Assistance Average monthly premium per person: $513 (+$140 from 2017) Average monthly tax credit per person: $263 (+$75 from 2017) Average monthly net premium per person (after tax credit): $250 (+$66 from 2017) Average monthly net premium per person (after tax credit) by FPL <100% 100%-138% 139%-150% 151%-200% 201%-250% 251%-300% 301%-400% >400% Other $57 $45 $47 $40 $81 $61 $106 $90 $148 $145 $197 $200 $203 $213 $464 $344 $506 $ *Individuals >400% FPL or Other (choose not to apply for tax credit) do not receive federal subsidies 13

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