END OF 2018 OPEN ENROLLMENT PERIOD (41 states)

Time: D H M S

Large Off-Enrollment Update out of Pennsylvania, W. Virginia & Delaware!

Hat Tip To: 
Uncle Toby

A beautiful find by new contributor Uncle Toby: Highmark Inc., a major insurer which serves Pennsylvania, West Virginia and Delaware, just did exactly what I've been wanting every insurer to do: They officially announced not just their off-exchange enrollments, but specified the exact date that these run through and the fact that they're all 100% ACA compliant.

As a bonus, they've included specific state-by-state breakdowns as well as a comparison against their on-exchange enrollments. 32% of PA's, 27% of WV's and 29% of Delaware's QHP enrollees to date have been off-exchange. This proves exactly what I've been saying: There are absolutely several million (at a minimum) direct QHPs out there which simply haven't been documented publicly yet.

All told, this adds 41,117 to the total Off-Exchange tally:

PITTSBURGH (March 11, 2014) — Today, Highmark Inc. shared enrollment numbers that showed individuals continue to choose the health insurer for their coverage both on and off the federal marketplace in Pennsylvania, West Virginia and Delaware.

Highmark's current total enrollment* for individuals who have purchased Affordable Care Act-compliant plans both on the federal marketplace exchange and through Highmark directly:

Pennsylvania: 108,390 total with 74,006 on-exchange and 34,384 off-exchange
West Virginia: 14,980 total with 10,970 on-exchange and 4,010 off-exchange
Delaware: 9,244 total with 6,521 on-exchange and 2,723 off-exchange

Through both on- and off-exchange purchases, Highmark is seeing a significant percentage of new members, which are likely those who were previously uninsured or had insurance with a competitor.

Pennsylvania: 53 percent new members
West Virginia: 66 percent new members
Delaware: 70 percent new members

"As the enrollment period nears its end, we're happy to see that consumers are continuing to choose Highmark products on and off the exchange," said Deborah Rice Johnson, president of Highmark Health Plan. "Highmark is committed to providing individuals with affordable health care options, and we look forward to serving our new customers."

Highmark also continues to see a high percentage of enrollment in its Community Blue plans in Pennsylvania. Of all of the individual plans sold by Highmark, 78 percent have been Community Blue plans.

...*Enrollment numbers as of March 10, 2014 are of those who have been loaded to Highmark's system through completed enrollments (834s that have been verified and processed by Highmark). These enrolled members may have not yet paid their first month's premium, therefore have not completed the entire enrollment process.

Even better: By providing their total enrollments, this helps give a sense of the larger off-exchange numbers in these 3 states (the numbers in the PR are through 3/10 instead of 3/01, but the ratios should be about the same since then, which is my focus here:

  • Pennsylvania had 159,821 exchange QHPs as of 3/01. Highmark claims 74,006 in PA, or 46.3%. This suggests total PA off-exchange enrollments are around 74,200.
  • West Virginia had 10,599 exchange QHPs as of 3/01. Highmark claims 10,970 in WV...which is actually higher than the total...and there's a reason for this: Highmark is the only insurance company operating on the WV exchange! This means, as a bonus, that we now have an updated number of exchange-based QHPs for West Virginia (371 more on the 10th than the 1st).
  • Delaware had 6,994 exchange QHPs as of 2/28. Highmark claims 6,521 of these, or 93%. This suggests total DE off-exchange enrollments are around 2,900.