OE8

Every Open Enrollment Period (OEP) for for the past several years, the Centers for Medicare & Medicaid (CMS) have issued a Weekly Snapshot Enrollment Report including the top-line Qualified Health Plan (QHP) enrollment data via HealthCare.Gov for that week along with the cumulative totals. They normally post these reports, which run Sunday - Saturday, on the following Wendesday...but yesterday came and went without one being released this year.

Given the insanity surrounding last week's Presidential election (along with the results) and the ongoing COVID19 pandemic, I was beginning to wonder whether they'd bother issuing those reports at all. Fortunately, they followed through late this afternoon:

Week 1, November 1-November 7, 2020

In week one of the 2021 Open Enrollment period, 818,365 people selected plans using the HealthCare.gov platform. As in past years, enrollment weeks are measured Sunday through Saturday. 

This is kind of interesting. It looks like the Nevada Health Link (NV's state-based ACA exchange) is offering something new this year:

Nevada Health Link connects consumers to VSP Individual Vision Plans, in time for Open Enrollment 2021

Carson City, Nev. – The Silver State Health Insurance Exchange (Exchange), the state agency that connects Nevadans to Qualified Health Plans (QHPs) through the online State Based Exchange (SBE), known as Nevada Health Link, announces a partnership with VSP® Individual Vision Plans, an offering of VSP Vision Care, the only national not-for-profit vision benefits company.

The Open Enrollment Period for 2021 insurance plans runs from Nov. 1, 2020 through Jan. 15, 2021. Health plans offered through Nevada Health Link are ideal for Nevadans who don’t qualify for Medicare or Medicaid but still need financial assistance; those who don’t have employee-sponsored health insurance, including independent contractors and gig workers; and anyone seeking comprehensive, quality and affordable plans.

Way back in October 2013, when the first ACA Open Enrollment Period (OEP) launched, there were infamously massive technical problems with the federal exchange (HealthCare.Gov) as well as some of the state-based exchanges (such as those in Massachusetts, Maryland, Oregon, Nevada and Hawaii).

Over the next few years, some of those exchange websites were replaced with brand-new ones (MA & MD). Some of the states scrapped theirs altogether and moved onto the mothership at HC.gov (OR, HI & NV, although Nevada has since split back off onto their own exchange again, and seems to have gotten it right this time).

The timing of this press release is a little odd; it came out on November 9th, even though the 2021 ACA Open Enrollment Period actually launched on November 1st. In fact, in California specifically, they've been allowing existing enrollees to actively renew/re-enroll for 2021 since October 1st!

Given the insanity of this year's Presidential election on November 3rd, along with the ongoing COVID19 pandemic, I can hardly blame CoveredCA for the delay, however; after all, this is the first Open Enrollment update I've posted since it kicked off on Nov. 1st as well...

Anyway, via the Covered California newsroom:

Covered California Officially Launches Open Enrollment with Millions of Masks to Encourage Californians to “Get Covered/Stay Covered” and a New Ad Campaign

There's a lot on everyone's plate at the moment. A global pandemic which has already killed over 230,000 Americans and infected 9 million more. The entire West Coast is on fire while the Gulf Coast is being hit with hurricanes. And there's some sort of election coming up on Tuesday, I hear.

Meanwhile, in just eleven days the Republican-controlled Supreme Court will hear oral arguments in a case brought by Republican plaintiffs (and sided with by a Republican Justice Department) over whether the Affordable Care Act should be struck down en masse because a Republican-controlled House and Republican-controlled Senate decided to change the individual mandate penalty amount from $695 to $0.

However, there's one other important thing happening with the ACA in just two days: The 2021 ACA Open Enrollment Period begins on Sunday, November 1st.

As I do every year, here's a list of important things to remember when selecting a health insurance policy. Some of these are the same every year and apply nationwide; others are specific to the 2021 enrollment period and/or to particular states.

1. DON'T MISS THE DEADLINE!

Normally Rhode Island's Open Enrollment Period deadline ends on New Year's Eve (already 2 weeks longer than the federal OEP). This year they're bumping it out even longer:

HealthSource RI extending Open Enrollment period to help more Rhode Islanders get health coverage for 2021

OK, right after saying I was putting a lid on my 2021 Rate Change project, I'm slipping in one more: The District of Columbia posted their approved rate changes a few weeks back:

Information About Approved Rates for January 2021 Health Plan Offerings on DC Health Link

Open Enrollment for Plan Year 2021 DC Health Link’s open enrollment begins November 1, 2020 through January 31, 2021. DC Health Link is an online marketplace created for individuals, families, and small business owners in the District of Columbia to shop, compare, and select health insurance that meets their health needs and budgets. For more information, visit dchealthlink.com or call (855) 532-5465.

This page contains approved health plan rate information for the District of Columbia’s health insurance marketplace, DC Health Link, for plan year 2021.

My 2021 Rate Change project still isn't complete yet for two reasons: First, I only have the final/approved 2021 rate filings for 28 states as of today (vs. preliminary rates for all 50 states + DC). Second, a higher-than-usual number of carriers have made it impossible (or at least highly difficult) to dig up their effectuated enrollment data for 2020.

Without that number, I have no way of running weighted averages for that state's individual market; those are listed in grey below. In a few cases (like Florida), the state insurance dept. actually provided the weighted average but I still had to guess at the total enrollment number (also in grey).

This is a bigger problem than you might think. Let's say a state has 3 carriers requesting a 5% rate reduction, a 2% increase and a 15% increase. The unweighted average would be +4%....but if it turns out that the first carrier holds 90% of the market share this year, the weighted average would be more like -4%. You see the problem here.

A couple of weeks ago I posted North Dakota's preliminary 2021 individual & small group policy premium rate filings, which averaged a 7.4% increase on the individual market and a 4.1% unweighted average increase for the small group market.

A few days ago, the North Dakota Insurance Dept. posted the final/approved rate hikes, including several significant reductions over those requested:

BISMARCK, N.D. – Insurance Commissioner Jon Godfread today released the approved health insurance rates for both individual and small group plans for 2021, and encourages consumers to start early, stay informed and shop around.

Back in early August, the Pennsylvania Insurance Dept. issued the preliminary rate filings for PA's individual and small group market carriers. At the time, the weighted average rate change being requested on the individual market came to a 2.6% reduction in unsubsidized premiums, while the average small group plan was set to increase by 2.3%.

Last week, the PA DOI issued their final decisions for the long list of carriers on each market, and the changes were...minimal, really. In fact, there was no change at all made to most requested rate filings--only two of the 17 indy market carriers saw a change (reductions for each), and only four of the 21 small group carriers did...and even then, the changes aren't terribly dramatic, just a few percentage points in most cases.

Here's the press release:

Insurance Department Announces Lower ACA Individual Plan Health Insurance Rates, Attributes Them To New State-Based Exchange And Reinsurance Program

Back in late July, the Rhode Island insurance dept. issued a press release with the preliminary 2021 rate filings for the state's individual and small group markets. At the time, the weighted statewide average increases being requested were around +5.0% and +2.2% respectively.

A month later, the RI DOI issued their approved 2021 rate decisions, and made some small tweaks to each. In fact, it looks like there was at least one revision in between, as the new press release lists slightly different numbers for the "preliminary" requests.

In any event, Rhode Island indy & sm. group enrollees will be looking at roughly 4.2% increases on the individual market and 2.6% increases for small group plans:

Way back in June, the Washington Insurance Dept. posted the state's preliminary 2021 preliminary individual & small group market premium rate filings. At the time, the weighted average across all carriers was a 1.8% drop in individual market premiums and a 3.4% increase in small group rates. They also announced the addition of two new carriers to the individual market: Community Health Network and UnitedHealthcare of Oregon. It's important to note that both of these new carriers will only be providing WA's new (quasi) Public Option plans.

Last month, however, the WA DOI announced the approved 2021 rates...for the individual market only, and even then it's missing two carriers which are still under review (Asuris and Health Alliance NW). The missing carriers only have 1,200 enrollees between them, however, so any changes to their requested rates won't move the needle noticeably:

Back in late August, the Florida Office of Insurance Regulation posted preliminary 2021 individual & small group market rate filings. At the time, the weighted average increases were around 1.8% on the individual market and 3.3% for small group plans. Unfortunately, the actual enrollment data for each carrier is protected as a trade secret in Florida, but the FLOIR did post those weighted statewide averages.

Last month (I'm a bit behind) they posted the approved, final rate filings. The average individual market increases actually went up a bit, which is unusual (usually they're whittled down a few points), while the small group market average is exactly the same (oddly, they had it as 3.3% in August but say that the preliminary average was 3.4% now):

Back in late July, the Colorado Insurance Dept. released the preliminary 2021 Individual and Small Group Market rate filings. At the time, they came in averaging around +2.2% on the individual market and +5.7% on the small group market.

The final/approved rates have recently been posted, and rates in both markets have been significantly cut down: Individual market rates are now averaging a 1.4% reduction while the increase on the small group market is down to 3.8%.

Via the Alabama Insurance Dept:

The Alabama Department of Insurance (ALDOI) has approved the final 2021 premium rates for the Affordable Care Act Individual Market in Alabama. The rates will be effective on January 1, 2021. The two carriers in the Alabama individual market are Blue Cross Blue Shield of Alabama (BCBS) and Bright Health Insurance Company of Alabama (BHIC). In general, rates for BCBS increased five percent and rates for BHIC increased 22 percent. The actual rates and the supporting material may be found by clicking on the links below.

Unfortunately, the linked documents are still redacted and thus don't include the enrollment numbers for Bright (and this press release says nothing about the small group market), but as far as I can tell this doesn't change the averages of either market much from the preliminary filings. Assuming Bright still only has a tiny part of the market, even its 22% average increase doesn't move the needle much.

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