Pennsylvania

Excellent find by contributor deaconblues; HighMark is one of the few major insurance companies which has been very open about their off-exchange QHP enrollments. This press release contains some great updates for 3 different states, including a total exchange QHP update for West Virginia (since HighMark is the only insurance company operating on the exchange there anyway):

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

Pennsylvania: 148,003 total with 104,324 on-exchange and 43,679 off-exchange
West Virginia: 20,131 total with 14,839 on-exchange and 5,292 off-exchange
Delaware: 13,010 total with 9,187 on-exchange and 3,823 off-exchange

Through both on- and off-exchange purchases, Highmark had a noteworthy 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: 63 percent new members
Delaware: 67 percent new members

Two different people sent me two different articles which help piece together more of the off-exchange puzzle.

From January, this article about Independence Blue Cross of Pennsylvania:

Independence, the region's largest health insurer, with 13 plans on the marketplace, reported enrolling 52,278 people from Oct. 1, when healthcare.gov opened, through Dec. 24, the last day to buy for the new year....

Just over half of Independence's new members - 27,528 - went through the federal marketplace; 24,750 of them used the company's website, telesales, or the mobile Independence Express and brokers.

OK, that's 24,750 (47.3%) off-exchange enrollments through 12/24.

Then, yesterday (3/18):

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.

UPDATE: On the down side, I was off by 4% this time around.

On the up side, I UNDERESTIMATED:

Actual Feb. enrollments: 942,833, for a total of 4,242,325 thru 3/01/14.

Sarah Kliff at Vox just announced that the February HHS report is expected to be released today at around 4:00pm. A few items in anticipation of that:

  • As I've noted several times, I'm projecting the report to total around 902,000 exchange-based private QHP enrollments for the month of February (technically 2/02 - 3/01)
  • If accurate, this would bring the cumulative total of exchange-based private QHP enrollments to 4.202 million (from 10/1/13 - 3/01/14)
  • From the data I have, the average daily enrollment rate in February was almost identical to that of January, which had about 1.146 million QHP enrollments. HOWEVER, the January report included five weeks of data (12/28 - 2/01), while the February report will only include four weeks (2/02 - 3/01). Therefore, even at the same daily average, it'll be about 20% lower no matter what.
  • Don't be surprised if Peter Lee of CoveredCA decides to steal some thunder by announcing that California has enrolled 1,000,000 QHPs all by itself either today or tomorrow. However, that would include the past 10 days, while the HHS number will only run thru 3/01.
  • If you want to get REALLY specific, call it 902,800 and 4,202,292.
  • I've been dead-on target 6 times in a row without hyping up my projections beforehand. This time I am hyping myself up beforehand, so I'll probably be way off...but as long as I've UNDERestimated the tally, I'll be perfectly fine with that...
  • The report will be released in about 5 minutes, but my kid gets home from school in about 10, so it'll be a good 20 minutes before I can really post anything. Feel free to follow Sarah Kliff of Vox in the meantime!

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