WASHINGTON HEALTH BENEFIT EXCHANGE · Qualified Health Plan Enrollees ... Data Source: ProviderOne...

Open Enrollment 5: Nov. 1, 2017 - Jan. 15, 2018

WASHINGTON HEALTH BENEFIT EXCHANGE

HEALTH COVERAGEENROLLMENT REPORT

HEALTH COVERAGEENROLLMENT REPORT

WAhealthplanfinder.org

Published March 2018

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 ................................................................................ 5 2017 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

Washington Health Benefit ExchangeEnrollment Report

OE5

This Enrollment Report in an excel spreadsheet with additional data is also available online at:https://www.wahbexchange.org/about-the-exchange/reports-data/Qualified 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

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.................................................................................... 10 By Plan Type QHP with Dental By Age By Gender By Carrier Washington Apple Health Enrollees ................................................... 11 Age Under 19 Race/Ethnicity Medicaid Plan Selection By FPL Additional Data ..................................................................................... 12 Special Enrollment Period (SEP) Churn Additional Household Data ................................................................. 13 Partnered Households Households Additional Financial Data

TOTAL:

QHPsTotal: 209,802 (12%)

1,725,780

WA Apple HealthTotal: 1,515,978 (88%)

Total Enrollees

Subsidized/Non-Subsidized by Month

Enrollees Qualified Health Plan Enrollees

* Washington Apple Health is comprised of Medicaid MAGI (1,454,392) and CHIP (61,586) enrollees through Jan. 2018.

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.


OE5

1

Non-SubSubsidizedTotal

0

50K

100K

150K

200K

250K

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 55,877 ........... 55,231 ............54,583 ........... 54,299 ...........53,854 ........... 53,906 ...........53,737 ........... 53,026 ...........52,089 ...........49,772 ...........73,694 ............77,219 137,339 ........ 135,433 .........133,574 .......... 131,857 ..........130,270 ..........128,973 .........127,405 ..........125,531 ..........122,777 ......... 117,344 ......... 124,423 ......... 132,589 193,216 ......... 190,664 .......... 188,157 .......... 186,156 .......... 184,124 ..........182,879 ......... 181,142 ...........178,557 .........174,866 ..........167,116 ........... 198,111 ..........209,802

TOTAL:

Non-SubsidizedTotal: 77,219 (37%)

SubsidizedTotal: 132,589 (63%)

209,802

* Qualified Health Plans (QHP)

TOTAL:

SilverTotal: 108,159 (51%)

BronzeTotal: 72,669 (35%)

CatastrophicTotal: 3,250 (2%)

209,812

GoldTotal: 25,734 (12%)

QHP Enrollees

By Metal Level

*Chose not to apply for tax credit. lBronze Plans cover 60% of the cost of essential health benefits, while the patient pays 40% ; lSilver Plans cover 70%, while the patient pays 30%; lGold Plans cover 80%, while the patient pays 20%; lCatastrophic 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.

0

10K

20K

30K

40K

50K

By Percent of Federal Poverty Level (FPL)

By FPL/Metal Level

2

<100% 100%-138% 139%-150% 151%-200% 201%-250% 251%-300% 301%-400% >400% Other* 7,387....................... 3,843 ......................15,586 .....................42,857 .....................28,225 .....................19,521 .................... 26,069 .................... 21,732 .....................44,592 199 ...........................66........................... 341......................... 1,449 .......................3,426 ......................3,064 .......................4,169 .......................3,726 .......................9,294 6,610 ....................... 3,543 ......................13,582 .....................34,262 ..................... 15,669 .....................6,946 ...................... 8,709 .......................6,402 ......................12,436 512 ..........................224 ........................1,603 ....................... 6,952 ....................... 8,881 ......................9,020 ......................12,501 ......................11,017 ......................21,959 66 ............................ 10 ............................ 60 ........................... 194 ..........................249 ..........................491 ..........................690 ..........................587.......................... 903

TOTAL:

<100%Total: 7,387 (4%)

139%-150%Total: 15,586 (8%)

151%-200%Total: 42,857 (20%)

201%-250%Total: 28,225 (14%)

OtherTotal: 44,592 (21%)

>400%Total: 21,732 (10%)

301%-400%Total: 26,069 (12%)251%-300%Total: 19,521 (9%)

209,812

100%-138%Total: 3,843 (2%)

Total GoldSilverBronzeCatastrophic


OE5

7,387

3,843

15,586

42,857

28,225

19,521

26,069

21,732

44,592

*Chose not to apply for tax credit.

*

TOTAL:

New Non-SubsidizedTotal: 35,458 (50%)

NewSubsidizedTotal: 35,384 (50%)

70,842

New QHP Enrollees

Total New

* Washington Apple Health is comprised of Medicaid MAGI (1,454,392) and CHIP (61,586) enrollees through Jan. 2018.

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.

0

5K

10K

15K

20K

25K

30K

By FPL Level

By Metal/FPL Level

3

<100% 100%-138% 139%-150% 151%-200% 201%-250% 251%-300% 301%-400% >400% Other* 2,469 .......................1,125 ...................... 4,330 ......................11,796 ...................... 7,130 ......................4,825 .......................6,916 ....................... 6,810 ......................25,449 79 ............................ 21 ............................117 ...........................479 ......................... 1,117 ....................... 1,004 ....................... 1,417 ....................... 1,444 .......................5,933 2,170 ........................1,037 ...................... 3,649 ...................... 8,862 .......................3,247 .......................1,133........................1,650 ....................... 1,664 .......................6,808 186 ...........................62...........................533 ........................ 2,368 .......................2,670 ......................2,487 ...................... 3,555 .......................3,458 ...................... 12,188 34 ............................. 5 ............................. 31 .............................87 ............................ 96 ........................... 201 ..........................294 ..........................244 ......................... 520

TOTAL:

<100%Total: 2,469 (3%)

139%-150%Total: 4,330 (6%)

151%-200%Total: 11,796 (17%)

201%-250%Total: 7,130 (10%)

Other*Total: 25,443 (36%)

>400%Total: 6,808 (10%)

301%-400%Total: 6,916 (10%)

70,842

100%-138%Total: 1,125 (2%)

251%-300%Total: 4,825 (7%)

Total GoldSilverBronzeCatastrophic


OE5

2,4691,125

4,330

11,796

7,130

4,825

6,916 6,810

25,449



<100%

0 5K 10K 15K 20K 25K 30K 35K

100%-138%

139%-150%

151%-200%

201%-250%

251%-300%

301%-400%

>400%

No APTC

10,8929,41229,96730,60920,18220,163

13,97213,52818,22216,88714,03411,65418,39923,436

2018 2017

4,7464,9872,5932,331

Dec. 2017 QHP Enrollees:Total: 167,101

Did not renew:Total: 34,094 (20%)

Renewals:Total: 133,007 (80%)

Paid till Feb. 2018:Total: 214,963

QHP Renewals

Movement by Carrier

Renewals By FPL


OE5

4

Movement by Metal Levels

2017 Renewals:38,746

Remained With MetalTotal: 28,379 (73%)





Bronze Silver GOLD

Coordinated CareContinued coverage with the carrier:Total: 25,748 (91%)

2017 Enrollees: 28,363

Kaiser Permanente WAContinued coverage with the carrier:Total: 28,816 (96%)


Kaiser NorthwestContinued coverage with the carrier:Total: 4,925 (99%)


LifeWiseContinued coverage with the carrier:Total: 6,153 (43%)


MolinaContinued coverage with the carrier:Total: 16,194 (52%)


PremeraContinued coverage with the carrier:Total: 10,771 (71%)


Other*


TOTAL:

Non-PaymentTotal: 28,268 (46%)

62,006

Voluntary Total: 33,738 (54%)

QHP Disenrollment

2017 Disenrollment By Metal Level


OE5

5

TOTAL:

Gold Total: 4,988 (8%)

BronzeTotal: 20,907 (34%)

62,006

SilverTotal: 35,108 (57%)

CatastrophicTotal: 1,003 (2%)

By FPL/Metal Level

0

3K

6K

9K

12K

15K

<100% 100%-138% 139%-150% 151%-200% 201%-250% 251%-300% 301%-400% >400% Other* 1,864 ......................... 817 ........................ 3,439 ......................11,895 ..................... 9,048.......................6,444 ...................... 7,784 ....................... 7,419 ...................... 13,296 61 ............................. 10 ............................ 48 ...........................294 .........................553 ..........................538 ......................... 713 ...........................908......................... 1,863 1,518 ..........................711 ........................ 2,935.......................9,349 ...................... 5,734 .......................2,866 .......................3,173 ....................... 2,981 ....................... 5,841 271............................93........................... 441 ........................ 2,192 ...................... 2,653 .......................2,849 ...................... 3,672 .......................3,362 .......................5,374 14 .............................. 3 ............................. 15 .............................60 ........................... 108 ........................... 191 ..........................226 .......................... 168 ...........................218

Total Gold SilverBronzeCatastrophic

1,864

817

3,439

11,895

9,048

6,444

7,7847,419

13,296


Notes: Includes 2017 enrollees whose coverage ended before Dec. 2017. Excludes enrollees who moved to Medicaid (17,703) or reported other changes impacting their eligibility.

Enrollees by County

QHP by County

12,666

18,257

848

3,243

8,790

3,402

21,122

81,525

6,263

1,483

331

3,458

1,257

1,118 88

64

418

1,415

2,617

1,069

162

1,157

373

1,002

1,789

351 12,457

356807

2,929

1,834

1,741 1,375

962,325

711

1,260

2,470

7,173

KING .................................. 81,525

SNOHOMISH ................. 21,122

PIERCE............................... 18,257

CLARK ............................... 12,666

SPOKANE ........................ 12,457

WHATCOM ......................... 8,790

KITSAP ................................. 7,173

THURSTON ........................ 6,263

BENTON .............................. 3,458

SKAGIT ................................. 3,402

Top 10

6

10,000+ Enrollees (5 Counties)

2,000 - 9,999 Enrollees (10 Counties)


1 - 999 Enrollees (12 Counties)

Washington Apple Health by County

96,3164,990

KING ................................. 329,903

PIERCE.............................. 186,091

SNOHOMISH ................ 136,284

SPOKANE ........................ 131,174

CLARK .............................. 100,182

YAKIMA ............................. 95,965

THURSTON ...................... 54,646

BENTON ............................ 49,438

WHATCOM ....................... 45,698

KITSAP ............................... 43,204

Top 10

*Washington Apple Health enrollees 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.

100,000+ Enrollees (5 Counties)


10,000 - 29,999 Enrollees (12 Counties) 1 - 9,999 Enrollees (15 Counties)

100,182

186,091

5,311

95,965

45,698

29,935

136,284

329,903

54,646

21,967

1,931

49,438 30,741

13,901 920

506

5,282

13,919

20,785

8,298

1,96311,677

3,511

11,100

31,260

2,646 131,174

8,649 7,006

17,434

6,021

21,061 15,245

914 29,845

5,353

3,059

12,335

43,204


OE5

TOTAL:

Toddler 1-5Total: 4,097 (24%)

Adolescent 13-18Total: 5,918 (35%)

16,909

Infant <1Total: 608 (4%)

School Age 6-12Total: 6,286 (37%)

TOTAL: Not ProvidedTotal: 74,074 (35%)

AsianTotal: 21,864 (10%)African AmericanTotal: 3,302 (1%)


WhiteTotal: 100,061 (48%)

209,802

American IndianTotal: 1,219 (1%)

Pacific IslanderTotal: 3,456 (2%)

QHP Enrollees Data Washington Health Benefit ExchangeEnrollment Report

OE5

Age Under 19

Race/Ethnicity

Gender

U.S. Citizenship

7

TOTAL: 35-44Total: 35,218 (17%)

55-64Total: 65,200 (31%)

45-54Total: 40,789 (19%)

26-34Total: 34,567 (16%)

<18Total: 15,965 (8%)

209,802

65+Total: 2,193 (1%)

18-25Total: 15,870 (8%)

TOTAL:

FemaleTotal: 114,846 (55%)

MaleTotal: 94,956 (45%)

209,802

TOTAL:

Lawfully Present Total: 27,148 (13%)

CitizenTotal: 182,654 (87%)

209,802

10,005 marked “Hispanic” with their ethnicity, while 145,504 did not declare.

Hawaiian:Total: 144

Note: Additional FPL data available online.

/Alaska Native

By Carrier

Coordinated CareTotal: 54,516 (26%)Kaiser NorthwestTotal: 9,800 (5%)Kaiser Permanente WATotal: 73,289 (35%)LifeWiseTotal: 12,895 (6%)MolinaTotal: 25,437 (12%)PremeraTotal: 33,297 (16%)BridgeSpanTotal: 568

TOTAL:209,802

*Reporting race/ethnicity is not required

0

2K

4K

6K

8K

10K

Lorem ipsum

Language Data Washington Health Benefit ExchangeEnrollment Report

OE5

Top Language Requests By Washington Healthplanfinder Applicants

8

Limited English Proficient Applicants Spanish Language

TOTAL: 117,469

QHPsTotal: 11,001 (9%)

WA Apple HealthTotal: 106,468 (91%)

Chinese Vietnamese Russian Korean Arabic Somali 3,952 ..... 3,662 2,895 ............ 2,671 1,084 .............. 995 916 .................855 107 ............... 103 19 ................. 173 5,023 ..... 4,776 5,782 ............ 5,619 4,243 ............4,189 1,786 ............. 1,724 1,357.............1,425 1,032 ..............976 8,975 ..... 8,438 8,677 ............ 8,290 5,327.............5,184 2,702 .............2,579 1,464 ............1,528 1,051 .............1,149

QHPWAHTotal

*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.

Spanish Language Requests By Washington Healthplanfinder

Applicants

Interpreter QHP ............. 3,789 (5%)WAH ......... 70,708 (95%)TOTAL ................ 74,497

TranslationQHP ............. 3,672 (5%)WAH ......... 71,664 (95%)TOTAL ................ 75,336

Interpreter

QHP

Washington Apple Health

QHP

Washington Apple Health

Translation

Note: Includes applicants as of February 2018 who indicated in Washington Healthplanfinder they do not speak and/or read English.

Language Data Washington Health Benefit ExchangeEnrollment Report

OE5

Top Language Requests Through Telephonic Interpretation Services

Customer Service

9

Spanish ........... 26,011

Vietnamese ....... 6,169

Russian .............. 4,695

Madarin ............ 1,727

Korean ................. 722

Cambodian.......... 143

Somali .................. 125

Laotian ................... 48

NON-ENGLISH CALLS ANSWERED

Language Count

Note: Includes calls answered by bilingual and multilingual Customer Service Representatives (CSRs) at the Washington Healthplanfinder Customer Support Center from Oct. 2017 - Feb. 2018. Additional language data provided online.

0 300 600 900 1200 1500

Note: Includes total calls from Oct. 2017 - Jan. 2018. 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.

Language Count Language Count Language Count

VIETNAMESE 1,375

SPANISH 497

MANDARIN 363

ARABIC 323

SOMALI 276

KOREAN 225

RUSSIAN 218

FARSI 215

AMHARIC 187

PUNJABI 146

Dental Enrollees Washington Health Benefit ExchangeEnrollment Report

OE5

10

By Plan Type QHP with Dental

By Age By Gender

By Carrier Delta Dental of Washington ..........................................28,085 Dentegra Insurance Company ........................................ 4,009 Premera Blue Cross .................................................................947 KaiserNorthwest .......................................................................153 LifeWise Health Plan of Washington ................................130 Total ........................................................................................33,324

TOTAL: Family DentalTotal: 31,894 (96%)33,324

Pediatric DentalTotal: 1,430 (4%)

TOTAL:209,802

Enrolled in QHPand also in QDPTotal: 31,342 (15%)

TOTAL:

FemaleTotal: 17,973 (54%)

MaleTotal: 15,351 (46%)

33,324TOTAL:

65+Total: 258

18-25Total: 2,391 (7%)

26-34Total: 5,803 (17%)35-44Total: 5,250 (16%)

55-64Total: 7,249 (22%)

33,324

<18Total: 6,686 (20%)

45-54Total: 5,687 (17%)

0

200K

400K

600K

800K

1M

1.2M

TOTAL: 65+Total: 505

18-25Total: 187,669 (12%)26-34Total: 213,417 (14%)

35-44Total: 153,137 (8%)

55-64Total: 93682 (6%)

1,515,978

<18Total: 752,373 (50%)

45-54Total: 115,195 (8%)

WA Apple Health Enrollees Washington Health Benefit ExchangeEnrollment Report

OE5

11

Age Under 19

Race/Ethnicity Medicaid Plan Selection

TOTAL:

Coordinated CareTotal: 31,520 (9%)

Amerigroup Washington IncTotal: 32,725 (9%)

United HealthCareTotal: 60,993 (17%)

351,811

CHPWTotal: 56,253 (16%)

MolinaTotal: 170,320 (49%)

TOTAL:

Toddler 1-5Total: 224,552 (29%)

Adolescent 13-18Total: 214,490 (27%)

785,694

Infant <1Total: 41,854 (5%)

School Age 6-12Total: 304,798 (39%)

Hawaiian:Total: 3,883

By FPL

TOTAL: Not ProvidedTotal: 142,762 (9%)

AsianTotal: 69,515 (5%)African AmericanTotal: 118,570 (8%)


WhiteTotal: 854,779 (56%)

1,515,978

American IndianTotal: 56,487 (4%)

Pacific IslanderTotal: 44,739 (3%)

FPL CHIP MAGI Total <100% ...........3,223 ......... 1,092,716 ........ 1,095,939 100-138% .....707 ............ 228,465 ................229,172 139-150% .....175 ............ 28,724 .................... 28,899 151-200% .....482 ............ 80,914 .................... 81,396 201-250% .....29,541 ...... 18,064 .................... 47,605 251-300% .....22,233 ...... 3,275 ....................... 25,508 301-400% .....4,884 ......... 1,564 ..........................6,448 >400% ...........341 ............ 670 .............................1,011 Total ................61,586 ...... 1,454,392 ....... 1,515,978

<100% 100%-138% 139%-150% 151%-200% 201%-250% 251%-300% 301%-400% >400%

341,364 marked “Hispanic” with their ethnicity, while 345,860 did not declare.

Medicaid MAGI CHIP

/Alaska Native

TOTAL:

Changes in household sizeTotal: 57 (2%)

Loss of MECTotal: 1,912 (59%) 3,323

OtherTotal: 119 (4%)

Change in program eligibilityTotal: 914 (28%)

Change in residence Total: 221 (7%)

Additional Data Washington Health Benefit ExchangeEnrollment Report

OE5

12

Special Enrollment Period (SEP)

QHP - WA APPLE HEALTH

March 1, 2017 - Feb. 1, 2018 Avg. Monthly Churn Percentage:

0.846%

Avg. Monthly Churn Total:1,549

Highest Month Churn Percentage: Dec. 1, 2017 - 2.37%

Highest Month Churn Total: Dec. 1, 2017 - 3,987

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.

WA APPLE HEALTH - QHP

March 1, 2017 - Feb. 1, 2018 Avg. Monthly Churn Percentage:

0.13%

Avg. Monthly Churn Total:2,175

Highest Month Churn Percentage: Jan. 1, 2018 - 0.32%

Highest Month Churn Total: Jan. 1, 2018 - 4,887

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.

Churn

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

Additional Household Data Washington Health Benefit ExchangeEnrollment Report

OE5

Partnered Households HouseholdsTotals

QHP Households Total: 150,179

Mixed Households Total: 23,230 (11%)

QHP

Mixed households have family members enrolled in both QHP and WA Apple Health

Additional Financial Data

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)

Medicaid HouseholdsQHP Households

Broker Total: 52,176 (25%)

Navigator Total: 15,606 (7%)

Broker Total: 33,812 (2%)

Navigator Total: 186,569 (12%)

13

*Household account partnered to a Navigator and/or Broker in Washington Healthplanfinder

2018 Premiums and Financial Assistance <100%

0 100 200 300 400 500 600

100%-138%

139%-150%

151%-200%

201%-250%

251%-300%

301%-400%

>400%

Other

$81$61$106$90$148$145

$197$200$203$213$464$344$506$354

2018

$57$45$47$40 2017

Average monthly net premium per person (after tax credit) by FPL

*Individuals >400% FPL or Other (choose not to apply for tax credit) do not receive federal subsidies

WASHINGTON HEALTH BENEFIT EXCHANGE · Qualified Health Plan Enrollees ... Data Source: ProviderOne...

Documents

Transcript of WASHINGTON HEALTH BENEFIT EXCHANGE · Qualified Health Plan Enrollees ... Data Source: ProviderOne...