Health insurance exchanges

Proposed rate increases for 2016 health insurance coverage that a dozen carriers will sell on Covered California’s state-run exchange will be just 4% compared to the 4.2% rise approved for 2015.

Public exchange plan participants spent less money on medications in the first quarter of 2015 than the first quarter of 2014 amid changes in the demographic mix of enrollees, according to newly released data from Express Scripts Holding Company.

The federal health insurance marketplace may have issued subsides to persons not eligible to receive them during the first open enrollment period, a new report from the Department of Health and Human Services’ Office of the Inspector General has found.

Connecticut’s AccessHealthCT is poised to become the nation’s first state-run marketplace that will be financially self-sustaining in 2016 when federal grants end for these online marketplaces as stipulated under the Affordable Care Act.

While Montana has one of the nation’s lowest head counts, it ranked a close second behind New Hampshire in terms of the highest rate of 2015 public exchange re-enrollment among 34 states that direct their residents to Healthcare.gov.

For the first time, brokers and agents will be eligible to receive continuing education credits through the training, which is required to eligible to sell on the federal marketplace.

Three Republican senators have sent a letter to the Centers for Medicare and Medicaid Services expressing concern for the “lack of oversight for more than $1 billion in federal grants” given to state-based marketplaces.

State-based marketplaces were overall quite successful in retaining enrollees, however, a large number of consumers shopping within the marketplace during 2015 open enrollment decided to switch plans based on the price of services offered.

As pressure mounts on state-run public health insurance exchanges to be financially self-sufficient in time for 2016, consumer operated and oriented plans created under the Affordable Care Act face the same challenge. And with two recent troubling developments in the CO-OP space, there are renewed questions about the long-term viability of these nonprofit entities.

Narrow networks are more prevalent in public exchanges than the commercial market, and while this trend helps keep costs more manageable, it also significantly restricts any movement for consumers and could undermine network adequacy standards.