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HealthCare Checkup

The Seattle Times health-care team tracks the local impact of the Affordable Care Act.

October 13, 2014 at 4:06 PM

State offers auto-renewal of health insurance

Home page for Washington Healthplanfinder.

Home page for Washington Healthplanfinder.

Most Washington residents who bought individual health insurance through the state’s marketplace will be able to automatically renew their coverage for 2105 without taking any additional steps.

The Washington Health Benefit Exchange, which runs the marketplace, is sending out renewal letters to its customers beginning this week. Insurance companies are sending their own letters to inform customers of any changes in their benefits. Open enrollment starts Nov. 15.

“The great news is that most customers won’t need to take further action if they like the health plan they had last year,” said Richard Onizuka, chief executive officer for the exchange, in a press release.

Roughly 100,000 of the exchange’s 147,000 customers will potentially be eligible for automatic renewals.

But while auto-renewal is easy, it might not be the best option for everyone. The number of plans available is almost doubling to 90 health plans from 10 insurers sold on the exchange for next year. That compares with 46 plans from eight insurance companies for coverage in 2014.

Consumers need to carefully consider their health-insurance options. In the first round of sign-ups, some people may have chosen plans with the lowest monthly premiums, but been surprised that they had to pay high deductibles out of their own pockets before insurance coverage kicked in for many services.

“The cost is not just what you pay each month for your premium,” warned Michael Marchand, spokesman for the exchange.

The exchange will try to do more to educate consumers about health-care terminology and the cost tradeoffs, Marchand said.

Criteria for auto-renewal include:

— The customer’s plan must be renewed for 2015.

— They need to have given the exchange permission to check their eligibility for tax credits.

— They must still qualify for coverage based on income level, household size, residency and citizenship status.

Last year some consumers around the country were upset over notices that their insurance was being canceled because it didn’t provide a minimum level of benefits required by the Affordable Care Act. They protested the cancellations, noting that President Obama, when he was promoting the ACA, said that people who liked their insurance could keep it.

In response, some states allowed insurance companies to resuscitate canceled plans, even those with benefits that were too skimpy to meet ACA rules.

Washington Insurance Commissioner Mike Kreidler decided not to revive the discontinued plans. That means that other than exempt “grandfathered” plans that predate the ACA, individual plans providing coverage in 2014 met the new rules so they won’t need to be canceled.

“We will not have that issue this year,” said Stephanie Marquis, spokeswoman for the Office of the Insurance Commissioner.

Insurance carriers can decide to change or discontinue plans for other reasons.

Plans sold through the Washington Healthplanfinder exchange are eligible for tax benefits based on one’s income. Plans that are rated at the “silver” level, meaning they have roughly mid-level benefits, can also qualify for lower charges for deductibles and other medical costs that are passed along to consumers.

While Healthplanfinder has been more successful than many other U.S. marketplaces, the site has been plagued by glitches where consumers pay their premiums to the exchange, but the money isn’t transferred to the insurance companies and it appears they don’t have coverage. That has created problems for patients, doctors and insurance companies.

Since the exchange launched in October last year, some 24,000 accounts have had payment issues. The number of accounts with problems shrank to 1,300 earlier this month.

“We have made substantial progress on resolving these issues,” said Brad Finnegan, associate director of operations with the exchange. State officials said they intend to fix the remaining problem accounts before the Nov. 15 launch of the next enrollment period.

Customers have the option of signing up for their insurance through Healthplanfinder, but rather than making their premium payments to the exchange, they can send them directly to their insurance company.

They can also bypass the exchange and shop for insurance directly through brokers or insurance companies, but only plans bought through the exchange are eligible for tax benefits.

Comments | Topics: Affordable Care Act, health insurance, Healthplanfinder


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