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Private Insurers Submit 293 Health Insurance Policies for Approval to Offer to Individuals, Small Businesses on DC Exchange

Friday, May 17, 2013
The plans include 259 policies for small businesses and 34 for individual purchasers.

Four major health insurance companies intend to offer nearly 300 different health insurance policies for sale on the DC Exchange Marketplace, a new online portal that will allow individuals, families, and small businesses to shop for coverage that fits their needs and budgets. This robust choice of plans means, for the first time, that residents and employers in the District will be able to compare dozens of plans side-by-side when the Marketplace opens for enrollment on October 1, 2013 for coverage that becomes effective January 1, 2014.

Earlier this month, the four insurers – Aetna, CareFirst BlueCross BlueShield, Kaiser Permanente, and United Healthcare – committed to participating in the Marketplace. Because they sell coverage in today’s market, their participation in the Marketplace ensures all currently insured in the small group and individual markets will not have to change insurers unless they choose to do so.

“This is wonderful news for the residents and local businesses, which will have more choices and better choices than they have today,” said Mayor Vincent C. Gray. “I’m pleased to see our strategy for improving the health and financial security of our residents is working.”

The four insurers have filed a total of 259 small group products and 34 individual products.  These include health maintenance organizations (HMOs) and preferred provider organizations (PPOs) health insurance policies. All policies must cover, at a minimum, a set of essential health benefits that include doctor and hospital visits, prescription drugs, pre-natal and maternity care, prevention, lab tests, and vision and dental care for children. A detailed list of plan offerings by insurer is listed below.

“This shows that insurance companies serving the District’s insurance consumers are committed to offering good options for businesses and people here.  I thank the insurance companies for their commitment to helping the District’s Marketplace Exchange be successful.  As a result, we will have a strong, competitive market where individuals and small businesses will have a wide variety of options when buying high-quality health insurance,” said Mila Kofman, J.D., the Executive Director of the DC Health Benefit Exchange.

Insurers have until May 31 to file their proposed rates with the Insurance Department. Actuaries will review the rates to determine whether they are set at appropriate levels. Once health insurance policies and rates are approved, the Exchange will provide additional information.  Many DC residents will be eligible for significant financial help in the form of federal tax credits to reduce the cost of insurance for them.

“For coverage to be meaningful, it must be affordable,” said William P. White, commissioner of the District’s Department of Insurance, Securities and Banking, whose agency is responsible for the rate review process. “Insurers have an obligation to charge premiums that cover the cost of paying claims and maintaining a reasonable reserve to protect against uncertainties. With thousands of uninsured DC residents waiting to gain coverage, it is crucial that 2014 rates are reasonable and justified. We will work with insurers to accomplish that result.”

Health Insurance Policies for the Exchange Filed for Approval With DISB

Carrier Total Plans Individual Plans SHOP Plans
CareFirst BlueChoice, Inc. 50 11 39
Group Hospitalization and Medical Services, Inc. (GHMSI) 27 4 23
Optimum Choice, Inc. 88 0 88
United Healthcare Insurance Company 89 0 89
Aetna Life Insurance Company 12 9 3
Aetna Health Inc. 3 0 3
Kaiser Foundation of the Mid-Atlantic States, Inc 24 10 14
Total 293 34 259