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Originally published Friday, August 30, 2013 at 8:55 PM

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2 more insurers OK’d to sell health plans on exchange

Insurance Commissioner Mike Kreidler said Friday that approval has been granted to Community Health Plan of Washington and Kaiser Foundation Health Plan of the Northwest.

Special to The Seattle Times

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The state Office of the Insurance Commissioner (OIC) has approved two additional insurance companies to sell individual health plans through the state’s new online insurance-exchange marketplace, called Washington Healthplanfinder.

The move marked a reversal for the two companies, which previously had been rejected for the exchange.

Insurance Commissioner Mike Kreidler said Friday approval has been granted to Community Health Plan of Washington, which currently serves Medicaid enrollees, to sell three commercial plans in 26 counties through the exchange in 2014.

He also gave the go-ahead for Kaiser Foundation Health Plan of the Northwest, which operates in Southwest Washington, to offer seven plans in Clark and Cowlitz counties.

Their addition increases the number of approved carriers from four to six, and the number of individual health plans that will be offered on the exchange from 31 to 41.

All plans now need certification by the board of the Washington Health Benefit Exchange, the agency that operates the exchange.

The board is to meet Wednesday.

In an interview Friday, Kreidler said he was pleased to approve more insurers.

“It coincides with what I always wanted,” he said, which is to provide consumers as much choice as possible among health plans offered through the exchange, a key component of the federal Affordable Care Act.

The exchange, which opens for enrollment Oct. 1, will enable consumers to purchase coverage that will begin Jan. 1 and apply subsidies based on income level to pay for insurance premiums.

Kreidler has faced criticism from some quarters that he had approved too few health plans to provide enough choice and competition on the exchange.

His announcement Friday was the result of settlement agreements reached with Community Health and Kaiser after they had been rejected earlier. Kreidler said earlier that he had turned down their health plans for not meeting state and federal standards by July 31, the filing deadline.

Both insurers filed appeals this month, as did two other rejected carriers, Coordinated Care, a subsidiary of Centene, and Molina Healthcare of Washington.

Kreidler said the appeals process enabled his staff to engage in direct talks with the insurers to try to resolve problems he found in their bids.

Community Health, for example, had submitted plans that would charge consumers a co-pay for visits to some providers, but not for visits to community clinics.

Kreidler said he likes the idea, but that a “two-tier pricing structure” is in conflict with federal standards.

In settlement discussions, Community Health agreed to charge consumers the same co-pay, regardless of provider.

With Kaiser, the problems amounted to numerous small mistakes in the company’s filing, Kreidler said.

Kaiser was able to address those problems relatively quickly, he said.

But Coordinated Care, which is also appealing its rejection, is still “a long way away” from making changes to meet the criteria for the exchange, Kreidler said.

He decided against initiating a settlement agreement with Coordinated Care in light of the challenges the company faced in trying to fix its plans, he said.

Coordinated Care still has a chance of getting approved for the exchange, but that decision is in the hands of an administrative-law judge who is hearing its appeal.

In a statement, the company expressed disappointment Friday that the insurance commissioner chose not to hold settlement talks with the carrier.

“We continue to request meetings daily to quickly resolve this with the OIC, and hope that now that the OIC has settled with two other plans, they will work with us to resolve any other issues,” the statement said.

Molina Healthcare appealed its rejection then withdrew the appeal.

The company reactivated its appeal Thursday night, Kreidler said.

Amy Snow Landa is a freelance writer in Seattle. This story was produced through a partnership with Kaiser Health News, an editorially independent part of the Kaiser Family Foundation, a health-policy research and communication organization that is not affiliated with Kaiser Permanente.

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