Only one company will participate in West Virginia’s new individual health insurance marketplace.
Media outlets report that Highmark Blue Cross Blue Shield and Carelink/Coventry applied and were accepted to participate in the individual marketplace. But Carelink/Coventry later decided to withdraw.
“We came to this decision (not to participate in the marketplace) as part of our ongoing review of Aetna’s overall company strategy, including the impact of the Coventry acquisition which closed in May, after the original exchange filings were submitted for both companies,” Walt Cherniak, a spokesman for Aetna, Carelink/Coventry’s parent company, told the Charleston Gazette (http://bit.ly/1as3XSy ).
“We are taking a measured, multi-year approach to exchanges. In 2014 we are focusing on the markets where we can be most competitive and deliver the greatest value to our customers,” Cherniak said.
Highmark plans to offer 11 different plans in the individual market and four plans in the state’s small business marketplace.
“We do intend to make good on our commitment to continue to participate. We’ll be there and enrolling people in the West Virginia plan,” Highmark CEO William Winkenwerder said in a conference call Wednesday.
The health insurance marketplace is part of the Affordable Care Act. Enrollment begins Oct. 1. Coverage will begin Jan. 1, 2014.
Perry Bryant, executive director of West Virginians for Affordable Health Care, said that he hopes more companies over time will participate in the marketplace.
“If we had more competition, you’d probably see more competitive premiums. Nobody knows what the premiums are yet, but will there be affordable prices despite lack of competition? We just don’t know yet,” Bryant said.
He said his group is grateful that Highmark will participate in the marketplace.
“And I suspect there will be a lot of West Virginias happy Highmark is going to continue to participate. It’s a challenging environment for insurance companies, so I’m glad Highmark rose to the occasion.”
Under the new law, residents can’t be turned down or charged more for health insurance because of pre-existing health conditions.
All individual and small group plans must offer a core set of 10 essential health benefits starting in 2014, including doctor visits, hospitalization, emergency room care, prescriptions and mental health services.
Individuals, families and small businesses without health insurance must have coverage by Jan. 1, 2014 or pay a government penalty.