Managers of the Patient Protection and Affordable Care Act (PPACA) exchange program in Oregon have given 22 carriers permission to put products on its shelves.
Cover Oregon has invited 10 carriers to offer medical plans, or “qualified health plans” (QHPs); seven to offer stand-alone dental plans; and five to offer both medical and dental plans.
PPACA requires the U.S. Department of Health and Human Services (HHS) and states to have exchanges, or Web-based health insurance supermarkets, serving individuals and small groups by Oct. 1.
A state can choose whether to run its own state-based health insurance exchange — or “HIX” — or have HHS handle part or all of the work.
Oregon is running its own exchange program.
The carriers admitted to the Oregon HIX still have to submit applications to get specific plans into HIX slots, officials said.
“There are still many steps the carriers must follow to make their plans available this fall,” officials said.
To participate in the Oregon exchange, the QHP carriers had to agree to offer a standard “essential health benefits” (EHB) package.
Each carrier will offer four standardized levels of coverage, ranging from about 60 percent of the actuarial value of the EHB package for the bottom-level bronze plan to 90 percent of the actuarial value of the EHB package for the top-level platinum plan.
Specific plan descriptions and proposals are due April 30.
The state insurance division will review the plans’ rates and verify that the plans cover the EHB package, officials said.
Two of the QHP issuers approved are new health CO-OP plans — Community Care of Oregon and Freelancers CO-OP of Oregon.
PPACA drafters included a provision that was supposed to increase the level of competition in the health care market by encouraging nonprofit groups in each state to form nonprofit, member-owned CO-OP health insurers.
The companies approved to offer both QHPs and dental plans through Cover Oregon are:
- Kaiser Foundation Health Plan of the Northwest.
- LifeWise Health Plan of Oregon Inc.
- ODS Health Plan Inc.
- PacificSource Health Plans
- Trillium Community Health Plan, Inc.
The QHP issuers approved are:
- ATRIO Health Plans Inc.
- BridgeSpan Health Company.
- Family Care Health Plans, Inc.
- Freelancers CO-OP of Oregon.
- Health Net Health Plans of Oregon.
- Mid Rogue Health Plan Inc.
- Oregon’s Health CO-OP (incorporated as Community Care of Oregon).
- Providence Health Plan.
- Regence BlueCross BlueShield of Oregon.
The dental issuers approved issuers:
- Ameritas Life Insurance Corp.
- BEST Life and Health Insurance Company.
- Dental Health Services.
- Dentegra Insurance Company.
- Guardian Life Insurance Co.
- Premier Access Insurance Company.
- Willamette Dental Insurance Inc.
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