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Maryland exchanges to offer six medical carriers

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Managers of the Maryland Health Connection — Maryland’s Patient Protection and Affordable Care Act (PPACA) exchange system – have come out with their plan menu.

The Maryland Health Benefit Exchange (MHBE) says it expects to offer at least six major medical carriers and 10 providers of stand-alone dental coverage.

The medical carriers, or “qualified health plan” (QHP) providers, are:

  • Aetna (NYSE:AET).
  • CareFirst.
  • Coventry,
  • Evergreen Health Cooperative.
  • Kaiser.
  • United HealthCare (NYSE:UNH).

The QHP list does not include Cigna (NYSE:CI) or WellPoint (NYSE:WLP).

The QHP list does include CareFirst — the holder of the Blue Cross and Blue Shield licenses for Maryland — and Evergreen.

Evergreen is one of the new nonprofit, member-owned cooperative health plans spawned by the PPACA Consumer Operated and Oriented Plan provision.

One of the companies on the QHP list, Aetna, recently completed efforts to acquire another company on the list, Coventry. 

But Maryland is still hoping the initial plan menu will include one of the new PPACA multi-state plan (MSP) options that the U.S. Office of Personnel Management (OPM) is developing.

The dental carriers on the first exchange menu will be:

  • Aetna.
  • BEST Life.
  • CareFirst.
  • Coventry.
  • Delta Dental.
  • DentaQuest.
  • Dominion Dental.
  • Guardian.
  • Metropolitan Life (NYSE:MET).
  • United Concordia.

PPACA calls for the U.S. Department of Health and Human Services (HHS) to set up exchanges for individuals and small businesses in all 50 states and the District of Columbia. States can choose whether to start their own exchanges or build their own. Maryland is building its own exchange.

Maryland exchange officials noted that they will be starting their exchange for individuals Oct. 1, 2013, with the first coverage taking effect Jan. 1, 2014, but that they will wait until Jan. 1, 2014, to open their Small Business Health Options Program (SHOP).

SHOP coverage will start to take effect March 1, 2014, officials said.

The Maryland Insurance Administration hopes to complete reviews of the QHP benefit design, rate and form proposals by July. The exchange managers then will put the plans through a final certification process, officials said.

Officials noted that one state mandate will require carriers update their provider directories at least once every 15 days, to help consumers know which providers are really in a plan’s network.

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