DES MOINES, Iowa (AP) — The Iowa Patient Protection and Affordable Care Act (PPACA) exchange program has attracted a total of six would-be “qualified health plan” (QHP) issuers.

But only two want to sell individual coverage throughout the state, only two want to sell small-group coverage throughout the state, and the state’s biggest carrier, Wellmark Blue Cross and Blue Shield, is sitting on the sidelines.

The Patient Protection and Affordable Care Act (PPACA) calls for the U.S. Department of Health and Human Services (HHS) and state agencies to set up exchanges for individuals in all 50 states and the District of Columbia by Oct. 1. HHS and state agencies also are supposed to offer exchange services to small employers.

Iowa is working with HHS to set up a “partnership exchange.”

Sunday was the deadline for insurance carriers to file for inclusion in the Iowa exchange next year.

Iowa’s insurance commissioner said Coventry, a unit of Aetna Inc. (NYSE:AET), and CoOportunity Health hope to sell individual plans throughout the state.

CoOportunity is part of the new PPACA Consumer Operated and Oriented Plan (CO-OP) program, which encourages nonprofit, member-owned carriers to sell coverage through the PPACA exchanges.

Two carriers, Avera Health Plans and Gunderson Health Plans Inc., want to offer individual and group plans in limited market areas.

Sanford Health and Health Alliance Midwest Inc. want to compete solely in the small-group market, officials said.

Wellmark is not on the 2014 QHP applicant list. 

John Forsyth, the company’s chief executive officer, said Monday that the insurer will enter the online insurance marketplace in 2015. He said the decision to delay exchange entry was based on concern that implementation would be bumpy in year one.

Allison Bell contributed information to this article. 

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