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Life Health > Health Insurance > Health Insurance

Collins: Where's the PPACA group plan enrollment data?

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The house Small Business Committee today held a hearing on the public health insurance exchange small-group program and was unable to get any small-group enrollment data from the Obama administration.

The committee wrote to the U.S. Department of Health and Human Services (HHS) in January to ask for Small Business Health Options Program (SHOP) enrollment data. The committee asked HHS for information about the number of businesses and workers using SHOP plans and the amount of premiums the enrollees were paying.

HHS told the committee in March that it was unable to provide the data.

Rep. Chris Collins, R-N.Y., chairman of the committee’s health subcommittee, wrote to HHS again in June and still has not received any SHOP enrollment data.

Mayra Alvarez, director of the state exchange group at the Center for Consumer Information and Insurance Oversight (CCIIO) — the arm of the Centers for Medicare & Medicaid Services (CMS) responsible for managing the Patient Protection and Affordable Care Act (PPACA) exchange system — appeared at the hearing today and had no SHOP enrollment data. has reported, based solely on reports from state-based exchanges, that the state-based exchanges have enrolled about 72,000 people in SHOP plans.

Alvarez said that about 79,000 agents and brokers had trained to help users of the state exchanges directly managed by HHS in 2014, and she reported that “many” of those producers had completed a SHOP-specific course.

CCIIO was unable to get a SHOP enrollment website working in time to enroll employers in SHOP plans for 2014. The agency is planning to get a SHOP enrollment site working by Nov. 15, Alvarez said. Employers in five states — Delaware, Illinois, Missouri, New Jersey and Ohio — will be able to set up accounts, assign agents and load employee rosters through a feature testing period before the system goes live nationwide.

See also: managers announce producer portal.

Jon Gabel, an analyst at a University of Chicago research center, looked at prices for SHOP coverage and off-exchange coverage in 26 states. In those states, where researchers could get the data needed from state insurance websites and SHOP exchanges, SHOP coverage for a 40-year-old nonsmoker at a one-employee firm was 7 percent lower than coverage sold only off-exchange, he said.

It’s possible that the SHOP coverage was cheaper because the SHOP plans used narrower networks and offered fewer benefits outside the official PPACA essential health benefits package, Gabel said.

But, for the most price-conscious employers, “SHOP is the place to shop,” Gabel said.

Gabel said the insurers most interested in selling SHOP plans are new carriers and small carriers that have traditionally had a hard time competing with the big carriers. He said lack of broker interest in SHOP plans might be partly responsible for soft sales.

“Eighty percent of small employers use brokers or agents,” Gabel said. “Insurers reported in our interviews that brokers do not feel ‘plugged in’ to the SHOP marketplace and view SHOPs as competitors…. The dilemma for SHOPs is that they need broker cooperation, but that SHOPs aim to reduce administrative expenses, and a major component of administrative expenses are brokers’ fees that may constitute 5 percent of premiums or more.”


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