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Life Health > Health Insurance

Will Covered California let UnitedHealth and Oscar in?

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Insurers that stayed out of California’s state-based health insurance exchange in 2014 are now asking if they can possibly participate in 2016.

Covered California had glitches in 2014 and still has glitches. Today is supposed to be the plan selection deadline for consumers who want exchange qualified health plan (QHP) coverage to take effect by Feb. 1. Some consumers converged on Twitter to complain about website and call center problems.

“Almost convinced that Covered California isn’t a real thing, but just a sentient collection of hold music and password error messages,” one would-be customer posted on Twitter.

But Julianne Broyles, a representative from the California Association of Health Underwriters, said at the exchange program’s December board meeting that the open enrollment period for 2015 coverage — which started Nov. 15 and is set to end Feb. 15 — has been going much more smoothly this year than it was going at this time last year, according to a batch of minutes included in a Covered California board meeting packet.

See also: 3 ways the PPACA exchange picture has changed

Brandon Cuevas, the chief executive officer of UnitedHealth of California, and Kevin Nazemi, co-founder of Oscar, a new carrier that’s trying to appeal to millennials, paid the Patient Protection and Affordable Care Act (PPACA) exchange the compliment of writing letters asking for slots on Covered California’s shelves.

For 2014, managers of the exchange encouraged insurers to get on the exchange early by saying they would require insurers to sell exchange QHPs in 2014 to be in the exchange QHP market in 2015.

See also: California officials unveil exchange plan menu

This year, managers have been suggesting that they would make only limited exceptions for the 2016 plan year. Anne Price, director of the exchange plan management division, said in December that the exchange would be happy to add carriers to the Small Business Health Options Program (SHOP) menu, and might be interested in adding new carriers that are already active in the Medicaid market, or that want to sell coverage in areas of California without many exchange QHP options.

Nazemi says Oscar can offer California exchange users something unique.

“Oscar was created by people with a background in technology,” Nazemi writes in Oscar’s letter. “Oscar seeks to do things differently — to make health insurance simple, human, smart and transparent.”

Oscar members can use a personalized search engine to get clear cost information on quality treatment options through a computer or a mobile phone, Nazemi says.

Oscar now has 20,000 enrollees in New York, and it is only now big enough to expand into other states, he says. 

Cuevas talks about UnitedHealthcare’s ability to offer enrollees access to cost, quality and policy benefits information through their phones, and UnitedHealthcare’s ability to provide greater access and more cost savings in underserved communities.

UnitedHealthcare would sell coverage statewide, in through both the individual and SHOP programs, he says. He says UnitedHealthcare would also enter the Medicaid market in “select geographies.”

See also: “Dude, what’s in PPACA for me?”


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