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HealthPocket: Nonprofits mount broad, hard fight for silver sales

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Nonprofit health insurers may tend to use a different individual health insurance pricing strategy than for-profit issuers.

Jesse Geneson, an analyst at HealthPocket, has published data on issuers’ individual plan pricing strategies in an analysis of plan price data from counties in states that use the Patient Protection and Affordable Care Act (PPACA) exchange enrollment system.

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Geneson compared the strategies of for-profit and nonprofit issuers by looking at counties in which for-profit issuers are competing with nonprofit issuers, and getting the price and issuer type for the cheapest plans in those counties.

Geneson did not try to distinguish between smaller nonprofit carriers and big nonprofit players like Health Care Service Corp.

Nonprofit carriers issue about 46 percent of all plans, and for-profit carriers issue 54 percent.

Geneson found that, overall, nonprofit carriers have the cheapest silver plans in 1,072 or 58 percent, of the 1,841 counties in which both nonprofit carriers and for-profit carriers offer silver-level plans.

The cost of silver plans is critical, because the PPACA exchange system ties access to PPACA premium exchange subsidies to the cost of the second-cheapest silver plan in each market. Silver plans account for 67 percent of 2015 exchange plan selections.

Geneson found that for-profit carriers are more likely to offer the best prices outside the silver plan level.

Nonprofit carriers offer the cheapest plan in the counties analyzed 51 percent of the time for bronze plans, 51 percent for gold plans, and just 50 percent of the time for platinum plans. 

See also: 3 important health enrollment findings

Offering more competitive rates for bronze, gold and platinum coverage than for silver coverage could be a sign that the for-profit issuers are fighting harder for the business of consumers who do not qualify for PPACA premium subsidies and have to pay the full cost of coverage out of their own pockets. 

See also: 5 Oregon insurers under orders to raise their rates