April 7 2016 Secretary Rita Landgraf Department of Health and Social Services Delaware s Health Insurance Marketplace Update on Activity Agenda Enrollment Update Marketplace Enrollment ID: 719972
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Delaware Health Care Commission
April 7, 2016Secretary Rita Landgraf Department of Health and Social Services
Delaware’s Health Insurance Marketplace: Update on ActivitySlide2
Agenda
Enrollment UpdateMarketplace EnrollmentMedicaid Expansion EnrollmentStories from the GroundTax ReminderPlan Management
Key Dates and RemindersQuestions/Comments
2Slide3
Enrollment Update
3Slide4
Marketplace and Medicaid Enrollment Update
As of Jan. 31, 2016, 38,152 Delawareans have enrolled in health care coverage through Medicaid expansion and the Health Insurance Marketplace.
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Marketplace and Medicaid Enrollment Update
Enrollment as of Jan. 31, 2016:
Total Number of EnrolleesIncrease from previous year
Marketplace
*
28,256
13%Medicaid9,8963%Total38,152
10%
*This number represents Delawareans who have selected a Marketplace plan, either through Healthcare.gov or through direct enrollment with an issuer (with or without the first premium payment having been received directly by the Insurance Company.)
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Marketplace Enrollment
6Slide7
Delaware Enrollment at a GlanceNumber enrolled: 28,256
Number who completed applications: 39,361Percentage who received tax credit: 82%Average monthly premium before tax credit: $477Average monthly tax credit: $328Average monthly premium after tax credit: $150Average percentage reduction in premium after tax credit: 69%
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7Slide8
Growth in Covered Lives
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Delaware’s Uninsured RateDelaware Behavioral Risk Factor Surveillance System (adults age 18-64): 9.7% in 2015. In 2014, the rate was 10.8% and in 2013, 14.3%.Gallup-
Healthways Well Being Index (adults 18 and older): 7.4% in 2015. In 2014, the rate was 9.6% and in 2013, it was 10.5%.CDC – National Health Interview Survey (ages 0-64): 5.4% in 2014, down from 10.7% in 2013. No results yet for 2015.9
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Enrollment TypeUsed HealthCare.gov for Enrollment
Total Selecting 2016 Plan
New ConsumersTotal Reenrollees
Active Enrollees
Auto-Renewals
Delaware
28,25633%67%42%25%All FFM States
9.6 million
42%
58%
41%
17%
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Reenrollee StatusUsed HealthCare.gov for 2015 and 2016 Coverage Years
% of Reenrollees
% Auto-Renewed% Active Renewals
% Chose New Plan
Avg
Monthly Premium Savings of Switchers
Delaware70%38%32%30%$25
All FFM States
57%
30%
27%
43%
$40
11Slide12
Premium Tax Credit
Delaware (2015)Delaware (2016)
All FFM States (2016)Description
Total Enrollment
25,036
28,256
9.6 million% with Tax Credit
84%
82%
85%
Monthly Premium (before Tax
Credit)
$404
$477
$396
Avg
Monthly Tax Credit
$264
$328
$290
Avg
Monthly Premium
(after Tax Credit)
$140
$150
$106
Avg
% Reduction in Premium (after Tax Credit)
65%
69%
73%
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Financial Assistance
DelawareAll FFM StatesDescription
Total Enrollment
28,256
9.6 million
% with Financial Assistance
82%85%% with Premium Tax Credit
82%
85%
% with Cost-Sharing
Reduction
43%
59%
13Slide14
Comparison by Age
Enrollees
%
Enrolled
Age Groups
0
-173,673
13%
18 – 25
2,260
8%
26 – 34
4,521
16%
35 – 44
4,238
15%
45 – 54
5,934
21%
55 – 64
7,347
26%
65+
283
1%
Total
28,256
100%
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Enrollment Update: Comparison by Gender
All FFM StatesDelaware Marketplace
Delaware Medicaid ExpansionDescription
Total Enrollment
9.6 million
28,256
9,896% Female
54%
54%
63%
% Male
46%
46%
37%
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Metal Level Comparisons
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Metal Level
Delaware
All FFM States
Bronze
22%
21%
Silver*
61%
71%
Gold
13%
6%
Platinum
3%
1%
Catastrophic
0%
1%
Total Enrollment
28,256
9.6 million
*Only silver plans are eligible for a cost-sharing reduction.Slide17
Self-Reported Race/Ethnicity
% DelawareMarketplace Delaware Population (all ages)*
% from FFM States
U.S. Population (all ages)
Self-Reported Race/Ethnicity
White
68%
70.8%
63%
77.4%
African-American
13%
22.2%
12%
13.2%
Asian
9%
3.8%
9%
5.4%
Latino
8%
8.9%
15%
17.4%
American Indian
0%
0.7%
0%
1.2%
Native Hawaiian/Pacific Islander
0%
0.1%
0%
0.2%
Multi-Racial
2%
2.5%
1%
2.5%
Total
20,307
935,614
6.1M
318.8M
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* Total Delaware and U.S. population breakdowns from U.S. Census (2014). Slide18
Household Income
% from Delaware % from FFM States
Household Income (% of FPL)
< 100%
2%
3%
100%-149%15%38%*150%-199%
27%
25%
200%-249%
21%
15%
250%-299%
14%
9%
300%-399%
16%
8%
> 400%
4%
2%
Total Enrollment with Data
25,547
8.9 million
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*18 of the 19 states that have not expanded Medicaid are part of the FFM.Slide19
Medicaid Expansion Enrollment
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Medicaid Enrollment: January 2016As of the end of January, 9,896 Delawareans ages 19-64 qualified for Medicaid under the expanded eligibility requirements (income between 100% and 138% of the Federal Poverty Level).
Of those:63% were female, 37% male54% New Castle County, 19% Kent,
26% Sussex 24% ages 19-25
24% ages 26-34
21% ages 35-44
18% ages 45-54
13% ages 55-64
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Medicaid Enrollment by Age: 2014-2016
AgeJan. 2014Jan. 2015Jan. 201619-25
15%20%24%26-34
34%
26%
24%
35-4427%22%21%45-5412%18%18%55-6412%13%13%
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Percentage of Delawareans ages 19-64 who qualified for Medicaid under the expanded eligibility requirements from 2014 to 2016.Slide22
Medicaid Enrollment by Gender: 2014-2016
Jan. 2014Jan. 2015Jan. 2016Female
74%64%63%Male
26%
36%
37%
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Percentage of adult Delawareans ages 19-64 who qualified for Medicaid under the expanded eligibility requirements from 2014 to 2016.Slide23
Stories from the Ground
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Stories from the GroundA 47-year-old single mother from Dover who also cares for her grandchildren re-enrolled with Westside. She was eligible for a tax credit of $395 a month plus cost sharing, choosing a silver Highmark plan for $37.14 a month.
During a Coverage to Care Workshop on Palm Sunday at Iglesia De Dios Maranatha in Seaford, a Chatman navigator was able to enroll two parishioners through a Special Enrollment Period. The church’s pastor wants Chatman to come back for a full-day workshop.A 30-year-old man and his wife from Claymont enrolled through an SEP with Westside. They qualified for a $566 tax credit and chose a silver Aetna plan with a monthly
premium of $107.87. They were very happy because the QHP has no deductible and a low monthly premium.
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National Update
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Tax Reminder
Make sure you use your health insurance tax form to file your 2015 federal income taxes.Marketplace: Use Form 1095-A, Health Insurance Marketplace Statement. If you received a tax credit, you will use this form to reconcile your credit with your final income for 2015.Employer-based, retiree plan, SHOP or COBRA: Use Form 1095-B, Health Coverage, or Form 1095-C, Employer-Provided Health Insurance Offer and Coverage. Other coverage, including Medicare, Medicaid or CHIP: Use Form 1095-B, Health Coverage.No coverage:
Either pay the penalty with your federal return or you must claim a health coverage exemption.26
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Plan Management Updates
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Insurer Letters of Intent for Plan Year 2017In January the Department
of Insurance (DOI) invited insurance companies to submit a letter of intent
to apply for QHP certification for Plan Year 2017The following companies submitted
letters of
intent:
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Medical Plans
Stand Alone Dental Plans
Aetna
Delta Dental
Highmark BCBSDE
Dentegra
Dominion
28Slide29
QHP Review for Plan Year 2017The DOI is working with insurance companies to prepare for the review of Qualified Health Plans (QHPs) for P
lan Year 2017.The DOI has released state-specific standards, guidance and templates to insurers to support their QHP applications.
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29Slide30
Marketplace QHP Review TimelineActivity
Proposed TimelineIssuers submit QHP applications including initial rate and form filings April – May 2016
DOI reviews plans for compliance with state and federal laws and standardsMay – September 2016
DOI
conducts public information sessions and accepts written comments
June – July 2016
DOI completes review of QHP applications and rates and makes recommendations to CMSAugust – September 2016CMS sends final list of certified QHPs to stateOctober 2016DOI posts final premium rates
Mid-October 2016
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Key Dates
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Consumers who experience qualifying life events such as birth/adoption of a child; marriage or divorce; loss of minimum essential coverage; denial of Medicaid; aging out of parents’ insurance at age 26; or domestic violence eligibility may enroll outside of open enrollment.
Navigators
, assisters and agents and brokers are available to help with enrollments outside open enrollment.
Visit
www.ChooseHealthDE.com to find free assistance. Enrollment in Medicaid and in the SHOP marketplace for small businesses is open year-round.
Date
Milestone
Nov. 1, 2016
Open enrollment begins for Plan Year 2017
Jan. 31, 2017
End of open
enrollment for Plan Year 2017Slide32
Questions/CommentsHealth Care Commission
Public
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