Delivery of 2018 Individual & Family sales kits has been delayed due to the announcement from the federal government that cost-sharing reduction plans will no longer be funded. Sales kits will start shipping Oct. 27, 2017, and we still intend to have all 2018 information posted online by Oct. 25. However, 2018 plan rates can be viewed here.
Soon, we’ll be notifying our Individual & Family plan subscribers with news about their health plan for 2018. Each subscriber will get a customized letter and a flyer with information about their plan’s renewal or discontinuation.
There are two deadlines we’re required to meet:
- For members whose plans are being discontinued, notification must be postmarked by Oct. 1, 2017.
- For members whose plans are renewing, members must receive notification by Nov. 1, 2017.
Below, you can review an outline of what’s contained in the letters and flyers, read about rate changes, and click to view the documents being sent to subscribers.
About the notification letters
The letters are templates prescribed by the Office of the Insurance Commissioner (OIC). The letters include:
- Customized information about whether a subscriber’s plan is renewing, if there are plan changes, or if the plan is being discontinued.
- Projected 2018 monthly premium rates, which incorporate rate adjustments and age-band changes.
- For on-exchange plans, the premium rate doesn’t take into consideration any tax-subsidy and/or cost savings reductions a member may be eligible for; this information will be provided by the Washington Health Benefit Exchange (WHBE).
- A benefit and cost share comparison between 2017 and 2018 rates.
- The Individual & Family pharmacy benefit is moving from 3-tier to 4-tier. You can access the formulary starting Nov. 1, 2017.
- Information about changing plans, including required references to the OIC and Washington Healthplanfinder websites.
About the flyer (renewal or discontinuance)
The flyers include information about:
- Changing plans, including how to get information about other options.
- For all of our exchange enrollees:
- They may or may not be auto-enrolled in coverage next year. They should watch for a letter from the Washington Health Benefit Exchange, starting mid-October, which will let them know if there’s anything they need to do for 2018.
- They may need to update their dashboard on Washington Healthplanfinder to determine if they’re still eligible for the same plan.
- For our exchange members enrolled in the current Core Silver HSA plan:
- Their plan is renewing, however it’s only renewing off the exchange. If they want to keep this plan — without any subsidies — they’ll need to apply direct with Kaiser Permanente.
- Washington Health Benefit Exchange will notify these members that their current Core Silver HSA plan is not on the exchange for 2018 and will map them to the VisitsPlus Silver HD.
About the overall 2018 rate adjustments
- The OIC-approved average rate increase is 18.9%. (This rate reflects that cost sharing reductions continue to be funded by the federal government.)
- Rate increases reflect several factors, including medical trends, the uncertainty in the marketplace about certain financial programs mandated by the Affordable Care Act, including whether cost share reduction plans remain funded and the insurance mandate remains in place.
- Rates are based on overall average rate increases.
- Actual rate adjustments vary by plan, rating region, and age band.
- Average rate adjustments do not take into consideration annual age-band changes that are based on member age as of Jan. 1, 2018 or member age as of their effective date after January.
- Average rate adjustments do not take into consideration the impact of the ACA-required child age band rating changes effective Jan. 1, 2018. (The change is from an age band rating for those 0 through 20 to various age bands for those 0 through 14, 15, 16, 17, 18, 19, and 20.)
- The OIC has also approved an overall rate increase of 28.3% if the federal government stops funding cost share reductions in 2018. The OIC has determined that it may legally modify the original lower rate adjustment to the approved higher rates of Silver plans on the exchange.
- Federal law requires insurance companies to discount out-of-pocket costs to customers who qualify for cost share reductions in Silver plans. If the federal government stops funding cost share reductions, insurance companies would be responsible for those payments.
- The increase takes into account the impact of insurance companies assuming cost share reduction payments.
- The Flex Silver and VisitsPlus Silver HD plans offered on and off the exchange would be affected by this rate increase.
- If cost share reduction funding is discontinued, we’ll let you and our mutual clients know about any applicable special enrollment periods that might result.
- Rates for Gold, Bronze, Catastrophic and the Core Silver HSA (only offered off exchange) plans would not be affected.
View the renewal and discontinuation communication
Off-exchange Access PPO plan discontinuation with no plan mapping
Off-exchange plan renewal
Member aging off catastrophic plan
On-exchange plan renewal
Cost share changes and plan mapping
- Details about our 2018 plans will be available soon at producer.ghc.org.
- If you’re interested in selling our exchange-only I&F plans, click here to find training dates and register for a session.
- Dental coverage will automatically renew and no action is required unless members want to change their current dental plan or cancel their dental plan.
We’re here to assist you during this renewal and upcoming open enrollment period. If you have any questions, please contact us at 1-800-358-8815. As always, thank you for your hard work and your continued business.