iLoveBenefits: Industry News Blog

62% of Exchange Plans Will Be HMOs in 2017



McKinsey & Company recently released an analysis of 2017 exchange plan designs across the U.S.

Here are some key findings from the report:


HMOs will comprise 62% of all plans for 2017.
68% of consumers will have access to competitively priced managed plans only.
The lowest-price silver plan premium will increase 9% for managed plans in 2017.
82% of consumers will have access to both managed and unmanaged plans in 2017.
For unmanaged plans, the lowest-price silver plan premium increase will be 18%.
97% of national plans will be managed in 2017, up from 62% in 2014.



Source: McKinsey & Company, August 2016

Health care Premium Increases and Exchange Participation

    • Premium increases in the health insurance marketplaces created under the Affordable Care Act (ACA) will likely be higher in 2017 than in recent years. Kaiser Family Foundation analysis of proposed rates in states that make the information publicly-available shows an average premium increase in the benchmark second-lowest-cost Silver plan in 17 major cities of 9% in 2017, compared to an average increase of 2% in these cities in 2016.
    • Aetna CEO Mark Bertolini announced Tuesday (Aug. 2) that while the company is pleased with its overall second-quarter results, it will not enter exchanges in additional states in 2017 as planned and is revisiting its current position in 15 states.

Putting a Positive Spin on a Critical Problem

53% of Exchange Consumers are Satisfied With Their Health Plan

Deloitte recently published their 2016 Survey of US Health Care Consumers. Here are some key findings from the report:

  • More than half (53%) of exchange consumers are satisfied with their health plan overall.
  • 54% of those with employer insurance and 74% of those with Medicare are satisfied.
  • 7 in 10 exchange consumers say they had no financial difficulty paying out-of-pocket costs last year.
  • 34% of exchange consumers feel prepared to handle future health care costs compared with 16% in 2015.
  • Nearly half of exchange consumers (45%) say they feel confident about being able to get affordable care.
  • 67% of exchange consumers looked online for help selecting a policy vs. 30% with employer coverage.

Source: Deloitte, May 11, 2016

Year 2: Did you know that open enrollment begins in November

The Kaiser Family Foundation released a poll that finds nearly 90 percent of uninsured individuals do not know that open enrollment starts next month. Two-thirds said they know “only a little” or “nothing at all” about the marketplaces and over half (53 percent) don’t know that financial assistance is available for low- to moderate-income Americans.

Will employer plan sponsors maintain their cost leverage on Rx

Silver plans offered through the exchanges may require patients to pay more than twice as much out of pocket for prescription medicines as they would under a typical employer plan, offering employers a prime opportunity to use health care benefits as retention and recruitment tools for their employees.

Read more here:


What is the future for private exchanges

According to a recent survey of large employers with a median employee population of 23,000:

  • 91% believe they have a ‘good to excellent’ understanding of the complexities involved in moving to a private exchange
  • 60% said they would want to remain self-insured if they moved to a private exchange
  • 37% have no plans to evaluate private exchanges
  • 13% have done an evaluation and decided not to proceed with replacing their current medical benefit plan with an exchange
  • 35% said that they have started to evaluate private exchanges as a potential benefits strategy for active employees
  • 11% are interested in evaluating exchanges
  • 3% are currently in an exchange

Source: Large Employers ‘Fully Committed” to Company-Sponsored Benefits, Express Mixed Reaction to Private Health Insurance Exchanges.” Pacific Resources Press Release, April 29, 2014,

Data from The First Week of Enrollment in Washington State’s Health Insurance Marketplace

Web and Call Center Data
Unique Visitors – 165,332
Total Site Visits – 837,152
Page Views – 2,725,138
Unique Page Views – 2,023,610
Accounts Created – 39,115
Call Center Volume – 23,243
Average Call Center Wait Times – 10 min 25 sec

Enrollments Completed
Qualified Health Plans – 916
Medicaid Newly Eligible/Coverage Jan. 1 – 5,946
Medicaid/Immediate coverage – 2,594
Total – 9,452

Source: Washington Health Benefit Exchange

Health Exchanges: If they think the first day was busy . . . wait until the final days

If you know a Benefits Director, you would have expected this. A launch of any significant changes in health plans draws huge traffic. This was huge. But they haven’t seen anything yet. Wait until the last week… those last few days will seen an avalanche of visitors.


ACA website records 4.7M visitors on first day, HHS says
HHS said Wednesday that it logged 4.7 million visitors to, the primary website for Affordable Care Act enrollment, during the first 24 hours of the law’s new health insurance exchanges. The site remained slow on Wednesday after technical problems plagued its initial launch on Tuesday. “While this overwhelming interest is continuing to cause wait times, there will be continuing improvements in the coming hours and days,” HHS spokeswoman Joanne Peters said. The Hill/Healthwatch blog (10/2)

Survey: As Open Enrollment Begins, Insurance Marketplaces Are Mystery to Many

As the key components of the Affordable Care Act roll out this week, more than three-quarters of U.S. adults are aware of the law’s requirement that everyone have health coverage, but only four of 10 are aware of the new insurance marketplaces set to open on October 1, or the financial assistance available to defray the cost of insurance premiums, a new Commonwealth Fund survey finds.

The survey, conducted between July and September of this year, is part of The Commonwealth Fund’s efforts to track implementation of the health reform law. It finds that the people most likely to benefit from the health insurance marketplaces and premium subsidies are often least likely to be aware of them. But the results also reveal broad support for expanding Medicaid in all states, with a large majority of respondents saying they are somewhat or strongly in favor of making Medicaid available to more residents in their state.

Read all about the survey’s findings in our issue brief What Americans Think of the New Insurance Marketplaces and Medicaid Expansion. And be sure to check out our infographic.

September 30, 2013 | Categories: healthcare,insurance | Tags: , , , | Comments (0)

Senior’s Misconceptions About Medicare and Exchanges

According to a national survey from Express Scripts, of those age 65 and older, one-in-five seniors mistakenly thinks they can enroll in a medical and prescription drug plan through a health insurance exchange, even though the eligibility age ends at 65. Another 17 percent believe health exchanges could replace their Medicare plan altogether.

Eighty-six percent of survey respondents reported confusion about how healthcare reform will affect their Medicare prescription drug coverage. Among the notable misconceptions:

-Nearly one-third of seniors (29 percent) believe the ACA raises the Medicare eligibility age, with 68 being the average age cited;
-52 percent falsely believe they’re paying more for their prescription drugs in the Coverage Gap under healthcare reform; and
-65 percent do not know that Medicare enrollment begins in October.

Source: Express Scripts

September 30, 2013 | Categories: healthcare,insurance,Medicare | Tags: , , , | Comments (0)
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