State’s health exchange board delays vote on plans

OLYMPIA — The board for the state health exchange delayed a vote Wednesday on approval of 31 plans proposed to be part of the system while some companies that were rejected by the insurance commission appeal their exclusion.

Earlier this month, Insurance Commissioner Mike Kreidler authorized the individual health plans and rates of four health companies for inclusion in the exchange, where plans can be purchased starting on Oct. 1.

Of the nine companies that applied to sell health plan in the exchange, the four that were preliminarily approved were Bridgespan, Group Health Cooperative, Premera Blue Cross and LifeWise, a subsidiary of Premera.

The companies that applied but were not approved for the exchange were Moda Health Plan Inc., Kaiser Foundation Health Plan of the Northwest, Community Health Plan of Washington, Coordinated Care Co. and Molina Healthcare of Washington Inc.

So far, Kaiser, Community Health Plans of WA, and Coordinated Care Co. have appealed Kreidler’s decision, according to Kreidler’s office.

After Wednesday’s decision by the board, officials with Molina — which initially appealed but then withdrew its appeal — say they’ve resubmitted their plan application with the health exchange.

“The board wants to do everything in its power to ensure that when the exchange opens Oct. 1 we have as many carriers and participating plans as possible to provide options for residents,” exchange spokesman Michael Marchand said.

After Kreidler’s decision, state Sen. Linda Evans Parlette, R-Wenatchee, issued a statement that called the dismissal of the prospective insurers before the exchange board could consider them a “step in the wrong direction.”

“After all, don’t we want as many options as possible for people who are purchasing health insurance?” she wrote.

Kreidler has said that some of those not approved couldn’t guarantee access to certain providers and hospitals, or for example, in the case of Molina, didn’t have an approved retail pharmacy.

“I have a duty to protect consumers and to hold all insurers to the same standards,” Kreidler said in a written statement issued Wednesday. “There were substantial problems in the plans we rejected.”

Kreidler said some of the plans didn’t have adequate access to transplant surgeons or to HIV/AIDS specialists, and that in some cases people would be required to drive more than 45 miles to see a cardiologist.

“These were not minor technicalities,” he wrote. “They were major problems.”

However, officials with Molina argued that they have a pharmacy network of more than 1,100 contracted pharmacies that currently serves the company’s 413,000 members in the state and would continue to provide those pharmacy services to the exchange.

But Rich Roesler, a spokesman for Kreidler, said the network proposed by Molina three years ago was not approved by the insurance commissioner, and that the company made no moves to fix it.

Molina spokeswoman Laura Hart said the company had also addressed concerns about gaps in adequate access to HIV/AIDS specialists and proctologists, but Roesler said it did not provide confirmation that it had signed contracts with the providers by a July 31 deadline.

“It’s not enough to just be working toward that goal,” Roesler said in an email.

Group Health Cooperative, LifeWise and Premera also have approved individual plans for outside of the exchange, and six additional insurers have applied for plans outside of the exchange, but Kreidler has until the end of September to approve those plans and rates.

Kaiser is the only company that has applied to sell small employer plans inside the exchange, and it was approved by Kreidler to sell nine plans in Clark and Cowlitz counties. That approval also requires a vote by the health exchange board.

Talk to us

More in Local News

Paul McElhany points out how far the new building will extend past the current building at Northwest Fisheries Science Center's Mukilteo Research Station on Tuesday, April 23, 2019 in Mukilteo, Wash. (Olivia Vanni / The Herald)
Oh, crab! NOAA’s Mukilteo waterfront fish lab won’t be rebuilt

Bids for a new Northwest Fisheries Science Center research station are too high. Are condos next?

Austin Johnson, 26 years-old, trains on the Centennial Trail in Lake Stevens and is planning to do a 24-hour run to raise money for the American Foundation for Suicide Prevention.  (Kevin Clark / The Herald)
24 hours, 80 miles, $23k raised for mental health

Austin Johnson completes a 24-hour run along the Centennial Trail to raise money for suicide prevention.

Samantha Lake
Missing girl, 12, found safely

Seattle FBI located Samantha Lake on Friday.

A pre-loaded syringe with the Pfizer COVID-19 vaccine sits on the table for the next person in line during a vaccine clinic as South Pointe Assisted Living on Friday, Feb. 12, 2021 in Everett, Wa. (Olivia Vanni / The Herald)
Snohomish County to receive its largest shipment of vaccines

Even as case counts drop, researchers are finding a growing number of COVID variants in the state.

Snohomish County Sheriff Adam Fortney during an interview at the sheriff’s department June 17, 2020. (Sue Misao / The Herald)
Auditor denies Fortney recall group the extra time it seeks

He said he could extend the deadline for signature gathering if ordered by a court or the Governor.

Everett man identified after being found dead in creek

The cause of death for Renee Baltazar Romero remained under investigation Thursday.

Everett man found dead in creek near Lake Stevens

The man, 28, was reported missing Thursday. A neighbor found his body in Little Pilchuck Creek.

Autopsy shows Lake Stevens woman, 20, drowned Saturday

Anna M. Lopez was swimming when witnesses noticed she was not responsive, according to officials.

Joe Hempel swims off of the shore of Seawall Park on Friday, Jan. 29, 2021 in Langley, Wa. (Olivia Vanni / The Herald)
Scantily clad is the dress code for these cold rush swimmers

Immersed for 30 minutes in frigid water would kill most of us. It energizes these swimmers.

Most Read