WellPoint, Blues plans big winners among exchange shoppers

WellPoint and many Blue Cross Blue Shield plans took an aggressive approach to participating in the health insurance exchanges--and it paid off. In 12 of the 15 states with exchange information available, WellPoint and Blues plans dominated the marketplaces last year, according to a new study from Avalere Health.

The key to their aggressive method was to participate in almost every state where the insurers already sold plans on the individual market. As a result, most consumers enrolled in WellPoint's exchange plans in California, Colorado, Connecticut, Indiana and Virginia. Meanwhile, Blues plans had the highest enrollments in the District of Columbia, Florida, Maryland, Michigan, Rhode Island, Vermont and Washington exchanges.

Interestingly, the study also found that consumer oriented and operated plans (CO-OPs) attracted a sizeable share of the market in some exchanges. For example, Maine's CO-OP garnered the lion's share of enrollment in the state's exchange, outpacing Anthem, FierceHealthPayer previously reported.

But these big winners might be facing some new challenges come open enrollment in November.

"New entrants and pricing strategies in this consumer-driven market threaten to shake things up in 2015, particularly for new enrollees," Avalere CEO Dan Mendelson said in the report.

Largely driving the issue is that insurers struggled to set prices for 2015 exchange plans because they lacked some essential information, including the size of provider networks that the federal government would approve or new enrollees' health status.

Consequently, nine of the WellPoint and Blues plans that led their markets last year proposed to increase their premium rates by at least 9 percent for 2015 exchange plans, the study found.

"It's important to pay attention to the premium increases among the highest-enrollment plans in 2014 because current enrollees who renew their coverage will be directly impacted," Avalere Vice President Caroline Pearson said.  

To learn more:
- read the Avalere study