From The AIS Report on Blue Cross and Blue Shield Plans. Not affiliated with the Blue Cross Blue Shield Association or its member companies.

Brand Recognition, Pricing May Help Blues Dominate Exchanges (with Table: AIS Analysis of BCBS Plan Offerings on Federally Facilitated Exchanges)

From THE AIS REPORT ON BLUE CROSS AND BLUE SHIELD PLANS, a hard-hitting independent monthly newsletter on new products, market share, strategies, conversions, financing, profitability and strategic alliances of BC/BS plans. (Not affiliated with the Blue Cross and Blue Shield Association or its member companies.)

October 2013Volume 12Issue 10

Blue Cross and Blue Shield plans are participating in most of the 36 federally facilitated and state-partnership exchanges, according to data released Oct. 1 by CMS. And with nearly 40,000 product options they are positioned to capture significant enrollment. In all of those states, Blues plans have positioned their bronze and silver plans with lower-than-average premiums, according to an AIS analysis (see table, p. 6-7).

“When you consider the lowest and second-lowest-priced plans, the Blues are clearly a market leader with one of the two lowest-cost silver plans in almost every region,” says Caroline Pearson, vice president of health reform at the Washington, D.C. consulting firm, Avalere Health, LLC. “And that’s not surprising. The Blues dove headfirst into this market…and have been aggressive in structuring [provider] networks so they could keep premiums low.”

Collectively, not-for-profit Blue Cross and Blue Shield plans are participating in 24 federally facilitated exchange (FFE) states — WellPoint, Inc. is in eight — and 1,091 counties.

While many health plans see exchanges as a way to grow enrollment, Blues plans, which tend to dominate small-group and individual markets — had to view the exchanges offensively as well as defensively. Some existing small-group members, for example, will be eligible for federal premium subsidies and opt to buy individual coverage through an exchange.

Consumers Are Price-Sensitive

“If you’re a dominant Blues plan in a state, and you just want to maintain your non-group market share, you have to be playing competitively in the exchange,” Pearson tells The AIS Report. “Consumers will be very price-sensitive, so we think enrollment will be concentrated in the lowest-cost silver plans and the bronze plans.”

Blues plans will face the most competition in densely populated markets. One of their fiercest competitors could be Humana Inc., which has either the lowest-priced or second-lowest-priced bronze or silver plan in five of the 10 most populous counties in the FFE markets, according to an analysis by Deutsche Bank Securities, Inc. The report analyzed more than 78,000 products being offered through FFEs. Blues plans had the lowest-priced bronze plan in six of those counties and the second-lowest-priced plan in two others.

To see Deutsche Bank’s analysis, visit http://tinyurl.com/le9t5rf. For a list of all health plans and prices available through FFE states, visit http://tinyurl.com/kq3ylhw.

AIS Survey Data: AIS Analysis of BCBS Plan Offerings on Federally Facilitated Exchanges

Collectively, Blue Cross and Blue Shield licensees are offering nearly 40,000 plan options by rating area for a 27-year-old individual on federally facilitated exchanges (FFEs). Blues plans are participating in almost all of the 34 FFE states, with the exception of Iowa, Mississippi and South Dakota. In New Hampshire and West Virginia, Blues affiliates are the only FFE participants. Across all FFE states that have both Blues and non-Blues participants, Blues plans offer lower-than-average premiums on all tiers except platinum. On average across all tiers, Blues plans have lower-than-average premiums in 14 states, and higher-than-average premiums in 15 states. See the September issue of The AIS Report for average rates on state-operated exchanges (The AIS Report, 9/13, p. 4).

State

Metal Level

Avg. Premium for Individual Age 27

Blues

Non-Blues

All

AK

Catastrophic

 

$236.00

$236.00

AK

Bronze

$309.53

$268.00

$296.75

AK

Silver

$367.95

$336.00

$358.12

AK

Gold

$417.73

$402.00

$413.80

AL

Catastrophic

$136.93

$139.64

$137.04

AL

Bronze

$158.32

$183.72

$159.41

AL

Silver

$202.18

$208.35

$202.31

AL

Gold

$254.75

$237.64

$254.37

AL

Platinum

$305.64

$267.92

$304.03

AR

Catastrophic

$172.23

$132.56

$152.66

AR

Bronze

$187.49

$237.31

$213.20

AR

Silver

$239.17

$296.95

$269.40

AR

Gold

$278.20

$335.16

$311.64

AZ

Catastrophic

$159.11

$183.09

$170.24

AZ

Bronze

$211.33

$227.42

$222.15

AZ

Silver

$253.81

$281.51

$267.57

AZ

Gold

$305.55

$308.91

$307.68

AZ

Platinum

 

$254.81

$254.81

DE

Catastrophic

$172.44

$137.18

$154.81

DE

Bronze

$203.62

$213.42

$210.97

DE

Silver

$236.22

$271.71

$250.42

DE

Gold

$289.18

$327.46

$297.69

DE

Platinum

$345.81

 

$345.81

FL

Catastrophic

$192.53

$160.08

$175.50

FL

Bronze

$224.76

$213.75

$222.17

FL

Silver

$259.26

$267.65

$260.88

FL

Gold

$285.02

$308.25

$289.08

FL

Platinum

$315.67

$322.59

$316.02

GA

Catastrophic

$197.38

$144.21

$167.50

GA

Bronze

$250.67

$193.20

$231.49

GA

Silver

$305.08

$233.32

$276.84

GA

Gold

$385.57

$270.05

$333.46

GA

Platinum

 

$271.93

$271.93

IA

Catastrophic

 

$154.45

$154.45

IA

Bronze

 

$192.19

$192.19

IA

Silver

 

$238.87

$238.87

IA

Gold

 

$270.39

$270.39

IA

Platinum

 

$324.06

$324.06

IL

Catastrophic

$171.88

$148.04

$155.78

IL

Bronze

$172.03

$207.78

$195.26

IL

Silver

$224.02

$275.36

$259.72

IL

Gold

$284.04

$306.14

$298.83

IL

Platinum

 

$325.92

$325.92

IN

Catastrophic

$177.33

$181.86

$178.70

IN

Bronze

$221.06

$232.94

$224.79

IN

Silver

$272.47

$288.34

$277.98

IN

Gold

$361.70

$353.34

$358.82

KS

Catastrophic

$132.24

$95.83

$123.61

KS

Bronze

$179.06

$148.45

$170.14

KS

Silver

$209.65

$191.60

$206.35

KS

Gold

$250.90

$211.62

$245.03

KS

Platinum

$299.78

 

$299.78

LA

Catastrophic

 

$153.46

$153.46

LA

Bronze

$203.89

$215.78

$206.98

LA

Silver

$269.29

$273.23

$270.32

LA

Gold

$309.62

$287.61

$304.18

LA

Platinum

$357.13

$326.69

$340.42

ME

Catastrophic

$202.31

$191.06

$196.69

ME

Bronze

$250.61

$231.64

$245.19

ME

Silver

$308.32

$277.04

$292.68

ME

Gold

$385.03

$348.43

$375.88

MI

Catastrophic

$138.37

$196.23

$164.50

MI

Bronze

$173.33

$223.92

$207.65

MI

Silver

$238.19

$274.92

$264.77

MI

Gold

$294.34

$317.27

$310.27

MI

Platinum

 

$288.36

$288.36

MO

Catastrophic

$169.83

$126.71

$144.77

MO

Bronze

$213.28

$198.77

$208.88

MO

Silver

$263.82

$243.54

$258.92

MO

Gold

$346.88

$280.82

$329.13

MS

Catastrophic

 

$198.26

$198.26

MS

Bronze

 

$253.38

$253.38

MS

Silver

 

$305.14

$305.14

MS

Gold

 

$361.37

$361.37

MS

Platinum

 

$286.93

$286.93

MT

Catastrophic

$173.18

$160.02

$164.41

MT

Bronze

$179.11

$185.70

$183.23

MT

Silver

$216.10

$221.58

$219.39

MT

Gold

$260.68

$250.13

$256.16

MT

Platinum

 

$254.08

$254.08

NC

Catastrophic

$162.74

$116.65

$151.35

NC

Bronze

$218.51

$193.07

$213.95

NC

Silver

$262.45

$251.88

$261.89

NC

Gold

$315.86

$286.21

$312.73

NC

Platinum

$357.44

 

$357.44

ND

Catastrophic

$165.34

$157.17

$160.05

ND

Bronze

$200.85

$197.33

$199.44

ND

Silver

$240.25

$251.77

$244.85

ND

Gold

$269.71

$287.26

$274.54

NE

Catastrophic

$157.57

$139.59

$145.48

NE

Bronze

$209.69

$181.75

$200.46

NE

Silver

$264.65

$215.18

$234.15

NE

Gold

$326.65

$245.36

$265.10

NE

Platinum

 

$257.65

$257.65

NH

Catastrophic

$157.19

 

$157.19

NH

Bronze

$196.58

 

$196.58

NH

Silver

$237.44

 

$237.44

NH

Gold

$293.23

 

$293.23

NJ

Catastrophic

$185.92

$223.03

$204.48

NJ

Bronze

$285.87

$277.78

$278.95

NJ

Silver

$307.35

$312.66

$311.59

NJ

Gold

$363.32

$368.21

$367.50

NJ

Platinum

 

$446.00

$446.00

OH

Catastrophic

$177.57

$141.18

$153.59

OH

Bronze

$223.80

$205.99

$215.63

OH

Silver

$272.88

$244.69

$259.11

OH

Gold

$329.61

$298.41

$307.04

OH

Platinum

 

$232.71

$232.71

OK

Catastrophic

$150.73

$140.46

$145.19

OK

Bronze

$139.92

$198.41

$165.61

OK

Silver

$200.47

$232.19

$210.80

OK

Gold

$253.96

$279.45

$262.10

OK

Platinum

 

$308.51

$308.51

PA

Catastrophic

$115.14

$164.38

$148.62

PA

Bronze

$177.09

$198.73

$190.61

PA

Silver

$219.85

$218.59

$219.12

PA

Gold

$260.91

$256.73

$258.38

PA

Platinum

$296.63

$242.75

$267.53

SC

Catastrophic

$202.01

$174.37

$191.10

SC

Bronze

$229.56

$191.97

$216.67

SC

Silver

$261.88

$242.27

$256.61

SC

Gold

$305.64

$289.63

$298.68

SD

Catastrophic

 

$196.63

$196.63

SD

Bronze

 

$267.29

$267.29

SD

Silver

 

$299.30

$299.30

SD

Gold

 

$366.36

$366.36

SD

Platinum

 

$321.72

$321.72

TN

Catastrophic

 

$168.97

$168.97

TN

Bronze

$138.18

$193.13

$151.48

TN

Silver

$189.66

$239.86

$197.21

TN

Gold

$248.88

$286.97

$254.65

TN

Platinum

$302.15

$279.20

$300.58

TX

Catastrophic

$174.24

$161.74

$170.23

TX

Bronze

$162.29

$207.64

$178.64

TX

Silver

$227.70

$253.31

$235.83

TX

Gold

$282.07

$282.93

$282.31

TX

Platinum

 

$265.35

$265.35

UT

Catastrophic

$207.32

$156.74

$171.26

UT

Bronze

$184.70

$188.66

$188.39

UT

Silver

$233.35

$228.39

$228.65

UT

Gold

$269.68

$257.67

$258.56

UT

Platinum

 

$212.01

$212.01

VA

Catastrophic

$148.30

$775.33

$617.43

VA

Bronze

$183.12

$848.64

$617.55

VA

Silver

$232.85

$820.88

$498.80

VA

Gold

$292.73

$900.23

$599.69

VA

Platinum

$386.74

 

$386.74

WI

Catastrophic

$167.01

$186.20

$183.86

WI

Bronze

$210.73

$233.18

$229.31

WI

Silver

$258.24

$275.68

$273.82

WI

Gold

$345.93

$345.31

$345.39

WI

Platinum

 

$423.21

$423.21

WV

Catastrophic

$168.71

 

$168.71

WV

Bronze

$187.55

 

$187.55

WV

Silver

$224.13

 

$224.13

WV

Gold

$271.06

 

$271.06

WY

Catastrophic

$321.00

$262.90

$291.95

WY

Bronze

$341.75

$298.90

$320.32

WY

Silver

$401.10

$347.45

$358.18

WY

Gold

$487.30

$386.77

$406.88

WY

Platinum

 

$439.35

$439.35

SOURCE/METHODOLOGY: Calculated from example premium rates released by HealthCare.gov on Oct. 2, 2013. In this analysis, the Blues category may include non-Blues-branded products offered by BCBS affiliates. Premium data was still incomplete for some plans at this time. Does not factor in rating areas; plans may or may not participate in all rating areas in a state. Premium amounts are before application of tax credits. Full lists of premium rate examples that have been released from federal and state public exchanges are available in the CD Edition of AIS’s Health Insurance Exchange Directory and Factbook, available later this month from AIS. For more information or to order, call (800) 521-4323 or visit http://aishealth.com/marketplace/aiss-health-insurance-exchange-directory-and-factbook.

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