80% of Exchange Enrollees Have Paid Premiums, NYT Analysis Finds
Health insurers have received first month premium payments from about four-fifths of U.S. residents who signed up for coverage through the state and federal health insurance exchanges, according to a New York Times analysis.
For the analysis, the Times reviewed insurers' quarterly reports and interviewed various insurance company executives about the payments.
Overall, insurers said about one-fifth of individuals missed payment deadlines for coverage to begin in January, even though many insurers extended their payment deadlines at the request of the Obama administration. As a result, those individuals did not receive coverage.
For example, Matthew Wiggin -- a spokesperson for Aetna, which extended its payment deadline for coverage starting Jan. 1 to Jan. 14 -- said about 70% of consumers who selected its health plans paid their premiums. That figure also includes plans sold by Coventry Health Care, which is now part of Aetna and gave consumers until Jan. 17 to make payments.
According to the Times analysis:
- WellPoint Vice President Kristin Binns said 76% of its 500,000 applicants paid by the Jan. 31 deadline;
- Humana Senior Vice President Thomas Noland said 75% of its 200,000 applicants paid by Jan. 31;
- A spokesperson for Health Care Service Corp said about 80% of enrollees had paid by its Jan. 30 deadline;
- Blue Shield of California spokesperson Lindy Wagner said 80% of enrollees paid by the Jan. 15 deadline;
- A spokesperson for Independence Blue Cross in Philadelphia said 84% of its 27,528 applicants paid by Feb. 15; and
- A spokesperson for Blue Cross and Blue Shield of Minnesota said 95% of applicants met the Jan. 10 payment deadline.
According to the Times, there are several explanations for people missing the coverage deadline, such as consumers not wanting to enroll in the plan they selected or receiving a late invoice or no invoice at all from the insurer.
CMS spokesperson Julie Bataille was unable to verify the number of paid enrollees because the government has not yet completed back-end work on the system that would transmit insurer data on new enrollees (Pear, New York Times, 2/13).
CMS said it is in the process of developing that system, which will track the "834 forms" that contain the necessary data to estimate the number of paid enrollees (Easley, "Healthwatch," The Hill, 2/13).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.