Third health insurer entering NC exchange for 2015

June 27--UnitedHealthcare this week became the third health insurer to propose products and prices for the federal insurance marketplace in North Carolina, a move that would expand choice and increase competition here but not enough to prevent rates from climbing.

UnitedHealthcare notified the N.C. Department of Insurance on Wednesday that it intends to sell federally subsidized health insurance in the state, filing just days ahead of the Friday deadline to submit plans for federal certification.

The two insurers that sold federally subsidized policies this year -- Blue Cross and Blue Shield and Coventry Health Care of the Carolinas -- have also notified state insurance officials that they plan to participate in the federal insurance exchange in 2015.

Both Blue Cross and Coventry say they are proposing rate increases in 2015 to cover the higher costs of insuring older, sicker people who signed up for subsidized coverage this year. The public won't be able to compare the rates until November, after the state insurance department approves the applications and the U.S. Department of Health and Human Services signs off.

"When we and our competitors have approved rates from the DOI, we will share expected average rate increases," said Blue Cross spokesman Lew Borman.

In a cover letter to N.C. Insurance Commissioner Wayne Goodwin, Coventry said it remains committed to selling individual insurance policies here. But the company warned that factors such as rising medical costs and an influx of older customers necessitate increasing rates for subsidized policies.

Coventry also wrote that it is trying to keep down costs by offering incentives for doctors to improve quality of care rather than paying doctors for patient volume.

Increased rates may not affect customers who receive federal subsidies because the Affordable Care Act caps insurance premiums and out-of-pocket costs at specific levels pegged to household income.

Of the 357,000 North Carolinians who bought subsidized policies through Blue Cross and Coventry for 2014, 91 percent qualified for subsidies, one of the highest subsidization rates in the nation.

UnitedHealthcare's decision to enter the North Carolina market answers the looming question of whether in its second year the Affordable Care Act would expand options for the uninsured.

Meeting the initial filing deadline does not commit insurers to offer insurance to the public, however. Last year a number of insurers around the country, including one in North Carolina, withdrew before potential customers could start enrolling.

Open enrollment will run from Nov. 15 through Feb. 15, 2015.

Blue Cross said it will operate in all 100 counties in 2015. It's not clear where Coventry and United will focus.

This year, Blue Cross offers subsidized plans in all 100 counties in the state, while Coventry operates in 39 counties.

Individual insurance policies are sold to people who don't have coverage through their employer, Medicare, Medicaid or through the military.

The Affordable Care Act requires most Americans to buy health insurance. The law makes it illegal to turn down applicants with pre-existing conditions.

Murawski: 919-829-8932

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