Wellmark to participate in 2017 Iowa marketplace enrollment period

After several years of wading in the calmer waters outside of the federal exchange marketplace, Des Moines-based Wellmark Blue Cross and Blue Shield decided finally to take the plunge.

The state's largest health insurer announced Monday it will sell marketplace plans during next year's open enrollment period - selling plans with coverage starting Jan. 1, 2017.

'From day one, we'd said we'd participate,” Wellmark Chairman and Chief Executive Officer John Forsyth said. 'We were just concerned with if it'd work well and effectively.”

The insurer had opted to stay off the Affordable Care Act health care marketplace - where those purchasing insurance are eligible for federal tax subsidies - since the initial open enrollment period in 2013. It announced in May of this year that it would again stay out of the 2016 open enrollment season.

Even still, this upcoming open-enrollment season, which starts Nov. 1, will have an influx of insurers selling plans.

Coventry Health Care of Iowa Inc. and Medica Insurance Co. will sell individual plans statewide, while United Healthcare of the Midlands will market individual plans in at least 76 counties, including Linn and Johnson, and United Healthcare Insurance Co. will have small-group plans statewide.

Forsyth said Wellmark had been waiting for the bugs to be fixed on both the front and back ends, and he now believes the exchange has improved to a level where the company is more comfortable and confident in participating.

For example, he said the shopping and purchasing experience on healthcare.gov - the federal website where insurance plans can be purchased - now runs far more smoothly than it did in its first year. He also believes whatever problems remain behind the scenes should be worked out by the 2017 open-enrollment period, which will take place in fall 2016.

Also factoring into the company's decision: the outcome of King v. Burwell - a U.S. Supreme Court ruling that decided the fate of health care subsidies for 6.4 million people in 34 states, including 39,000 in Iowa. The ruling was upheld in June.

'But it wasn't our primary concern,” he added.

Forsyth said getting on the exchange is a nine-month to yearlong process, explaining there are applications to complete, IT changes to be made and other tasks.

'If we didn't decide this week, we probably wouldn't have time to do it,” he said. 'We needed a very long runway.”

More than 1.7 million Iowans and more than 300,000 South Dakotans have Wellmark health plans, according to the company. Forsyth did not have any projections on how many Wellmark customers could shift to marketplace plans.

'We don't know people's income,” he said. 'And as people have left we didn't know if it was for subsidized plans or not. My thinking is, if I was eligible for a subsidy and found as good a plan on the exchange as I did off the exchange, wouldn't I have left already?”

Iowa has one of the lowest marketplace participation rates in the country, according to the Kaiser Family Foundation, a not-for-profit organization that looks at health issues. Only about 18 percent of the state's total population is enrolled in a marketplace plan.

Pete Damiano, director of the University of Iowa's Public Policy Center, said it's too soon to tell how the decision will affect overall enrollment numbers.

Damiano added that the state of Iowa has not done the best job marketing the exchange or the plans sold on it. If Wellmark actively markets plans, it could increase the exchange's visibility, he said.

'It offers a lot more potential for people to purchase subsidized health plans that weren't options before,” he said.