More Interesting Enrollment Data

Following last week’s release by HHS of the enrollment numbers for the initial annual open enrollment period, carriers are beginning to chime in with their own enrollment statistics.

One major carrier, Blue Cross Blue Shield of Texas, which is owned by Health Care Service Corporation, released its enrollment data on Thursday in a “News from the Blues” communication to its producing agents. Here are the numbers:

Three observations from the BCBS data

First, ACA-compliant Marketplace-based plans outsold ACA-compliant off-exchange plans by a margin of 3.75 to 1. This contradicts some recent reports that plans sold in the outside market may have equaled or even exceeded exchange-based plans. While the numbers will certainly vary by carrier and by location, this does emphasize the need for agents to have a solution that can sell both types of plans.

Second, silver plans were the most popular choice by far. Blue Cross Blue Shield sold plans in the bronze, silver, and gold levels – no platinum plans were offered – along with catastrophic plans for young adults, and silver-level plans accounted for 59% of the plans sold. There are two possible reasons for the popularity of these plans. First, many of these plans have up-front copayments for routine services like doctor visits and prescription drugs while plans in the bronze level typically do not. Second, people who earn up to 250% of the Federal Poverty Level can qualify for cost-sharing subsidies that reduce the out-of-pocket exposure and increase the actuarial value of the plans, but these subsidies are only available in the silver level.

Finally, bronze plans were much more popular than gold plans, proving that, when given the choice, more people buy down to lower-cost, less comprehensive plans than buy up to higher-cost, more comprehensive plans. Plans in this level tend to be either HSA-compatible plans that do not have up-front copayments but do allow people to pay for qualified expenses with pre-tax dollars through a Health Savings Account or reduced network HMO plans that limit the number of providers members have access to and require a referral to see a specialist.

As we dig into the enrollment data further and hear from more carriers about their numbers during the initial enrollment period, it will be interesting to see if some of the predictions or even the early news reports about the enrollment patterns prove to be accurate. Chances are they won’t.

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