SEPTEMBER 2016

WASHINGTON HEALTH BENEFIT EXCHANGE

HEALTH COVERAGEENROLLMENT REPORT

HEALTH COVERAGEENROLLMENT REPORT

WAhealthplanfinder.org

Publication Date: November 16, 2016

Table of contents

Total Enrollees .............................................................................................................................. 1 September Enrollees September QHP Enrollees Subsidized/Non-Subsidized by MonthDistribution of QHP Enrollees .................................................................................................... 2 By Metal Level By Percent of Federal Poverty Level (FPL) Enrollees by FPL/Metal LevelDisenrollment ............................................................................................................................... 3 2016 Disenrollment Disenrollment by Metal Level Disenrollment by FPL/Metal LevelEnrollees by Month ..................................................................................................................... 4 QHP Enrollees Washington Apple Health Enrollees Dental EnrolleesEnrollees by County .................................................................................................................... 5 QHP by County Washington Apple Health by CountyQHP Enrollees Data ..................................................................................................................... 6 Age Under 19 Gender U.S. Citizenship Race/Ethnicity Hispanic IndicatorLanguage Data ............................................................................................................................ 7 Limited English Proficient Applicants Spanish Languages Top Language Requests By Washington Healthplanfinder ApplicantsLanguage Data ............................................................................................................................ 8 Customer Service Top Language Requests Through Telephonic Interpretation ServicesWashington Apple Health Data ................................................................................................. 9 Age Under 19 Race/Ethnicity Medicaid Plan Selection Washington Apple Health Enrollees by FPL Additional Data .......................................................................................................................... 10 March 2016 QHP Enrollees by Carriers SEP (Special Enrollment Perioid) ChurnAdditional Data .......................................................................................................................... 11 Assisted Enrollees Families Premiums and Finanical Assistance - March 2016SHOP Enrollment ....................................................................................................................... 12 SHOP Employer by County Employer by Metal Level Employees and Dependents by Metal Level

Washington Health Benefit ExchangeEnrollment Report

September 2016

The 2016 Washington Health Benefit Exchange Enrollment Report in an excel spreadsheet with additional data is also available online at:http://www.wahbexchange.org/about-the-exchange/reports-data/enrollment-reports-data/

Qualified Health Plans (QHP) data:Author: WAHBE/Seema Gupta, Data Source: Washington Healthplanfinder as of September 30, 2016

Washington Apple Health - MAGI/CHIP data:Author: HCA/BIS/Thuy Ha; Data Source: ProviderOne ODS Data Warehouse as of October 18, 2016

TOTAL:

QHPsTotal: 166,098 (10%)

1,697,500

WA Apple HealthTotal: 1,531,402 (90%)

Total Enrollees

Subsidized/Non-Subsidized by Month

September Enrollees September QHP Enrollees

* Washington Apple Health is comprised of Medicaid MAGI (1,482,125) and CHIP (49,277) enrollees. QHP - Non-Subsidized: Includes individuals who selected a qualified health plan that either did not qualify for a tax credit or did not apply for financial help. Non-Subsidized also includes individuals who did not select tax credits.QHP - Subsidized: Includes individuals who have selected a qualified health plan (QHP) and eligible for a tax credit to lower their monthly premiums. Subsidized: exclude people who selected zero APTC.

Washington Health Benefit ExchangeEnrollment Report

September 2016

1

Non-SubSubsidizedTotal

0

50K

100K

150K

200K

10/1/15 11/1/15 12/1/15 1/1/16 2/1/16 3/1/16 4/1/16 5/1/16 6/1/16 7/1/16 8/1/16 9/1/16 33,082 ...........32,759 ............ 32,151............ 47,880 ...........51,450 ............53,731 ...........52,351 ............51,826............51,356 ............51,161 ............50,873 ........... 50,851 116,698 ..........117,072 .......... 113,343 ..........108,565 ......... 115,559 ..........120,225 ......... 119,290 .......... 118,192 .......... 117,437.......... 116,222 ..........116,010 ..........115,247 149,780 ......... 149,831 ..........145,494 ..........156,445 .........167,009 ..........173,956 ..........171,641 ........... 170,018 ..........168,793 ......... 167,383 ......... 166,883 ......... 166,098

TOTAL:

Non-SubsidizedTotal: 50,851 (31%)

SubsidizedTotal: 115,247 (69%)

166,098

TOTAL:

SilverTotal: 96,017 (58%)

BronzeTotal: 54,880 (33%)

CatastrophicTotal: 1,253 (1%)

166,098

GoldTotal: 13,948 (8%)

Distribution of QHP Enrollees

By Metal Level

Note: Distribution is of September 2016 QHP Enrollees. lBronze Plans cover 60% of the cost of essential health benefits, while the patient pays 40% ; lSilver Plans cover 70%, while the patient pays 30%; lGold Plans cover 80%, while the patient pays 20%; lCatastrophic Plans are type of health care plan only available through Washington Healthplanfinder for certain populations, such as individuals under age 30. This type of plan generally offers the least coverage. Tax credits and cost sharing reductions cannot be used to purchase a catastrophic plan.

0

10K

20K

30K

40K

50K

By Percent of Federal Poverty Level (FPL)

Enrollees by FPL/Metal Level

2

<100% 100%-138% 139%-150% 151%-200% 201%-250% 251%-300% 301%-400% >400% No APTC* 6,655 ...................... 3,097 ..................... 13,040 .....................44,733 .....................28,225 .................... 18,335 .................... 22,355 .................... 15,995 ..................... 13,663 212 ...........................54........................... 218......................... 1,240 ....................... 2,179 ...................... 1,800 .......................2,418 .......................2,673 ....................... 3,154 5,653 ...................... 2,678 .......................11,131 ......................34,968 ..................... 16,337 ..................... 7,091 ...................... 7,957 .......................5,653 .......................4,549 768 ..........................359 ........................1,676 ....................... 8,419 .......................9,549 .......................9,161....................... 11,719 .......................7,479 .......................5,750

TOTAL:

<100%Total: 6,655 (4%)

139%-150%Total: 13,040 (8%)

151%-200%Total: 44,733 (27%)

201%-250%Total: 28,225 (17%)

No APTCTotal: 13,663 (8%)

>400%Total: 15,995 (10%)

301%-400%Total: 22,355 (13%)

251%-300%Total: 18,335 (11%)

166,098

100%-138%Total: 3,097 (2%)

Total GoldSilverBronze

Washington Health Benefit ExchangeEnrollment Report

September 2016

6,655

3,097

13,040

44,733

28,225

18,335

22,355

15,99513,663

*Chose not to apply for tax credit. Totals include Catastrophic.

TOTAL:

Non-PaymentTotal: 14,214 (36%)

39,117

Voluntary Total: 24,903 (64%)

Disenrollment

2016 Disenrollment Disenrollment by Metal Level

Washington Health Benefit ExchangeEnrollment Report

September 2016

3

TOTAL:

Gold Total: 3,313 (8%)

BronzeTotal: 14,715 (38%)

39,117

SilverTotal: 20,388 (52%)

CatastrophicTotal: 701 (2%)

Disenrollment by FPL/Metal Level

0

2K

4K

6K

8K

10K

100% 100%-138% 139%-150% 151%-200% 201%-250% 251%-300% 301%-400% >400% No APTC* 1,092 ......................... 615 ........................ 2,426 ...................... 9,406 ...................... 6,996 ........................4,811 ...................... 5,366 ....................... 4,175 .......................4,230 803 ..........................509 ........................ 1,971 ....................... 7,052 ...................... 3,972 ....................... 1,639 .......................1,739 ....................... 1,365 ....................... 1,338 48 ............................ 13 ............................ 39 ...........................207 .........................448 ..........................436 ......................... 601 ...........................622.......................... 899 220 ...........................82...........................405 ........................ 2,096 .......................2,471 .......................2,593 ...................... 2,898 .......................2,088 ....................... 1,862 21 ..............................11 .............................11 ............................. 51 ........................... 105 ........................... 143 .......................... 128 ........................... 100 ........................... 131

Total Gold SilverBronzeCatastrophic

1,092615

2,426

9,406

6,996

4,8115,366

4,175 4,230

*Chose not to apply for tax credit.

Notes: Includes 2016 enrollees whose coverage ended before October 1, 2016. Excludes enrollees who moved to Medicaid (11,354).

Enrollees by Month Washington Health Benefit ExchangeEnrollment Report

September 2016

QHP Enrollees

0

50000

100000

150000

200000

10/1/15 11/1/15 12/1/15 1/1/16 21/16 3/1/16 4/1/16 5/1/16 6/1/16 7/1/16 8/1/16 9/1/16 149,780 149,831 145,494 156,445 167,009 173,956 171,641 170,018 168,793 167,383 166,883 166,098

166,098

Washington Apple Health Enrollees

0

500K

1M

1.5M

2M

1,531,402

10/1/15 11/1/15 12/1/15 1/1/16 21/16 3/1/16 4/1/16 5/1/16 6/1/16 7/1/16 8/1/16 9/1/16 1,504,413 1,514,523 1,532,779 1,536,123 1,534,806 1,533,708 1,531,054 1,529,617 1,531,752 1,530,698 1,533,611 1,531,402

Dental Enrollees

0

1K

2K

3K

4K

5K

6K

7K

8K

10/1/15 11/1/15 12/1/15 1/1/16 21/16 3/1/16 4/1/16 5/1/16 6/1/16 7/1/16 8/1/16 9/1/16 5,572 5,566 5,666 6,134 6,602 6,885 6,838 6,797 6,806 6,706 6,587 6,518

6,518

4

Enrollees by County

Washington Apple Health by County

QHP by County

11,429

14,664

786

3,608

7,170

3,158

16,420

56,424

5,250

1,634

292

3,217

1,308

1,152116

74

428

1,211

2,374

1,073

165

995

334

903

1,531

278 11,262

388587

2,375

1,476

1,508 1,278

1152,098

724

1,230

2,185

5,206

KING .....................................56,424

SNOHOMISH ....................16,420

PIERCE..................................14,664

CLARK ..................................11,429

SPOKANE ............................11,262

WHATCOM ........................... 7,170

THURSTON .......................... 5,250

KITSAP ...................................5,206

YAKIMA ................................. 3,608

BENTON ................................ 3,217

Top 10

96,3164,990

KING .................................. 338,546

PIERCE............................... 186,591

SNOHOMISH ................. 136,184

SPOKANE ......................... 131,591

CLARK ............................... 102,470

YAKIMA ...............................97,366

THURSTON ........................54,492

BENTON ..............................48,964

WHATCOM .........................45,855

KITSAP .................................43,936

Top 10

Washington Health Benefit ExchangeEnrollment Report

September 2016

*Washington Apple Health enrollees consist of Medicaid MAGI (1,482,125) and CHIP (49,277). A total of 621 Washington Apple Health enrollees listed “Other” under county, while 190 enrollees listed “Border” under county.

5

10,000+ Enrollees

2,000 - 9,999 Enrollees

1,000 - 1,999 Enrollees

1 - 999 Enrollees

100,000+ Enrollees

30,000 - 99,999 Enrollees

10,000 - 29,999 Enrollees1 - 9,999 Enrollees

102,470

186,591

5,468

97,366

45,855

30,316

136,184

338,546

54,492

21,797

1,941

48,96430,754

14,110915

547

5,449

13,922

21,364

8,414

1,90211,565

3,477

11,261

31,180

2,606 131,591

8,3536,915

17,565

6,166

21,366 15,256

90030,176

5,363

3,080

12,487

43,936

TOTAL:

Toddler 1-5Total: 2,265 (25%)

Adolescent 13-18Total: 3,125 (35%)

8,931

Infant <1Total: 396 (4%)

School Age 6-12Total: 3,145 (35%)

TOTAL:

FemaleTotal: 90,791 (55%)

MaleTotal: 75,307 (45%)

166,098

QHP Enrollee Data Washington Health Benefit ExchangeEnrollment Report

September 2016

Age Under 19

Gender

Race/Ethnicity

U.S. Citizenship

6

TOTAL: 35-44Total: 27,548 (17%)

55-64Total: 55,153 (33%)

45-54Total: 33,621 (20%)

26-34Total: 27,416 (17%)

<18Total: 8,331 (5%)

166,098

65+Total: 2,106 (1%)

18-25Total: 11,923 (7%)

TOTAL:

Lawfully Present Total: 22,231 (13%)

CitizenTotal: 143,867 (87%)

166,098

Note: Additional FPL data available online.

TOTAL: Not DeclaredTotal: 41,808 (24%)

AsianTotal: 17,447 (10%)African AmericanTotal: 2,925 (2%)

OtherTotal: 5,123 (3%)

WhiteTotal: 94,409 (58%)

166,098

American IndianTotal: 1,225 (1%)

Pacific IslanderTotal: 2,905 (2%)

Alaska Native:Total: 125

Hawaiian:Total: 131

Hispanic Indicator

TOTAL: Not DeclaredTotal: 48,192 (29%)

Non-HispanicTotal: 108,362 (65%)

166,098

HispanicTotal: 9,544 (6%)

0

1K

2K

3K

4K

5K

6K

7K

8K

Language Data Washington Health Benefit ExchangeEnrollment Report

September 2016

Top Language Requests By Washington Healthplanfinder Applicants

7

Limited English Proficient Applicants Spanish Language

TOTAL: 106,840

QHPsTotal: 9,036 (8%)

WA Apple HealthTotal: 97,804 (92%)

Vietnamese Chinese Russian Korean Arabic Somali 1,551 ......... 1,514 1,714 ............ 1,650 547 ............... 507 533 ................477 30 ..................31 9 ................... 7 4,529 ..........4,586 3,147 ............ 3,067 3,604 ............3,722 1,486 ............. 1,496 1,207............. 1,311 1,059 ............ 1,032 6,080 ........ 6,100 4,861 ............ 4,717 4,151 .............4,229 2,019 ............. 1,973 1,237.............1,342 1,068 ............ 1,039

QHPWAHTotal

*WAH: Washington Apple Health

Note: Excludes Spanish, the top language requested (see above). Includes applicants as of September 2016 who indicated in Washington Healthplanfinder they do not speak and/or read English and requested an interpreter or translation.

Spanish Language Requests By Washington Healthplanfinder

Applicants

Interpreter QHP ............2,967 (4%)WAH .......68,364 (96%)TOTAL ..............71,331

TranslationQHP ............3,049 (4%)WAH .......71,013 (96%)TOTAL ..............74,062

Interpreter

QHP

Washington Apple Health

QHP

Washington Apple Health

Translation

Note: Includes applicants as of September 2016 who indicated in Washington Healthplanfinder they do not speak and/or read English.

Language Data Washington Health Benefit ExchangeEnrollment Report

September 2016

Top Language Requests Through Telephonic Interpretation Services

Customer Service

8

Spanish ..........43,740

Russian .............7,109

Vietnamese ......6,675

Madarin ...........2,105

Korean ................980

Cambodian .........216

Somali .................165

Laotian ..................78

NON-ENGLISH CALLS ANSWERED

Language Count

Note: Includes calls answered by bilingual and multilingual Customer Service Representatives (CSRs) at the Washington Healthplanfinder Customer Support Center from January 2016 through September 2016. Additional language data provided online.

0 500 1000 1500 2000

SPANISH

VIETNAMESE

KOREAN

SOMALI

RUSSIAN

MANDARIN

ARABIC

PUNJABI

CANTONESE 333

AMHARIC 310

FARSI 218

CAMBODIAN 192

1820

979

730

567

512

457

444

340

Note: Includes total calls from January 2016 through September 2016. Telephonic interpretation services in over 175 languages are available to Exchange staff and the Customer Support Center through Language Line Solutions. Additional language data provided online.

Language Count Language Count Language Count

TOTAL: >65+Total: 477

18-25Total: 195,756 (13%)26-34Total: 223,384 (14%)

35-44Total: 154,578 (10%)

55-64Total: 91,572 (6%)

1,531,402

<18Total: 743,462 (49%)

45-54Total: 122,173 (8%)

WA Apple Health Data Washington Health Benefit ExchangeEnrollment Report

September 2016

9

Age Under 19

Race/Ethnicity Medicaid Plan Selection

TOTAL:

Coordinated CareTotal: 24,601 (9%)

Amerigroup Washington IncTotal: 26,414 (10%)

United HealthCareTotal: 49,502 (19%)

266,619

CHPWTotal: 46,962 (17%)

MolinaTotal: 119,140 (45%)

TOTAL:

Toddler 1-5Total: 223,729 (29%)

Adolescent 13-18Total: 208,593 (27%)

775,799

Infant <1Total: 42,122 (5%)

School Age 6-12Total: 301,355 (39%)

Alaska Native:Total: 939

Hawaiian:Total: 3,929

Washington Apple Health Enrollees by FPL

TOTAL: Not ProvidedTotal: 147,418 (10%)

AsianTotal: 70,629 (5%)African AmericanTotal: 116,375 (7%)

OtherTotal: 233,353 (15%)

WhiteTotal: 868,420 (57%)

1,531,402

American IndianTotal: 46,319 (3%)

Pacific IslanderTotal: 44,020 (3%)

0

200K

400K

600K

800K

1M

1.2MFPL CHIP MAGI Total <100% ...........3,888 ......... 1,116,954 ........ 1,120,842 100-138% .....706 ............ 243,896 ................244,602 139-150% .....153 ............ 28,405 .................... 28,558 151-200% .....324 ............ 74,969 .................... 75,293 201-250% .....23,679 ...... 14,237 .................... 37,916 251-300% .....16,997 ...... 1,992 ....................... 18,989 301-400% .....3,299 ......... 1,159 ..........................4,458 >400% ...........231 ............ 513 ................................ 744 Total ................49,277 ...... 1,482,125 ........ 1,531,402

<100% 100%-138% 139%-150% 151%-200% 201%-250% 251%-300% 301%-400% >400%

Note: Numbers are cumulative as of September 2016.*336,937 marked “Hispanic” with their ethnicity, while 269,605 did not declare.

Medicaid MAGI CHIP

Additional Data Washington Health Benefit ExchangeEnrollment Report

September 2016

10

Sept. 2016 QHP Enrollees by Carriers

Health Alliance NWTotal: 16

TOTAL: United HealthCareTotal: 3,684 (2%)

BridgeSpanTotal: 5,045 (3%)

Coordinated CareTotal: 32,673 (20%)

Group HealthTotal: 27,924 (17%)Kaiser NorthwestTotal: 7,219 (4%)

LifeWiseTotal: 12,474 (8%)

Regence Blue ShieldTotal: 2,259 (1%)

Premera MSPTotal: 15,407 (9%)

PremeraTotal: 34,933 (21%)

MolinaTotal: 24,401 (15%)

166,098

CHPWTotal: 63

Churn

QHP - WA APPLE HEALTH

Oct. 1, 2015 - Sept. 1, 2016 Avg. Monthly Churn Percentage:

1.05%

Avg. Monthly Churn Total:1,638

Highest Month Churn Percentage: Dec. 1, 2015 - 3.17%

Highest Month Churn Total: Dec. 1, 2015 - 4,756

QHP – Medicaid: Enrollees who were enrolled in a QHP in a given month and the next month they are enrolled in Medicaid. Percentage is calculated by dividing the total number of enrollees who moved to Medicaid by the total number of QHP enrollees the previous month.

WA APPLE HEALTH - QHP

Oct. 1, 2015 - Sept. 1, 2016 Avg. Monthly Churn Percentage:

0.13%

Avg. Monthly Churn Total:1,873

Highest Month Churn Percentage: Jan. 1, 2016 - 0.27%

Highest Month Churn Total: Jan. 1, 2016 - 4,029

Medicaid – QHP: Enrollees who were enrolled in Medicaid in a given month and the next month they are enrolled in QHP. Percentage is calculated by dividing the total number of enrollees who moved to QHP by the total number of Medicaid enrollees the previous month.

SEP (Special Enrollment Period)

TOTAL:

Income ChangeTotal: 149 (3%)OtherTotal: 647 (8%)

BirthTotal: 492 (4%)

Loss of Health CoverageTotal: 8,726 (82%)

10,448

Change ofResidenceTotal: 434 (3%)

There are special circumstances that trigger a special enrollment period for an individual or family outside of open enrollment. These exceptions include, but are not limited to, change in income; marriage status, death, birth or adoption; loss of health coverage; and change of residence. Washington Apple Health, Native Americans, Alaskan Americans and SHOP employees can enroll any time of the year.

September 2016 SEP:

MSP=Multi-State Plan

Additional Data Washington Health Benefit ExchangeEnrollment Report

September 2016

Assisted Enrollees Families

Families Enrolled Total: 120,385

Mixed Families Total: 22,021 (18%)

In the month of September 2016

QHP

Mixed families are the total families enrolled both in QHP and WA Apple Health in September 2016.

Premiums and Financial Assistance - September 2016

*Only eligible with Silver plan enrollmentFA - Financial AssistanceAPTC - Advanced Premium Tax Credits

Total QHP premiums Total: $61,625,712

APTC Total Total: $27,132,208

Premiums andTax Credits

Without FA Total: $372.65/month

With FA Total: $208.58/month

Average monthly premium per person

CSR for Sept. 2016 Total: $5,403,183

Enrollees receiving CSR Total: 70,477

Cost-sharingreductions (CSR)*

All 2016 Assisted WA Apple

Health Enrollees

Broker Total: 21,378 (1%)

Navigator Total: 184,038 (12%)

All 2016 Assisted QHP

Enrollees

Broker Total: 31,629 (14%)

Navigator Total: 14,332 (6%)

11

Total 2016 QHP Enrollees: 223,235 Total 2016 WAH Enrollees: 1,531,402

SHOP Enrollment Washington Health Benefit ExchangeEnrollment Report

September 2016

12

Employer by Metal Level

SHOP

Total 161

1

5

2

11

10

2

2

10

2 2

4 571

6

3

32

2

1

1

Enrollments

EmployersTotal: 64

EmployeesTotal: 562

Dependents Total: 191

Employer by County

Employees and Dependents by Metal Level

0

100

200

300

400

500

600

700

800

Employees Dependent TotalTotal 191 562 753 Gold 125 326 451Silver 63 202 265Bronze 3 34 37

1

1

1

1

TOTAL:

BronzeTotal: 16 (10%)

SilverTotal: 64 (40%)

GoldTotal: 81 (50%)

161

191

562

753

1

1