Providence, Health CO-OP Biggest Winners in Enrollment

The official enrollment numbers have yet to be released, but two insurers have commanding leads in the individual marketplace – Providence Health Plan and the Oregon Health CO-OP.

More than 69,000 people have signed up with Providence for individual and family plan products, according to Mike Cotton, CEO, who told The Lund Report: :

“Open enrollment has been successful for Providence Health Plan with membership growth in all lines of business. We believe our commitment to service, customer value and our integrated care model are the key reasons so many Oregonians have selected our plans.”

At this time last year, Providence had 19,000 individual and family plan members, according to Olivia Ramos, communications manager.

Providence also picked up 1,100 new employers, according to confidential sources.

The Oregon Health CO-OP also couldn’t be more pleased, having 23,000 members on board, considering it only had 10,000 members last year. At one point, the CO-OP even considered closing its doors to avoid rapid growth and were concerned they lacked the necessary reserves to handle this growing trend, Rob Sumner, director of sales, told The Lund Report.

“Our strategy from the beginning has been steady, controlled growth to avoid some of the issues that faced other CO-OPs,” he said. “Going into open enrollment, we anticipated the possibility of considerable growth given our price point in the market, our plan designs and provider network. We did have discussions with both the Oregon Insurance Division and Centers for Medicare & Medicaid Services regarding the possibility of temporarily suspending enrollment in 2016 to avoid too rapid growth. They were both supportive of that strategy. While we did realize significant growth for 2016 we came just shy of the enrollment levels that would have triggered suspension. We did communicate the possibility to the broker community late last year.“

Sumner cautioned that the 23,000 numbers “includes some membership who have not yet paid so that number may drop some.”

The Lund Report contacted other health insurers and only received a response from Kaiser Permanente. Its communications manager, Michael Foley, told The Lund Report. “The numbers are not clear right now, and won't be for a weeks. We can get sign up numbers. But it will take a little time to scrub the data for who is renewing and who is really a new member.

Jonathan Nicholas, vice president for strategic communications at Moda Health, also responded, saying "We still are busy processing enrollments.There has been a great deal of activity, right up until 1/15, and that’s what is making it hard for us to share any accurate projections. We don't want to estimate something we can’t confirm."

Richard Skayhan, an insurance agent with Leonard Adams Insurance, isn’t surprised to see Providence and the CO-OP take the lead.

“That’s what we predicted and were teasing Providence about this,” said Skayhan, who believes Moda Health, which had 102,000 members last year will end up the big loser. “Most people moved on because they were uncomfortable with the situation – all the media reports about them.”

On the other hand, the CO-OP has the most efficient enrollment system of anyone, Skayhan added. “They wanted everything online; it worked really well and we used that as an example against others and here it came from the littlest guy on the team.”

Regence BlueCross BlueShield also created a conundrum for its new members, requiring them to show two pieces of identification and a copy of a utility bill to provide residency before signing up. “It was just an additional hassle for brokers who were trying to enroll people,” he said.

At last count, 137,820 people had signed up for enrollment on the exchange, a 22 percent bump from 2015 when only 113,219 people sought coverage.

The Oregon Insurance Division doesn’t anticipate releasing enrollment numbers by health plan until April, according to Jake Sutherland, spokesman.

Diane can be reached at [email protected].