More than three-fourths of those enrolled in Medicaid-funded insurance plans under Arkansas’ so-called private option are in plans offered by Arkansas Blue Cross and Blue Shield or its national affiliate, figures released by the Arkansas Department of Human Services show.
The numbers also show that Centene Corp.’s Arkansas Health and Wellness Solutions, which offers plans in three of the state’s seven coverage regions, leads the companies offering the Medicaid plans in each of thosethree regions.
Arkansas Blue Cross and Blue Shield and the national Blue Cross and Blue Shield Association have the most statewide enrollees in part because they are the only insurers offering policies in all seven coverage regions delineated by the Arkansas Insurance Department.
Of those whose coverage under the plans started Wednesday, 46,275 were in plans offered by Arkansas Blue Cross or the national association, 11,063 were in plans offered by Arkansas Health and Wellness Solutions, and 1,246 were inplans offered by QualChoice Health Insurance.
Arkansas Health and Wellness Solutions is offering plans in the central, northwest and west-central coverage regions. QualChoice is offering plans in those regions as well as the northeast and south-central regions.
Arkansas Blue Cross and Blue Shield and the national association are the only companies offering plans in the southeast and southwest regions.
Human Services Department spokesman Amy Webb said the enrollment figures show that the private option is establishing the “building blocks” for competition in the state’s insurance market.
“The Private Option made the market more attractive to carriers and, we believe, brought more players into more regions,” Webb said in an email.
An estimated 250,000 Arkansans - adults with incomes of up to 138 percent of the poverty level - became eligible for Medicaid under the expansion of the program approved by the Legislature last year. The income threshold is $15,860 for an individual or $32,500 for a family of four.
Most of those who sign up can choose a silver, or medium-coverage, plan on Arkansas’ insurance exchange and have the premium paid by Medicaid, which also reduces or eliminates any other required out-of-pocket spending by the recipient.
About 10 percent of those who sign up are expected to be assigned to the traditional Medicaid program because they are considered to have exceptional health needs.
Enrollment in the expanded program began Oct. 1 for coverage that began Wednesday.
Arkansas Health and Wellness Solutions, which markets plans under the name Ambetter of Arkansas, is the only company with health plans on the exchange that include dental and vision coverage.
Medicaid covers the full premium for those plans, but the recipient in some cases must make co-payments associated with the vision and dental benefits.
In approaching Medicaid enrollment last month, Shanice Hood, a 21-year-old student at the University of Arkansas at Little Rock, said Thursday that she considered an Ambetter plan but ultimately opted for an Arkansas Blue Cross and Blue Shield plan because it seemed to have the broadest network of providers.
“If I was to go to another state, then Blue Cross would cover me,” said Hood, who spoke at an event in support of the private option last month.
Hood, who earns $250 a month working as a part-time assistant in student housing at the university, said she helped her mother, who lives in Jacksonville, enroll in the same plan.
The totals released Thursday by the Human Services Department include people who chose a plan on their own through a state website, insureark.org, as well as those who were automatically assigned to a plan after they failed to choose a plan within 12 days of the approval of their application for Medicaid coverage.
The assignments are designed to ensure a minimum market share for each of the companies offering plans in the seven coverage regions. The minimum share ranges from 33 percent to 20 percent,depending on the number of insurers in the region.
After the minimum share is reached, the Human Services Department makes the assignments evenly among the companies in the coverage region.
Webb said she didn’t have numbers Thursday on how many automatic assignments have been made.
Arkansas Blue Cross spokesman Max Greenwood said her company’s “vast network” of doctors and other providers is attractive to consumers, as is the company’s history in the state.
“We think people are comforted by the brand and by our reputation,” Greenwood said.
The company also has seven regional offices where applicants can get one-on-one help, and it has assigned staff members to help people enroll at Goodwill Industries of Arkansas stores in 10 Arkansas cities.
Spokesmen for St. Louis-based Centene Corp. and Little Rock-based QualChoice didn’t return a call seeking comment Thursday.
In addition to those enrolled in the private-option plans, 6,100 people who did not qualify for Medicaid have enrolled in Blue Cross plans on the state insurance exchange, Greenwood said.
Federal tax credits are available to pay some or all of the premiums for those plans for people who have incomes of less than 400 percent of the poverty level - $45,960 for an individual or $94,200 for a family of four.
Greenwood said Arkansas Blue Cross has been mailing out insurance cards to those whose coverage took effect Wednesday and hopes to have them all sent out by Jan. 15.
The delay in mailing out all the cards stemmed in part from a “large number” of applications for the non-Medicaid plans that the U.S. Department of Health and Human Services’ Centers for Medicare and Medicaid Services sent Blue Cross late last month. That information contained some errors that the federal agency later corrected.
“We’ve had staff working weekends and holidays” to process the applications, Greenwood said.
The deadline for signing up for coverage that takes effect Jan. 1 was initially Dec. 15. Because of problems with a federal enrollment website, healthcare.gov, that deadline was pushed back to Dec. 23, then to Dec. 24. Federal officials also said they would allow appeals from those who believe that technical issues prevented them from meeting the deadline.
Providers in the Blue Cross network can look up information on the insurance companies’ customers, so those who are enrolled can still see a doctor or have a prescription filled even if they don’t yet have an insurance card, Greenwood said.
Hood, the UALR student, said she has not yet received her insurance card although her mother recently received hers.
She said she was covered by the ARKids First program for children until she turned 18. Since then, the Medicaid family-planning program has helped pay for her birth control, but didn’t cover her asthma inhalers and other medical expenses.
Last year, for instance, a bout with bronchitis cost her hundreds of dollars and left her with a $400 bill from an emergency room visit that she still hasn’t paid.
“Just being able to get health insurance and having them continue to pay for my prescriptions is going to be a lot of help,” Hood said.
Front Section, Pages 1 on 01/03/2014