The Washington Health Benefit Exchange Board Operations Committee held a meeting in Seattle yesterday to discuss the Exchange entity, IT, self-sustainability and premium aggregation. The Exchange has been weighing two different approaches to the handling of premium aggregation, which received much of the meetings attention.
One option calls on the Exchange to administer individual premium aggregation, and based on phone calls:
“Overwhelmingly the consumers wanted premium aggregation, I don’t think anyone had a con,” said Beth Walter.
This model would simplify the purchasing process and place responsibility solely on the Exchange to collect consumer’s premium payments and federal subsidies.
With this the Exchange would be accountable for paying insurance companies the premiums and would allow enrollees to interact with the Exchange for the entire shopping experience, as illustrated in the diagram below:
In the second model, issuers would be responsible for collecting individual premiums and federal subsidies from consumers. Last week there was an open teleconference between the Exchange and insurance carriers to discuss options.
“I think the carriers support, overall, that the Exchange would aggregate premiums,” added Walter.
If issuers collect premiums, those payments would be made directly to the issuer of insurance and that issuer would hold the responsibility to combine payments from all sources without the Exchange, as illustrated below:
The committee plans to meet again before the next Exchange Board meeting set for June 13. We will provide details about that meeting when information becomes available.