Eight insurance companies are seeking approval to sell 504 health plans next year on the Illinois health insurance exchange, a noteworthy increase from 2014, the state said Thursday.
The surge in interest in the Illinois exchange allays widespread concerns that carriers would find the prospect of offering coverage under the Affordable Care Act too risky and unprofitable because of sicker-than-expected pools of patients, causing them to walk away.
The state did not say which carriers submitted plans, which include 306 policies for individuals and 198 for small groups.
"The significant increase in the number of carriers and the number of plans they are offering represents good news for Illinois health care consumers," said Jennifer Koehler, executive director of Get Covered Illinois, the state's health care expansion enrollment arm. "It means consumers will have even more good options to choose from next year."
In the inaugural sign-up period, just six insurers offered 165 policies in Illinois — 120 individual plans and 45 for small groups. That was far below the state's initial projections that at least 250 policies would be offered.
In total, eight companies will offer plans under 10 so-called issuers, compared with six companies that sold plans under eight brand names earlier this year.
Notably absent in Illinois in the first sign-up period was the state's second-largest insurer, UnitedHealthcare, which opted to sit out amid uncertainty in the market. The company confirmed Thursday that it plans to offer policies through the marketplace in 2015.
"This is a first step that will help inform our final participation decision, and we look forward to continuing our conversations throughout the approval process," said Kevin Shermach, a United spokesman.
The Illinois exchange, an online marketplace where consumers can compare and buy private health plans, is hosted at HealthCare.gov. It is a key pillar of the Affordable Care Act, the landmark 2010 health law that expanded coverage to millions of Americans, including about 566,000 Illinoisans, this year.
Through April 19, just more than 217,000 gained private coverage offered through the exchange, a market dominated by the state's largest insurer, Blue Cross and Blue Shield of Illinois.
Blue Cross said it enrolled about 200,000 people through the Illinois exchange in the first year, good for about 92 percent of the market. It plans to sell exchange-based plans again for 2015.
Its dominance left little for other carriers, including the startup Land of Lincoln Health, a co-op nonprofit funded in part with a $160 million federal loan that was able to sign up about 3,500 customers in its first year.
Land of Lincoln has said it plans to participate again in 2015. As will Health Alliance, the Urbana, Ill.-based insurer that offered plans throughout the state in 2014 outside the Chicago area.
Humana Inc., the final insurer that participated this year, has not announced its decision yet, but a spokeswoman said previously the Louisville, Ky.-based company has "no plans to reduce our footprint."
The Illinois Department of Insurance will review each plan and send its recommendations to the U.S. Department of Health and Human Services by Aug. 8 for certification. Open enrollment for 2015 coverage, begins Nov. 15 and continues through Feb. 15. Carriers have the option of withdrawing plans or exiting the market before the start of open enrollment.
The addition of UnitedHealthcare alone should increase competition in the market, according to a recent study released by the National Bureau of Economic Research.
The study, issued as a working paper, estimated that monthly premiums for the silver plans in 34 states, including Illinois, would have been 5.4 percent lower, on average, had United participated in the federally run marketplaces. It also found that health insurance premiums, on average, are "responsive to competition." The silver plans were one step above the lowest-priced bronze plans.
Whether the increased competition holds in check monthly premiums remains an unknown, though additional market participants should help moderate increases, said Caroline Pearson at Avalere Health, a Washington-based consulting firm that has closely followed the rollout of the law.
"While premiums will vary dramatically across carriers and states, we expect average exchange premiums to increase slightly in 2015 as a result of patient demographics and medical inflation," Pearson said. But for consumers, she said, "more choice and competition is generally a good thing."
A separate survey conducted by the consulting firm PricewaterhouseCoopers' Health Research Institute found that many insurance executives opted for a more conservative approach in 2014, holding back expansion plans until Obamacare's second year.
"We expect the exchange landscape in 2015 to include more insurers offering more plans in more states," said Ceci Connolly, the institute's managing director. "This is a growth opportunity for many companies."