Moda to exit Washington health insurance market

seattle washington health insurance rates industry

Moda Health will leave the Washington insurance market, including the state’s exchange

Moda Health, a prominent health insurance provider, has announced that it will be leaving Washington’s insurance exchange. The insurer provides coverage to some 47,000 consumers through the state’s exchange and many of these people may have to find coverage elsewhere in 2016. Enrollment for the state’s exchange begins in November, but consumers will no longer be able to find plans from Moda, as the insurers is focusing on other markets following some shortfalls in Washington and other states in which it offers coverage.

Insurer will focus more heavily on its core markets

Moda will be concentrating its efforts on its core markets, which are in Oregon and Alaska. The company is a leading provider in these states, holding a significant market share. Washington Insurance Commissioner Mike Kriedler was informed of the decision by Moda before the company made its announcement. Affected consumers will not be able to renew their Moda policies in the state and the decision affects more than those seeking coverage through Washington’s insurance exchange.

Financial impact of new federal policy has had an effect on Moda

seattle washington health insurance industryAccording to Moda Health, the insurer is ceasing the sale and renewal of all insurance products in Washington. This means that individual, small and large group plans will no longer be available. The decision follows the financial impact the insurer had seen from a new policy launched by the Centers for Medicare and Medicaid Services. The federal agency’s policy means that it will only pay out 12.6% of every dollar spent on “risk corridor” programs. As a result, Moda was expected to receive $89.5 million in compensation last year, but only received $11.3 million.

Moda will continue to honor its Washington contracts

Moda is expected to weather the financial impact of this policy, but has decided that focusing on its core markets is the best solution. Like other insurers that have exited markets in recent months, Moda believes it will be able to better serve its core customers. Moda will, of course, continue to fulfill all contracts it has in Washington until these contracts expire.

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