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Analysis of Marketplaces Show Wide Range in Number of Insurers

By Rebecca Adams, CQ HealthBeat Associate Editor

October 3, 2013 -- Sixteen states have one to three insurance companies operating in their individual marketplaces while 11 states have more than 10 insurers, according to an analysis released last week by the consulting firm Avalere Health.

The wide variability that federal officials have discussed is on exhibit in a map by the consulting firm showing how many insurance companies are operating in every state in the new marketplaces under the health care law (PL 111-148, PL 111-152).

Four to six insurers are operating in the individual marketplaces in 19 states and the District of Columbia, and seven to nine insurance companies are in four states.

"The federally facilitated marketplace landscape reveals meaningful competition among issuers and a variety of plan options for consumers to choose among," said Dan Mendelson, CEO of Avalere Health.

Many people in the federal marketplace will have a health care plan associated with the Blue Cross and Blue Shield Association as their second-cheapest option in the silver tier, according to Avalere. That is not a huge surprise because Blue Cross and Blue Shield plans dominate the current individual market.

The second-lowest-cost silver plan is the one upon which federal subsidies are based. Silver plans cover 70 percent of medical costs.

Consumers who want to get extra help paying for their copays and deductibles also must choose one of the plans at the silver tier level. People whose income is 250 percent of the federal poverty level or less qualify for extra financial help with their cost-sharing.

Avalere found that in a sampling of 13 states, the second-lowest-cost silver plan was associated with Blue Cross and Blue Shield in eight of the 13 states, a national Humana or Coventry plan in two of the 13 states,a local plan in two of the 13 states and a Medicaid/Medicare Advantage plan in one state.

Avalere looked at the federal database with premium information, which is available on, and checked offerings in the 13 federally-facilitated marketplace states that are expected to have the most people enroll. Those states were Arkansas, Florida, Georgia, Illinois, Indiana, Michigan, North Carolina, New Jersey, Ohio, Pennsylvania, Texas, Virginia and Wisconsin.

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