Cover Oregon fees to rise (as it looks for Fed bailout)

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by Betsy Earls
Associated Oregon Industries

Oregon’s largest business advocate

Cover Oregon Moves to Fed to Save Money – Yet Fees Go Up

Cover Oregon went through another round of explaining itself recently, updating legislative committees during three days of meetings designed to begin planning for the 2015 Legislative Session.

Clyde Hamstreet, Cover Oregon’s Interim Executive Director, and Tina Edlund, the Technology Transition Project Director, gave presentations to the House Health Care Committee and the Senate Health Care and Human Services Committee on the process of switching over to the federal exchange. This switch is the result of the Cover Oregon Board’s vote on April 25 to transition the commercially insured market (those purchasing qualified health plans or QHPs) to federal technology.

According to this week’s presentations, Cover Oregon now intends that people will be able to shop, apply and enroll for group coverage online no later than November 15, 2014. All currently enrolled QHP customers will have to reenroll at that time, as Cover Oregon is not able to transition coverage to the federal exchange. The federal exchange will provide a customer call center, as well as agent/broker training. Cover Oregon will continue to provide consumer outreach and education, certification of plans, and some QHP oversight.

Interestingly, given that so many of its responsibilities will be turned over to the federal government, Cover Oregon actually plans to increase administration fees in 2015. Fees for 2014 are $9.38 per member, per month (pmpm), but are scheduled to go up to $9.66 in 2015. When asked, Cover Oregon was unable to provide justification for the increase.