New Mexico Health Connections, the state’s startup health plan, has captured nearly 50 percent of the market on the state’s small business health insurance exchange.
As of Jan. 15, 368 people had purchased insurance through New Mexico’s SHOP (Small Business Health Options Program) exchange for small businesses. Of those, 170, or 46.1 percent, had bought Health Connections plans, according to statistics from the New Mexico Health Insurance Exchange.
Blue Cross and Blue Shield of New Mexico was in second place with 105 members, or 28.5 percent, and Presbyterian Health Plan had 65 members, or 17.6 percent. Lovelace Health Plan, which is no longer on the exchange, had 28 members, or 7.6 percent.
Lovelace is in the process of being bought by BCBSNM and was taken off the exchange by NMHIX because of the pending sale.
Health Connections CEO Dr. Martin Hickey credits the nonprofit’s early success to its lower prices and plan structures, which are different than ones offered by other insurers on the exchange, as well as the ability of consumers to compare plans on the SHOP site. NMHC offers plans that don’t have high initial out-of-pocket expenses, Hickey said.
Other insurers have what are called first-dollar deductibles for doctors’ office visits and prescription drugs. It means that if the plan has a deductible, that deductible must be used up before the insurance kicks in.
“We don’t have first-dollar deductibles for doctor’s visits or prescription drugs,” he said. “On our plans, the deductibles are on rare events like hospitalizations or medical specialty drugs. We are very excited.”
NMHC is a cooperative health plan formed under the Affordable Care Act. It is funded with federal loans and will be governed by its members, Hickey said.
“We are a different type of health plan, and our first and foremost thought is about our members. We are a doctor-led organization and we understand the issue of trust that people are looking for and that is how we designed it,” Hickey added.
So far, 370 people have enrolled in insurance plans on the SHOP exchange, according to the NMHIX. A total of 1,542 employers have set up accounts on the exchange and they represent 3,962 employees.
On the individual exchange run by the federal government, healthcare.gov, 7,688 New Mexicans have enrolled in health plans. While enrollment numbers by insurer aren’t available, Hickey said he thinks NMHC has gotten about a third of those customers.
Hickey said the company will launch a new wave of ads and market efforts in February. The NMHIX is also set to launch a new marketing effort aimed at getting “young invincibles” to enroll on the federal individual exchange.
Figures from the U.S. Department of Health and Human Services showed only 18 percent of New Mexicans who have enrolled on the federal exchange are in the 18 to 34 age group.
The exchanges need young people to buy insurance on the exchanges so they can subsidize older and sicker people. Some studies have suggested the exchanges could fail if they don’t attract enough young, healthy people.