Missouri Health Insurance Exchange Marketplace
Missouri uses the federally facilitated health insurance exchange marketplace, which means residents enroll through HealthCare.gov if they need a plan.
Open enrollment for 2020 health plans is over. However, Missouri residents with qualifying events can still enroll or make changes to their coverage for 2020 (this includes any person who loses employer-sponsored health insurance due to the Covid-19 pandemic; choices are available for these persons to maintain health coverage). The next open enrollment period, for plans effective in 2021, will start on November 1, 2020.
The Average Rate Decrease for 2020 and Three New Insurers
Missouri has established a task force aimed at making the state’s health insurance marketplace more robust and affordable, but even before the task force convened, many insurers had filed plans to join the state’s exchange or expand their existing coverage area for 2020. And the insurers that already offered health insurance plans in Missouri’s exchange implemented a small general rate decrease for 2020.
Four health insurance companies in Missouri provided plans in the exchange in 2019, and that grew to seven for 2020. Anthem (Healthy Alliance Life Insurance), Cigna, Ambetter/Celtic (Centene), and Medical offered coverage in different areas of Missouri in 2019. For 2020, Oscar Health, SSM Health Insurance, and Cox Health Systems joined the health insurance exchange market.
Cox Health Systems in Missouri
Cox Health Systems (SERFF filing number COXH-132005795) is providing EPO health insurance plans in seven counties in the Springfield area (Barry, Christian, Greene, Lawrence, Stone, Taney, and Webster, all of which are in Rating Area 8). Cox did not take part in the individual market in Missouri in 2019, but they did provide health insurance plans outside the exchange in 2018. For 2020, Cox’s filing noted that their health insurance plans would only be accessible through the exchange, with a projected enrollment of about 8,000 persons.
Oscar Health in Missouri
Oscar Health (SERFF filing number OHIN-131965597) provides coverage on- and off-exchange in the Kansas City area for 2020. Their filing was limited to Rating Area 3. They are offering health insurance plans in Jackson, Clay, and Platte counties (Cass County is also in Rating Area 3, but Oscar confirmed that their coverage area would not comprise Cass County).
Oscar’s filing memo stated that while the majority of their provider network is concentrated in Clay, Jackson, and Platte counties, they do also have some providers in neighboring counties, and members would also be able to access Oscar’s providers on the Kansas side of Kansas City location, in Johnson and Wyandotte counties. Oscar’s filing indicated that they anticipated about 2,500 individual marketplace enrollees for 2020. Oscar has not before offered coverage in Missouri’s individual market.
SSM Health Insurance in Missouri
SSM Health Insurance (SERFF filing number DHPL-132014049) provides coverage on- and off-exchange in St. Louis County, St. Charles County, and St. Louis City, which is all in Rating Area 6. SSM is an integrated delivery system with an established presence in the Midwest, but it had not earlier offered coverage in Missouri’s individual market.
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