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Aetna joins list of insurers who will be on N.J.'s exchange in 2014

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Four insurers have confirmed they will participate in the New Jersey health insurance exchange the federal government is creating for individuals and small businesses to shop for government-subsidized policies.

Horizon Blue Cross Blue Shield of New Jersey and AmeriHealth NJ said last week they would participate, and this week Aetna said it also will take part. A new cooperative health insurance company fostered by the Affordable Care Act, the Freelancers Co-Op of New Jersey, has applied for a state insurance license to sell policies on the exchange.

The ACA’s individual mandate requires most Americans to either get covered in 2014 or pay a penalty. The exchange is expected to launch Oct. 1, so insurers can start selling policies taking effect Jan. 1.

Cigna and UnitedHealthcare both said they won’t be on New Jersey’s exchange in 2014, but will continue selling plans in the state’s existing off-exchange insurance market and consider coming on board the New Jersey exchange in 2015.

New Jersey will have two exchanges, one for individuals and another for companies employing less than 50. Aetna spokeswoman Susan Millerick said the company will participate in the individual, but not the small-employer, exchange.

“Our decision-making process in New Jersey involved the same factors we took into consideration nationwide,” Millerick said. “Our goal has been to take a prudent, balanced approach to exchanges for 2014, and in each state we considered our current market presence, our ability to offer strong networks and competitively priced products, and the regulatory environment.”

Aetna has about 1.2 million members in New Jersey. Horizon is the state’s largest health plan provider, with 3.6 million members; UnitedHealthcare covers about 1.5 million New Jerseyans, while Cigna has about 470,000.

Christine Stearns, vice president of health and legal affairs at the New Jersey Business & Industry Association, said employers are uncertain about the new options the exchange will bring. “Employers are focused on price, and we just don’t know if the plans will be more affordable than the current market. And it’s not likely these questions will be answered until the fall.”

Ev Liebman, associate state director for advocacy at AARP, said the state must do more to support outreach. “If New Jersey’s large uninsured and underinsured residents don’t know about the exchange, they won’t get the benefits of quality, affordable coverage — a problem for them, but for the state as a whole, as well,” Liebman said.

Ward Sanders, president of the New Jersey Association of Health Plans, said alongside the ACA’s new exchange, New Jersey’s existing health insurance market will continue to offer coverage as it does today.

“I think this is where most of the small employer health coverage plans will be sold,” Sanders said, noting that since the ACA’s new rules apply to all health insurance policies, the benefits and the costs of health insurance, both on and off the exchange, will change significantly from what is available today.

Experts estimate several hundred thousand of New Jersey’s 1.1 million uninsured could get covered in 2014, through the expansion of Medicaid and through the exchange’s government-subsidized insurance policies that are expected to make coverage more affordable for low and moderate income consumers.

But there are still unknowns, said Jeff Brown chief of staff of the New Jersey Health Care Quality Institute, “and that might be why you see some hesitancy on the part of some of the (insurance) plans to jump in. … It’s going to be a long implementation process to get this thing up and running — it’s certainly not just going to flip on Jan. 1 and be completely good to go.”

He said UnitedHealthcare and Cigna “are both national health care plans that are picking what market they are going to enter in year one. So from a strategic perspective, I don’t think there’s anything to worry about there.”

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