- Associated Press - Monday, June 16, 2014

SIOUX FALLS, S.D. (AP) - Two health insurers said they intend to sell plans to South Dakota residents through the federal marketplace during the open enrollment period that begins in November, but it is unclear whether at least two other companies have filed documents with the state that would allow them to offer plans through the same system.

Insurers faced a Sunday deadline to submit their plans to the state’s Division of Insurance for review.

The nation’s new health care law requires nearly every American to have insurance coverage. The next period to enroll in a health plan using the federal www.healthcare.gov starts in November and coverage purchased at that time will go into effect in 2015.

Representatives for Avera Health Plans and Sanford Health Plan said they have filed policies with the state. Dakotacare, Avera and Sanford were the only insurers selling plan to South Dakota residents during the site’s first run.

Debra Muller, chief administrative officer for Avera Health Plans, said the insurer plans to keep some of its offerings and change others after taking into consideration consumer feedback. She said the insurer will offer additional high-deductible plans that are compatible with tax-free Health Savings Accounts. It will also sell an option that would reduce consumers’ medical bills should they choose an Avera provider.

“We are going to be enthusiastically participating again in the individual marketplace, both on and off the exchange, and with the smaller employer option,” Muller said.

Muller said Avera received 11,000 applicants through the marketplace during the open enrollment period that ended in March. She said 89 percent of those applicants paid their first month’s premium.

Lisa Carlson, Sanford’s director of planning and regulation, said the insurer intends to offer at the minimum the same four individual and five small group plans it sold through March. The insurer could not provide additional details because it offers plans in two other states that have later state filing deadlines.

Carlson said Sanford had 2,262 enrollees in South Dakota through the marketplace and an additional 500 are in pending status because they are yet to pay.

Premium fees could change or remain the same after undergoing an actuarial review from the state.

Aside from the federal enrollment website, South Dakota residents can shop for coverage directly from insurers. But those who choose that option cannot receive federal subsidies available to some with qualifying incomes under the law. Individuals who don’t purchase health coverage are subject to penalties.

The assistant director of the Division of Insurance, Melissa Klemann, said the state can’t confirm what insurers filed plans until officials have made a final decision on the proposed policies. Federal officials also have oversight power over the plans sold through the website.

Dakotacare spokesmen did not return messages seeking comment on whether the insurer will again offer some or all of the 19 individual and two small group plans it sold through March.

Wellmark, the largest private insurer in South Dakota, opted to stay out of the marketplace during the past enrollment period. The company hasn’t publicly announced whether it will sell plans on the website starting in November.

Muller said the competition would be welcomed.

“I think that allowing consumers to have a variety of choices of health plans - both on and off the marketplace - is a good thing for the residents of South Dakota,” Muller said. “I welcome anyone who is really invested in wanting to do the right thing and providing coverage for individuals who maybe are looking for support in being able to pay for their premiums or simply offering another choice to the consumer to be able to select from.”

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