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UPMC premium may edge out rival Highmark in Western Pa.

| Sunday, Nov. 9, 2014, 11:47 p.m.
This is the home page of HealthCare.gov, a federal government website managed by the Centers for Medicare & Medicaid Service.
This is the home page of HealthCare.gov, a federal government website managed by the Centers for Medicare & Medicaid Service.

Heated competition for health insurance shoppers in Western Pennsylvania is spilling onto the federal government's online exchange, where health giant UPMC dropped the premium price of its least expensive plan by 41 percent, allowing it to supplant Highmark Inc. as the cheapest carrier in the region.

Highmark, which is losing broad access to most UPMC hospitals and doctors next year in Pittsburgh, raised the price of its lowest-cost health plan premium by 10 percent for next year on HealthCare.gov, according to data released Sunday by the Centers for Medicare and Medicaid Services, which runs the exchange.

Last year, Highmark's lowest premiums were about 30 to 40 percent less expensive than its competitors, leading the state's largest health insurer to sign up more than 130,000 people on the exchange, or 41 percent of the statewide sign-up total of 318,000.

For 2015, UPMC Health Plan's more competitively priced policies should give it an enrollment boost, the company said.

“While this is the second year of the marketplace, this year is very different with the variety of choices and pricing changes,” UPMC Health Plan CEO Diane Holder said in a statement. “We encourage consumers to be smart shoppers.”

Highmark spokesman Aaron Billger said the insurer expects to retain “a large portion” of its 2014 enrollment. “We think we have very solid products,” he said.

The government opened a “window shopping” feature Sunday that lets people view plans and prices without first signing up. The exchange, which is the primary way uninsured people can shop for health coverage under the Affordable Care Act, opens for enrollment Saturday.

The lack of a window-shopping function was cited as one reason for poor performance on the exchange last year because many people who logged on simply to view plans and prices first had to sign up and create an account, which overwhelmed the site's capacity. Technical glitches hurt the site and caused delays that prevented some people from signing up for days to weeks.

“Using this tool, consumers can compare plans, covered benefits and physician and hospital networks before the marketplace annual open enrollment period starts on Nov. 15,” CMS Administrator Marilyn Tavenner said in a statement.

“New features will give consumers a comprehensive picture of the plans in their area so they can choose the one that's right for them,” she said.

About 8 million signed up for coverage on the exchange last year. A total of about 13 million, including people renewing their coverage, are expected to enroll for 2015, the government has said.

Not only are UPMC and Highmark duking it out for low-cost offerings, but there also are more insurers selling more plans on the exchange for 2015 than last year.

There are five insurers offering 23 plans at the silver level, compared with three carriers and 13 silver plans last year. United Healthcare and Assurant Health are new to the exchange. Aetna Inc.'s Coventry subsidiary replaces its HealthAmerica subsidiary for 2015.

Exchange plans are grouped by metal level according to richness of benefits, and range from a bronze plan that covers 60 percent of costs to a platinum plan that covers 90 percent of costs.

Silver plans were the most popular among enrollees last year.

Premium prices overall for next year fall within a more narrow range.

The least expensive 2015 silver plan for a 40-year-old in Allegheny County is $170 a month, not including tax subsidies that low-income workers might qualify for. The most expensive silver plan for that same person is $312 a month.

Silver plans for a 40-year-old in Allegheny County for 2014 ranged from $163 to $346.

For 2015, UPMC Health Plan is selling 12 silver plans that range in price for a 40-year-old in Allegheny County from $170 a month to $209 a month. Last year, its six plans ranged from $288 to $346.

Highmark has five plans at the silver level for 2015, with monthly premiums from $179 to $276. Last year, its six silver plans ranged between $163 and $240.

United's two plans for next year are $204 and $205; Coventry's two plans are $269 and $282; and Assurant has two plans at $306 and $312.

Alex Nixon is a staff writer for Trib Total Media. He can be reached at anixon@tribweb.com.

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