Centene is launching Custom Health Option and Individual Care Expense arrangements, recently rebranded from individual coverage health reimbursement arrangements, in four more states in 2027.
Ambetter Health Solutions President Alan Silver told Becker’s Oct. 8 that the expansion includes Alabama, Iowa, North Carolina and Pennsylvania. The company currently offers plans designed for CHOICE in 13 states.
“Particularly in the small to mid-sized business space, the 100 to 1,000 lives, these markets do present a very good opportunity for employers to take advantage of the individual market,” Mr. Silver said. “We want to be there for them when they try to take advantage of it.”
Mr. Silver called these four markets “ICHRA friendly,” adding that Ambetter weighed the employer base, risk pools and what collaboration would look like with insurance departments. He said other markets, such as mostly rural states, may not be as high-priority for Ambetter’s CHOICE expansion, considering how those states may not have consolidations of employers.
Mr. Silver said the company’s CHOICE expansion into some of the four new states is an effort to anticipate the market, while other expansions, such as into Pennsylvania, were driven by feedback.
“At the current moment in time, some of this is signaling from larger employers combined with a large group of smaller employers that are saying to ICHRA administrators or group brokers, ‘Look, if a market just had this, we would be much more comfortable moving from our group arrangement to the individual markets,'” Mr. Silver said.
He said that Ambetter is not done with its CHOICE expansion, and it is considering adding more markets into 2028 and 2029.
Beginning in 2027, Ambetter is also collaborating with advanced primary care provider Marathon Health to offer plans through CHOICE in select Indiana and Missouri counties. An Oct. 7 news release said eligible members will be able to access $0 primary care visits and lab services, as well as virtual primary care through Marathon Health.
Ambetter already has a presence in Indiana and Missouri. Mr. Silver said Indiana has a strong individual market for the type of innovation Ambetter is working on, thanks in part to the legislative environment. When Centene first rolled out ICHRAs to some of its own employees, Indiana was the launching point.
“We have a base of people who provide feedback on what it is that they like and want out of a health plan. We can respond to that, and we can respond to that both on the employer side and on the individual side,” Mr. Silver said. “Our partnership with Marathon is directly linked to us hearing feedback that advanced primary care is something that members and employers want to see in the individual market.”
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