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Special-enrollment customers have higher costs, lower risk scores

October 6, 2016

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Individuals who enrolled in federal health insurance exchange coverage during special-enrollment periods in 2014 and 2015 had higher health costs than those who enrolled during the standard open enrollment even though they had lower risk scores, according to an Avalere Health analysis published Wednesday.

People who enrolled during special-enrollment periods in 2015 cost 4.6% more per member per month than those who didn’t, but the risk scores of special-enrollment period enrollees were 20% lower on average than those choosing a health plan during open enrollment, Washington-based consultant Avalere found.

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