One of the issues here is that the most "desirable" policyholders are the one's that don't expect to use their coverage, and they will buy the cheapest policy available. Premera has more competition in other states, and the policies (by default) are listed in order of price on the exchange. If the competition doesn't have the baggage of paying expensive Alaska claims, they may be able to undercut Premera by a few bucks. That moves the competition up in the marketplace listings, and they will probably sell more policies. This is really, really true for those desirable policyholders that are not eligible for a subsidy.