CT insurers lower rate hike requests on Obamacare plans

The four companies selling individual health plans through Connecticut’s health insurance exchange have revised their proposals to raise rates in 2016, seeking lower increases than initially proposed.

In filings with state regulators, the companies cited varying reasons – ranging from lower claims costs to the expectation of covering a narrower network of health care providers.

The proposals are under review by the Connecticut Insurance Department, which is expected to issue decisions on the potential rate hikes by the end of August. Companies planning to offer health plans to individual-market customers in 2016 were required to file rate proposals by April 30, but the insurance department allowed them to submit revised proposals last month.

Prices for health plans sold on the individual market, the most affected by the federal health law, have drawn significant attention nationally as observers try to determine how insurance markets are affected by the law’s major changes — including requirements that nearly all Americans have insurance and that people be allowed to buy coverage regardless of their health history.

Among Connecticut insurers, the rate proposals for 2016 are the first to be based on health care expenses companies incurred for members after the major Obamacare changes took effect, providing a glimpse at the health care costs of those newly covered. In their initial filings, insurers indicated that they expected health care costs to stabilize, suggesting that they did not expect continued “pent up” medical needs among those who were previously uninsured.

Connecticut has for years had among the highest health insurance costs in the country, but the proposed rate increases this year were lower than in many other states, even before the companies revised their proposals. An analysis by HealthPocket, a company that compares health plans, found that the average proposed premium hike for 2016 exchange plans in 45 states was 12 percent, based on the price for a 40-year-old in each state’s largest city.

The Connecticut companies cited differing reasons for reducing the size of the increases they requested.

Anthem Blue Cross and Blue Shield, which cut its proposed average increase from 6.7 percent to 4.7 percent, used 2014 member claims for exchange plans as a guide for determining how much it would need to charge to have enough money to pay claims in 2016. The initial filing in April was based on 2014 claims that had been filed through March. Adding claims filed through May provided an updated picture of member health care costs — in this case, lower than the earlier estimate — and allowed Anthem to lower its projections of 2016 member health care costs, according to the company.

Anthem’s rate filing covers plans sold through the state’s exchange, Access Health CT, as well those sold outside the exchange.

UnitedHealthcare, meanwhile, told the insurance department that it had adjusted its proposal to account for having a narrower network of providers for its individual-market plans sold through the exchange. The company, which has 1,686 customers through Access Health, reduced its proposed average increase from 12.4 percent to 11.4 percent.

The average increases represent the change across all of an insurer’s plans. A customer’s cost for a particular plan could rise or fall by differing amounts under the proposals.

Proposed premium increases
Insurance companies are seeking rate increases for health plans sold on the state’s individual market, but some recently revised their original proposals to seek lower increases. This chart shows the size of the premium increase each carrier is seeking, and any changes to the proposal since the original request. The individual market includes plans sold through Access Health CT, the state’s health insurance exchange, and plans sold outside the exchange. Some companies file separately for plans sold on and off the exchange, while others file combined requests.
Company Revised Original On/off exchange People covered
Aetna No change 5.60% Off 7,291
Anthem Blue Cross and Blue Shield 4.70% 6.70% Both 55,000
Celtic No change 15.95% Off 0
Cigna No change 14.27% Off 660
ConnectiCare Benefits 0.70% 2% On 39,850
ConnectiCare Inc. 5.00% 5.20% Off 435
ConnectiCare Insurance Co. 9.80% 10.10% Off 34,400
Golden Rule No change 18.50% Off 3,414
HealthyCT 3.43% 13.96% Both 23,485
UnitedHealthcare 11.40% 12.40% On 1,686
UnitedHealthcare No change 32.90% Off 712
Connecticut Insurance Department

HealthyCT said it dropped its proposed rate hike – from an average of 13.96 percent to 3.43 percent – after further examining the impact of new and proposed initiatives aimed at controlling costs. The company’s filing cited several efforts, including “aggressive” fraud, waste and abuse programs; a telemedicine program that could help reduce emergency room and urgent care visits by allowing patients to access health care providers by phone or video conference; plans to reduce the use of specialty drugs among members; and efforts to reduce unnecessary imaging procedures and steer members to lower-cost radiology providers.

Like Anthem, HealthyCT’s filing covers plans sold on and off the exchange.

ConnectiCare Benefits, which has the most customers on the exchange, reduced its requested average increase from 2 percent to 0.7 percent.

Separately, ConnectiCare reduced the size of the increases it is seeking for plans sold outside the exchange.

ConnectiCare issued a statement saying it does not comment on rate filings while they are being reviewed, but that the company “routinely monitors emerging information and makes adjustments to rate filings as needed.”

“This is a standard procedure and not unique to this rate filing,” the company’s statement said.

Other companies that sell plans outside the exchange did not revise their rate proposals.

According to insurance department figures, 166,933 people are covered by plans purchased through the individual market this year. Just over 110,000 people signed up for private insurance through Access Health, although the number covered dropped to 101,294 last month.

Comments

comments