Free Daily Headlines :

  • COVID-19
  • Vaccine Info
  • Money
  • Politics
  • Education
  • Health
  • Justice
  • More
    • Environment
    • Economic Development
    • Gaming
    • Investigations
    • Social Services
    • TRANSPORTATION
  • Opinion
    • CT Viewpoints
    • CT Artpoints
DONATE
Reflecting Connecticut’s Reality.
    COVID-19
    Vaccine Info
    Money
    Politics
    Education
    Health
    Justice
    More
    Environment
    Economic Development
    Gaming
    Investigations
    Social Services
    TRANSPORTATION
    Opinion
    CT Viewpoints
    CT Artpoints

LET�S GET SOCIAL

Show your love for great stories and out standing journalism

Exchange premiums could rise more than 10 percent next year — or drop, for some

  • Health
  • by Arielle Levin Becker and CTMirror Contributor
  • June 3, 2014
  • View as "Clean Read" "Exit Clean Read"

Updated: 10:25 a.m.

Two insurers selling health plans through Connecticut’s exchange want to raise rates by more than 10 percent next year, while a third wants to lower its premiums, according to proposals filed with the Connecticut Insurance Department.

Meanwhile, individuals who buy coverage through the exchange are likely to get a fourth option in 2015. UnitedHealthcare indicated in a filing with the insurance department that it intends to sell individual-market plans through Access Health CT, the state’s exchange.

Some caution about what the filings mean, and what they don’t: These proposals are not the final say on what insurance will cost on the exchange next year. State regulators must first review the proposals, and that could lead to changes.

Any rate hikes that get approved won’t necessarily translate to significantly higher bills for the majority of Access Health’s customers who get federal financial assistance with their premiums.

And while the proposals provide insights into the companies’ expectations for 2015, they’re not based on the claims filed by current exchange customers — meaning that they’re not a gauge of how sick or healthy the people who bought coverage as part of the federal health law are.

Still, the rate proposals could mean significant cost changes for people who don’t qualify for help with their insurance premiums — a considerable number of people in Connecticut.

Here’s what you should know.

What are the proposed rate increases and decreases?

Anthem Blue Cross and Blue Shield proposed rate increases that average 12.5 percent for its plans sold on and off the exchange. The actual rate increases vary by plan.

Under the proposal, Anthem’s exchange plans would see premium increases ranging from 4.39 percent to 17.38 percent. There is one exception: Premiums for the catastrophic plan, which is available to people under 30, would drop by 4.8 percent.

anthem 2015 rate proposal

Insurance premiums vary based on a person’s age, county and the specific plan. Anthem’s proposal would also increase the cost people outside Fairfield County pay.

ConnectiCare Benefits proposed an 11.8 percent increase to its base rates.

But that doesn’t mean all customers would see that level of increase. A base rate is the starting point for calculating premiums. It then gets multiplied by specific numbers corresponding to the person’s age, county and plan type. ConnectiCare’s 2015 proposal wouldn’t change the multipliers for age or county, but does vary the multipliers for plan type. Why is that significant? It means that even if the base rate rises by 11.8 percent, the actual increase for individuals’ premiums would vary.

HealthyCT proposed decreasing its rates by an average of 8.9 percent. The companies rates are among the highest on the exchange this year. As with Anthem’s proposal, the level of proposed premium change varies by plan.

healthyct rate proposal

HealthyCT also proposed changing the amount that people in each county would pay. Although the overall rates would still drop, people in Litchfield, Middlesex, New Haven and Tolland counties would see somewhat less of a decrease, while people in Fairfield, Hartford, New London and Windham counties would see a somewhat larger price drop.

Why do the insurance companies say they need to raise or lower their premiums?

Anthem’s filing indicated that it expects sicker people to join its insurance pool in 2015, including people who were previously uninsured and have pent-up demand for health care that will make them particularly costly to cover.

The company’s proposal also indicates that it expects the increase in the use of medical services and cost of care to account for an 8.4 percent increase in costs. Other factors cited include changes in benefit design, anticipated changes from contracts with health care providers, and changes in taxes, fees and other expenses.

Anthem’s proposal also cites the expected cost of expensive new Hepatitis C drugs on the market, including the high-profile medication Sovaldi.

ConnectiCare’s proposal indicates that the company expects the use of medical services and cost of care to lead to a 10.7 percent cost increase, and that fees and costs related to the health law will add to the cost of each member’s premium.

HealthyCT’s rate decrease is largely the result of changes in projections about the health of the insured population.

As a new company in 2014, HealthyCT didn’t have any customer experience to use to develop its rates for this year. In coming up with its 2014 rates, the company anticipated that members would have pent-up health care needs because they had been uninsured in the past, and factored in additional costs to account for their medical care.

But since then, HealthyCT reviewed other companies’ filings and determined that that adjustment wasn’t necessary, according to the 2015 rate filing. In addition, the filing noted, the previously uninsured members anticipated in 2014 are now insured, and their costs are expected to be more typical of the rest of the insurance marketplace. As a result, HealthyCT removed the additional premium costs associated with having a sicker-than-usual population.

What happens now?

Actuaries at the Connecticut Insurance Department will review the rate proposals and issue a decision on each one. The department can approve the rates as proposed, reject them or require that the company adjust them to a different percentage.

As part of the review process, the department accepts comments from the public. The comments will be accepted through June 23.

What about people who get subsidies?

People who get financial assistance with their premiums — more than three-quarters of Access Health’s current private insurance customers — won’t face cost hikes or drops that match any premium changes the insurance department approves.

That’s because of the way their financial assistance is calculated. Under the federal health law commonly known as Obamacare, the level of subsidies that people get are set so that they won’t pay more than a certain percentage of their income to purchase a certain plan (in technical terms, it’s the second-cheapest silver plan). People can apply that dollar amount to buy any exchange plan they want.

But people who don’t qualify for subsidies will have to pay the full cost of any rate hike if they want the plan — and they’ll get any savings that come with a rate decrease. The income limit for getting financial aid next year will be about $46,680 for a single person and $95,400 for a family of four.

What do these proposals say about the health of the people currently in exchange plans?

Not much, according to the insurers.

One of the big questions about exchange plans is what the medical needs – and, by extension, cost – of the newly insured will be. An insurance pool with sicker-than-expected members could lead an insurer to seek higher premiums to cover additional costs in the future. A healthier-than-expected population could help keep rate hikes down.

But according to the insurers, these rate proposals weren’t based on the health care costs of the current exchange customers because there’s not enough data to draw conclusions yet. Members have only been insured for five months at most, and many people don’t use their insurance as soon as they get covered — meaning that it can be tough to gauge the health of people in each plan after only a few months of coverage.

“The actual 2014 experience is too small and immature to be a credible source for setting the 2015 rate levels,” Karen Clarke, HealthyCT’s vice president for external affairs said. The company had the smallest enrollment of exchange plans, with 3 percent of members. She said the company’s 2015 rates were based on public information about rates, rate filings and actuarial analysis.

Similarly, ConnectiCare said in a statement that, “Due to the submission date deadline, premium rates submitted reflect limited insight into the health of individual members purchasing their policies through Access Health CT.” The company expects to have a better understanding of health care usage later in the year.

Anthem’s rate filing indicated that the rates were developed using data from the small group market, which the company considered to have some similarities to the current individual market.

“In developing rates effective January 1, 2015, only limited 2014 experience is available. This experience is not deemed credible for purposes of rate development,” the rate filing said.

So what happens if the exchange population is much sicker than insurers expected? Insurers selling plans on the individual exchange markets are shielded some financial losses and expensive claims by protections built into the federal health law. Those expire after 2016.

What else do the rate filings show?

The filings indicate that Anthem, ConnectiCare and HealthyCT all plan to offer more plan options next year.

In addition, ConnectiCare proposed selling a platinum plan, which would have the highest premiums but the lowest out-of-pocket costs for members when they get care. No carriers offered a platinum plan this year, and Anthem’s filing indicates it does not intend to offer one in 2015.

Read more about Access Health’s plans for next year, including what’s changing and the benefit details of each standard plan.

Sign up for CT Mirror's free daily news summary.

Free to Read. Not Free to Produce.

The Connecticut Mirror is a nonprofit newsroom. 90% of our revenue comes from people like you. If you value our reporting please consider making a donation. You'll enjoy reading CT Mirror even more knowing you helped make it happen.

YES, I'LL DONATE TODAY

ABOUT THE AUTHOR

Arielle Levin Becker Arielle Levin Becker covers health care for The Connecticut Mirror. She previously worked for The Hartford Courant, most recently as its health reporter, and has also covered small towns, courts and education in Connecticut and New Jersey. She was a finalist in 2009 for the prestigious Livingston Award for Young Journalists and a recipient of a Knight Science Journalism Fellowship and the National Health Journalism Fellowship. She is a graduate of Yale University.

CTMirror Contributor

SEE WHAT READERS SAID

RELATED STORIES
What we’ve lost, what we’ve learned during our year of COVID
by CT Mirror Staff

On March 6, 2020, Gov. Ned Lamont announced that the first case of COVID-19 had been detected in Connecticut, and within weeks, life as we knew it was a memory. Schools were shut down, universities emptied, businesses shuttered. Those of us who were fortunate enough to be able to work from home set up shop at our […]

Plan to expand child tax credit offers hope along with direct payments
by Lisa Backus | C-HIT.ORG

When her car started making a noise more than a year ago, Chinara Johnson parked the vehicle and hasn’t used it since. As a New Haven mother of 5-year-old twin boys, one of whom is on the autism spectrum, and an 8-year-old daughter, Johnson doesn’t have the money to get the car running properly again. […]

Aid-in-dying bill clears key hurdle with committee passage
by Jenna Carlesso

The bill would let terminally ill patients access medication to end their lives.

With billions in federal relief on the way to CT, legislators assert their role in deciding how to spend it
by Keith M. Phaneuf and Mark Pazniokas

With an unusual bill, state legislators are reminding Gov. Ned Lamont they have significant role in disbursing federal coronavirus relief.

How does the public option bill differ from Gov. Ned Lamont’s health care plan? Here’s a look at the two proposals.
by Jenna Carlesso

With the rising cost of care a central issue this legislative session, lawmakers and Gov. Ned Lamont’s administration have each moved ahead with their own plans aimed at driving down prices.

Support Our Work

Show your love for great stories and outstanding journalism.

$
Select One
  • Monthly
  • Yearly
  • Once
Artpoint painter
CT ViewpointsCT Artpoints
Opinion Right to counsel is just as much a racial justice issue as a housing policy issue
by Pearson Caldwell

Despite the state and federal moratoriums on eviction, nearly 3,000 Connecticut families have faced eviction in the past 10 months. Over half of these families were Black or Latinx, even though these groups combined comprise less than a quarter of the overall population. The stop-gap measures pursued by the state are not enough. Connecticut needs a statewide right to counsel for tenants facing eviction to address the burning housing and racial justice crisis across the state.

Opinion We need justice, not politics
by Richard J. Colangelo Jr. and 13 State's Attorneys

The administration of justice should not be political. Prosecutors must be guided by the evidence in a case and the applicable law, not by partisan, political considerations. Political pressure should never sway a prosecutor’s decision-making.

Opinion Assisted suicide lobby spreads falsehoods to promote systemic ableism
by Stephen Mendelsohn

Proponents of assisted suicide repeatedly spread falsehoods to promote their lethal and ableist agenda.  The February 8 op-ed, “Aid in dying is not assisted suicide” is no exception. Suicide is defined as the act of taking one’s life intentionally.  The person who intentionally ingests a prescribed lethal overdose more closely fits the dictionary definition of suicide than the despondent person who jumps off a bridge.  The desire for suicide is a cry for help, even when redefined as a “medical treatment option.”

Opinion TCI will create a fourth gasoline tax
by Christian A. Herb

The Transportation Climate Initiative, or TCI, calls for a proposed emissions fee on gasoline to help battle climate change. On the surface, supporters say it is a small price to pay to help save the planet; and if you truly believe that this is the case, then you should consider voting for it. Despite the administration’s efforts to go out of their way to not call TCI a tax, the simple truth is that it will only create additional financial hardships on lower- and middle-income families struggling to make ends meet during the pandemic.

Artwork Grand guidance
by Anne:Gogh

In a world of systemic oppression aimed towards those of darker skintones – representation matters. We are more than our equity elusive environments, more than numbers in a prison and much more than victims of societal dispositions. This piece depicts a melanated young man draped in a cape ascending high above multiple forms of oppression. […]

Artwork Shea
by Anthony Valentine

Shea is a story about race and social inequalities that plague America. It is a narrative that prompts the question, “Do you know what it’s like to wake up in new skin?”

Artwork The Declaration of Human Rights
by Andres Chaparro

Through my artwork I strive to create an example of ideas that reflect my desire to raise social consciousness, and cultural awareness. Jazz music is the catalyst to all my work, and plays a major influence in each piece of work.”

Artwork ‘A thing of beauty. Destroy it forever’
by Richard DiCarlo | Derby

During times like these it’s often fun to revisit something familiar and approach things with a different slant. I have been taking some Pop culture and Art masterpieces and applying the vintage 1960’s and 70’s classic figures (Fisher Price, little people) to the make an amusing pieces. Here is my homage to Fisher -Price, Yellow […]

Twitter Feed
A Twitter List by CTMirror

Engage

  • Reflections Tickets & Sponsorships
  • Events
  • Donate
  • Newsletter Sign-Up
  • Submit to Viewpoints
  • Submit to ArtPoints
  • Economic Indicator Dashboard
  • Speaking Engagements
  • Commenting Guidelines
  • Legal Notices
  • Contact Us

About

  • About CT Mirror
  • Announcements
  • Board
  • Staff
  • Sponsors and Funders
  • Donors
  • Friends of CT Mirror
  • History
  • Financial
  • Policies
  • Strategic Plan

Opportunity

  • Advertising and Sponsorship
  • Speaking Engagements
  • Use of Photography
  • Work for Us

Go Deeper

  • Steady Habits Podcast
  • Economic Indicator Dashboard
  • Five Things

The Connecticut News Project, Inc. 1049 Asylum Avenue, Hartford, CT 06105. Phone: 860-218-6380

© Copyright 2021, The Connecticut News Project. All Rights Reserved. Website by Web Publisher PRO