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.
| 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 |
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.