Insurance companies are requesting higher rates for health plans next year. Here’s what you need to know.
Insurance companies that sell plans on and off Connecticut’s Affordable Care Act exchange, Access Health CT, are again seeking increases in the cost of premiums — this time for policies that begin in 2022.
The proposed average rate increase for individual health plans next year is 8.6%, compared to a request of 6.3% in 2021. The suggested rate hikes range from 5.1% to 12.3%, depending on the policy.
For small group plans, the proposed average rate increase is 12.9%, compared to 11.3% in 2021. The recommended rate hikes range from 7.4% to 15.8%.
“I shouldn’t be surprised, but I am disappointed that it’s the same story this year,” said Lynn Ide, director of program and policy for the Universal Health Care Foundation of Connecticut, an advocacy organization. “We are focused every year on the impact to the consumer, and we were watching to see if they would take into account the fact that many families and small businesses who buy on the individual and small group markets are still struggling. And we’ve been watching reports of banner profits for insurance companies over the past year and wondering — what will they do? Well, they gave us the same old answer: ‘We’re going to ask you for more money.’”
State Comptroller Kevin Lembo also criticized the proposed increases. Lembo was a staunch supporter of legislation creating a public option health plan in Connecticut, though the effort failed this year after pushback from the insurance sector.
“After an elaborate lobbying and advertising campaign to successfully kill reforms aimed at making health care more affordable, it only took six weeks for the industry to come back and ask for more money from Connecticut residents and small businesses,” Lembo said.
“The current health care options available to individuals, small businesses and nonprofits are not intended to keep people healthy. They’re intended to make a handful of corporations an unlimited amount of money. … I would encourage the public to issue comments opposing these rate increases and demand action from those whose job it is to represent their best interests.”
Residents will have a chance to weigh in on the requested increases, both online and in person.
Here are some key things to know about the proposed rate hikes:
What’s being requested?
Anthem Health Plans and ConnectiCare Benefits Inc., which sell individual and small group policies on the exchange, are both asking for increases.
Anthem is seeking an average hike of 12.3% for its individual plans that cover 28,701 people. ConnectiCare Benefits is requesting an average increase of 7.4% for individual policies that cover 81,852 residents.
Both are also seeking rate hikes for small group plans. Anthem has asked for an average increase of 11.5% for policies that cover 25,529 people, while ConnectiCare sought an average hike of 13.6% for plans that cover 1,786 residents.
Why are insurers seeking higher rates?
Carriers have attributed the proposed increases to rising demand for medical services and the swelling cost of prescription drugs, among other trends. They also pointed to an increase in morbidity and expected severity of claims because of delays in care during the pandemic.
“There is an expectation of pent-up demand experienced throughout 2021 and an increase in behavioral health disease anticipated in 2022,” the insurance department, which is reviewing the requests, said in a statement.
Additionally, the carriers cited recent legislation, including a bill adopted last year that caps a 30-day supply of insulin at $25, as a reason for the recommended hikes.
“We remain extremely mindful of the impact that rate increases have on our members and strive to keep our plans as fairly priced as possible within the reality of today’s health care environment,” Kimberly Kann, a spokeswoman for ConnectiCare, said in a statement. “Our proposed rates are based on several factors, including medical and pharmacy cost trends and use of medical services higher than historical norms.
“As we come out of the COVID-19 pandemic, we are experiencing increased disease burden, which is expected to continue to drive higher demand for medical services and anticipate ongoing costs of vaccinations and treatment.”
Alessandra Simkin, a spokeswoman for Anthem, added in a statement: “We’re committed to ensuring consumers have a choice of health plans that offer affordability, access to quality care, and benefits that meet their needs. Our filing reflects market conditions, and we look forward to working with the state as we continue the regulatory process.”
What happens now?
Actuaries with the insurance department will review the requests for increases. As part of the review, they will look at trends in unit cost (total expenditure incurred by the company), utilization of services, and expected severity of claims. The department will issue questions to the insurers and seek clarification if needed. It will also hold a public hearing to get input from the carriers, health care advocates and the public.
After the review, the department can approve the full requested increase, reject it or amend it to a different number it deems appropriate. The final changes will be published in September.
Are the proposed rate hikes always approved as requested?
No. Last year, for example, Anthem Health Plans had asked for a 9.9% average increase in its individual plans, which served 22,071 people through Access Health CT. The insurance department approved an increase of 1.9%.
ConnectiCare Benefits Inc. asked for an average hike of 5.5% in its individual plans on the exchange, which at the time covered 75,174 customers. The insurance department signed off on a decrease of 0.1%.
The same year, ConnectiCare requested a 4.9% increase on individual plans. The insurance department instead signed off on a 2% average increase.
How do I provide input?
The state will hold an informational hearing on Aug. 31. Insurers will talk about why they are seeking the increases, and the public is invited to comment.
The hearing will run from 9 a.m. to noon at 153 Market St. (7thfloor) in Hartford. Public parking is available at the nearby Morgan Street Garage.
There is also an option to submit comments on the department’s website. Click the ‘select’ button on any rate filing listed here and a comment box will appear.
When does open enrollment begin?
Open enrollment for 2022 health plans will begin Nov. 1.
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