Changes from 2015 to 2016... Rules, Premiums, Plans, Exchanges, Etc.

[Yagents]

Thanks YAgents. This is a great new resource! Am surprised that HealthCare.gov would publish these, since so many huge 2016 rate increases are included. For instance, BCBS-IL HMO = 29% PPO = 38%.

But then again, if the Govt wants private insurers out of the picture, showing these numbers will give additional ammo to single-payer proponents.

Edit to add: I see that all prior rate increases have been approved as requested, no matter how high. HHS can force a premium request lower, but the state of IL can't. So far, HHS hasn't had the will force reductions since being granted the authority to do so in 2010. At least not in Illinois.

The CNBC article that I also included stated the quote below. They are specifically singling out these plans (above 10%) so they can be bashed by regulators and consumer advocates. (Selective disclosure) I would also assume these are for the more richer gold/platinum plans. Noticeably, the Co-Op in AZ (meritus) is not even a choice to be selected. I hope the bronze/silver plans are the ones with under 10% rate increase, otherwise we are witnessing an implosion. (of the law and my book). Be sure to click on the plan name and read the rationale. This ain't pretty.

This came right out of the liberal politician playbook (year 3, chapter 1, verse 2). All going according to plan.



The federal agency in charge of Obamacare revealed on Monday afternoon details of many of the Obamacare insurance plans requesting premium rate hikes of 10 percent or more for 2016.

The data, which can be accessed at RateReview.HealthCare.gov. includes exactly how much more an insurer wants to charge next year, and the justification for that increase.

But information about lesser price increases being proposed, or even proposed price decreases, were not released. That makes it impossible, for the moment, to determine just how much insurers want to raise their premiums overall in the United States for 2016.

 

[FLM2]

The federal agency in charge of Obamacare revealed on Monday afternoon details of many of the Obamacare insurance plans requesting premium rate hikes of 10 percent or more for 2016.

The data, which can be accessed at RateReview.HealthCare.gov. includes exactly how much more an insurer wants to charge next year, and the justification for that increase.

But information about lesser price increases being proposed, or even proposed price decreases, were not released. That makes it impossible, for the moment, to determine just how much insurers want to raise their premiums overall in the United States for 2016. [/I]

While I don't like what is happening with rates for next year (not surprising) this new site does make the increases transparent and gives us insight into 2016 now instead of waiting until October.

In Florida, for example, although there may be some geographic exceptions, companies will remain in the same order overall with 15-20% increases on the average-this means that subsidized people are going to wind up with very similar rates while Off Exchange people are once again going to get nailed with a large increase.

For agents, if we can assume that FYC levels remain around the same, it should be another decent year with most of our subsidized clients renewing.

 

[AllenChicago]

The CNBC article that I also included stated the quote below. They are specifically singling out these plans (above 10%) so they can be bashed by regulators and consumer advocates. (Selective disclosure)

But information about lesser price increases being proposed, or even proposed price decreases, were not released. That makes it impossible, for the moment, to determine just how much insurers want to raise their premiums overall in the United States for 2016. [/I]

That's what I was wondering. Does the omission of a plan and/or company imply that that particular plan is requesting a less than 10% increase for 2016?

I was really hoping that our BCBS HMO plans would remain lowered priced than their expensive PPO sister plans. But with a 38% increase, that advantage would be wiped out instantly on 1/1/2016.

Like Arizona, our state Co-Op is not listed at https://ratereview.healthcare.gov/ . Does that mean that none of their plans will be increasing +10%? Under 10% wouldn't surprise me, because the government enabled (loaned $) Land of Lincoln Health to reduce plan premiums by 28% from 2014 to 2015. They took a sizeable chunk from BCBS. If LOLH is under 10% and BCBS is over 30% for 2016, there will be a lot of chaos..on several fronts. (Agents/Customers/Providers/Insurers, et.al.)

 

[somarco]

Cigna and Assurant were not listed in GA for 2016.

Of course we know Assurant will be off the table so I am assuming the same for Cigna. I did find Humana and BX rates.

Alliant, a very small player only in a few counties, is asking for 38.75% for the only plan they will offer in 2016. Their senior marketing officer left a few months ago.

Didn't look any further.

 

[sman]

Cigna and Assurant were not listed in GA for 2016.

Of course we know Assurant will be off the table so I am assuming the same for Cigna. I did find Humana and BX rates.

Alliant, a very small player only in a few counties, is asking for 38.75% for the only plan they will offer in 2016. Their senior marketing officer left a few months ago.

Didn't look any further.

While Assurant isn't listed, Time is. Aren't they the same? If so, they are asking for a 64.20% and 59.43% rate increase.

 

[Ann H]

This isn't pretty for AZ. There are two trends here.

1. HMO is getting hammered. PPO rate increases are less, or are not listed here (because they are in the "under 10% category).

2. Group rate increases are much lower than IFP.

At a broker conference for one of our major carriers, they told us that they got hammered on the claims loss ratio of Exchange business. IFP in total was a loss, but exchange business in particular carried most of the claims losses. Small Group was profitable for them. That might be why we are seeing IFP rates increasing more than group, and HMO getting hammered.

DETAILS:
Blue Cross (our biggest insurer) is requesting 23% to 26% on their IFP copay HMOs (17% to 20% on HMO HSA). Conversely, the PPO must be in the "below 10%" category. The same theory holds true for Health Net, where HMO rate increases are higher 13% to 25%, but PPO is 11%.

Humana's IFP HMOs are increasing 23%, but the PPO's aren't listed. Is that because the PPOs are in the "under 10%" category and therefore not listed, or is it because Humana is dropping PPO for IFP?

For Group, the HMOs and PPOs are tracking pretty evenly. For Blue Cross, only 2 Group plans made it to the "more than 10%" category, whereas most of the IFP products were in the 17% to 26% range.

 

[somarco]

While Assurant isn't listed, Time is. Aren't they the same? If so, they are asking for a 64.20% and 59.43% rate increase.

Time is the other brother from a different mother.

 

[FLM2]

Time is the other brother from a different mother.

They must have put those rates in just in case an unknown suitor decides to acquire the IFP division-by submitting the rates they can avoid the 5 year exclusion from the Marketplace, right?

 

[Yagents]

Click on the name of the plan once you see the rate increase %'s.

Read the justification. Then read the redacted PDF on top right.

Time states they are cancelling all plans, but keeping the PPO, and rolling out new plans. Probably for the new suitor, or to start over with higher rates. Sounds like these high rate increases (70+%) are for the NON grandfathered extended policies. Who knows.

General Policy Description:
This rate filing is for non
-
grandfathered indivi
dual major medical plans which cover the
Essential Health Benefits (EHB) as required under the Affordable Care Act (ACA). These
plans are guaranteed issue and guaranteed renewable as defined under the ACA and
HIPAA. Plans are marketed through general agenc
ies, brokers, wholesale arrangements,
and direct
-
to
-
consumer.
In 201
6
, Assurant Health will sell plans both inside and outside
of the public health exchanges in this state.
Coverage beyond age 65 will be secondary
to Medicare. Premiums are on an attained
age basis and will increase with age.
Premiums also vary by plan design, tobacco status and geogra
phic area. In 201
6
, only
the olde
st
three
dependents under age 21 will be charged a premium rate for a given
policy.
2.
Proposed Rate Increase:
This is a new
product filing
and therefore the rate increase is 0%
. Effective 1/1/2016, Assurant
Health will offer a new portfolio of plans in t
he Individual m
arket. Existing metallic customers
will be discontinued from their current contract and moved to this new contr
act upon their plan
Actuarial
Memorandum
–
Arizona
–
TIM16.QHP.POL.AZ, TIM16.POL.AZ
Page
2
year beginning on 1/1/2016. Appendix A shows the development of base rates for this new
product. The remaining sections of the memorandum detail the assumptions we used to
develop rates.
Relative to our existing metallic block, the
av
erage rate increase for this state is
75
%. This
increase excludes attained age increases.
The rate increase does vary by plan. These
adjustments are described in further detail in section 14 of this memorandum.
It is important to note that we
continue to
offer a broad PPO network product. We strongly
believe our PPO product is valued by a large customer segment in the individual market. These
customers value the ability to utilize the doctors and hospitals of their choosing, without the
added requirement
to go through a gatekeeper to direct their care

 

[FLM2]

Click on the name of the plan once you see the rate increase %'s.

Read the justification. Then read the redacted PDF on top right.

Time states they are cancelling all plans, but keeping the PPO, and rolling out new plans. Probably for the new suitor, or to start over with higher rates. Sounds like these high rate increases (70+%) are for the NON grandfathered extended policies. Who knows.

General Policy Description:
This rate filing is for non
-
grandfathered indivi
dual major medical plans which cover the
Essential Health Benefits (EHB) as required under the Affordable Care Act (ACA). These
plans are guaranteed issue and guaranteed renewable as defined under the ACA and
HIPAA. Plans are marketed through general agenc
ies, brokers, wholesale arrangements,
and direct
-
to
-
consumer.
In 201
6
, Assurant Health will sell plans both inside and outside
of the public health exchanges in this state.
Coverage beyond age 65 will be secondary
to Medicare. Premiums are on an attained
age basis and will increase with age.
Premiums also vary by plan design, tobacco status and geogra
phic area. In 201
6
, only
the olde
st
three
dependents under age 21 will be charged a premium rate for a given
policy.
2.
Proposed Rate Increase:
This is a new
product filing
and therefore the rate increase is 0%
. Effective 1/1/2016, Assurant
Health will offer a new portfolio of plans in t
he Individual m
arket. Existing metallic customers
will be discontinued from their current contract and moved to this new contr
act upon their plan
Actuarial
Memorandum
–
Arizona
–
TIM16.QHP.POL.AZ, TIM16.POL.AZ
Page
2
year beginning on 1/1/2016. Appendix A shows the development of base rates for this new
product. The remaining sections of the memorandum detail the assumptions we used to
develop rates.
Relative to our existing metallic block, the
av
erage rate increase for this state is
75
%. This
increase excludes attained age increases.
The rate increase does vary by plan. These
adjustments are described in further detail in section 14 of this memorandum.
It is important to note that we
continue to
offer a broad PPO network product. We strongly
believe our PPO product is valued by a large customer segment in the individual market. These
customers value the ability to utilize the doctors and hospitals of their choosing, without the
added requirement
to go through a gatekeeper to direct their care

It's got to be a placeholder for a potential acquirer because they have already started letting their internal sales directors go-mine was supposed to leave a few weeks ago.

Fortune 500 companies don't make public announcements about closing a division and then file plans to continue within the same time period, they would have to disclose this publicly within the guidelines of the SEC.