Large ACA Rate Increases Coming for Kids Ages 15-20

Discussion in 'Health Care Reform Forum' started by Yagents, Sep 4, 2017.

  1. Yagents
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    Did you know...............

    Changes to child age ratings between 15-20 for 2018 are throwing any premium forecasting out of whack. These are in addition to any normal rate increases. It is meant to gradually level off the "cliff" experienced at age 21 right now, which goes up 50+% currently.

    0-14 = 17% rate increase. (.65 to .765)
    15 yr old = 28% (.65 to .833)
    18 yr old = 40% (.65 to .913)

    https://www.cms.gov/CCIIO/Resources/...g-12-16-16.pdf

    PAGE 4 TABLE

    Appendix I - Federal default standard age curve
    PREMIUM PREMIUM PREMIUM AGE AGE AGE RATIO RATIO RATIO
    0-14 0.765 31 1.159 48 1.635
    15 0.833 32 1.183 49 1.706
    16 0.859 33 1.198 50 1.786
    17 0.885 34 1.214 51 1.865
    18 0.913 35 1.222 52 1.952
    19 0.941 36 1.230 53 2.040
    20 0.970 37 1.238 54 2.135
    21 1.000 38 1.246 55 2.230
    22 1.000 39 1.262 56 2.333
    23 1.000 40 1.278 57 2.437
    24 1.000 41 1.302 58 2.548
    25 1.004 42 1.325 59 2.603
    26 1.024 43 1.357 60 2.714
    27 1.048 44 1.397 61 2.810
    28 1.087 45 1.444 62 2.873
    29 1.119 46 1.500 63 2.952
    30 1.135 47 1.563 64 and Older 3.000

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    CMS Finalizes New Marketplace Payment Rule, Effective January 17, 2017

    Child Age Rating
    The final rule modifies current age rating requirements for children. The ACA permits premium rates to vary based on age only within a ratio of 3 to 1 for adults. Current age rating rules provide for a single age band for children ages 0 through 20. The default age factor for this group is .635. This single age factor not only does not accurately reflect claims costs for children (which are highest for children ages 0 to 4 and lowest for children ages 5 to 14), but has resulted in a significant jump in premiums (about 57 percent) when a child reaches age 21.

    The final rule increases the current age factor for children up to age 14 from .635 to .765 and then gradually increases the age factor year by year from age 15 to age 20 to create a smooth transition to age 21. This makes coverage somewhat more expensive for children and less expensive for adults. The rule is effective for plan years beginning on or after January 1, 2018. States continue to be able to set their own age rating curves if they chose to do so; CMS released on December 16 a separate guidance explaining the age rating curves and forms for states to disclose their own rating requirements.

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    http://us.milliman.com/uploadedFiles...0131_Final.pdf

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    Just to give you an idea, if u have 2 kids who are 15 and 18, and the rise in premium related to ONLY the age rating adjustment will cost $159/mo more based on last years LCB in Phoenix at $221/mo for 0-20 age.

    Add another 5% rate increase family age 48 family of 4, and you're looking at $1740/mo for the LCB Ambetter HMO in Phoenix (a second mortgage). Which means this family can make up to $255,780 and not owe the penalty due to affordability exemption.

    Praying for STM 3 mo rule reversal. Or more families will be priced out.
     
  2. taterpeeler
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    Warning!!!... There will be NO off exchange market in 2018... unless you got one foot on the grave and one on a banana peal.
     
  3. kgmom219
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    What's Off Exchange??? ;)
     
  4. taterpeeler
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  5. GreenSky
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    It's about time those little bastards paid their fair share.

    Rick
     
  6. tonyisme
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    No houses 4 sale in my area... guess the money will go to rent payments, youth sports, cell phone bills, eating out and car payments
     
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