Insurance Department Finalizes Exchange Rates
The question of cost has been on everyone’s mind since Connecticut first decided to set up its own health insurance exchange under Obamacare. On Monday, Connecticut residents got their first look at the unadjusted rates — meaning, the rates without the inclusion of offsetting government subsidies that will be made available to lower income families.
The state Insurance Department released the final monthly premiums on its website Monday after three months of wrangling with the four participating insurers over how they calculated their risk assumptions.
The rates posted Monday still don’t take into consideration the federal subsidies individuals may receive if they make less than 400 percent of the federal poverty level, which is $94,200 per year for a family of four. The rates posted Monday also don’t consider age or location by county.
Of the three companies offering insurance in the individual marketplace, ConnectiCare Benefits is the only company whose rates weren’t changed during the review by the Insurance Department. The rates for Anthem Blue Cross and Blue Shield were lowered through the process and the exchange’s only nonprofit insurer, HealthyCT, submitted an amended application voluntarily lowering its rates after a review showed individuals looking to join the plan would be healthier than initially predicted.
Each of the companies will offer insurance through three tiers — bronze, silver, and gold. Each tier has a different actuarial value with gold being the plan that covers more and has fewer out-of-pocket costs than the bronze or silver plans. The bronze plans will cover less and have higher out-of-pocket costs, while silver falls somewhere in the middle. There also are catastrophic plans for individuals under age 30.
In the individual plan marketplace, the base monthly premium for the ConnectiCare Benefits bronze plan is $215.17, HealthyCT is $245.45, and Anthem is $236.59. Again, those are the premiums before they get adjusted for age, geographic location, and government subsidy. The premium base rate for the ConnectiCare Benefits silver plan is $269.66, HealthyCT is $310.02, and Anthem is $299.21. The gold plan is $309.64 per month for ConnectiCare Benefits, $321.22 for HealthyCT, and $346.91 for Anthem.
An independent analysis by an actuarial consulting firm released last week found that individuals and families who live in Hartford County and who enroll in an individual market plan will have the lowest average premium, while those who live in Fairfield County will have the highest in that marketplace.
All the plans are “guaranteed issue,” which means no one, even an individual with a pre-existing condition, can be turned down from purchasing a plan. The underlying legislation also eliminates gender rating, so women will no longer be paying more than men for similar insurance policies.
In the small group plan marketplace, Anthem, HealthyCT, and UnitedHealthcare, are offering bronze, silver and gold plans with monthly premiums ranging from $277.95 to $407.37 for Anthem, $298.05 to $309.05 for HealthyCT, and $271.91 to $435.72 for United Healthcare.
Enrollment in the exchange begins Oct. 1 and the plans go into effect on Jan. 1. 2014. Everyone will have an opportunity to purchase insurance through the exchange, including the estimated 344,000 Connecticut residents who are uninsured.
Over the next few months the rates announced Monday will be entered into the software that will display the information to consumers. The virtual marketplace is expected to offer consumers a side-by-side comparison of rates and benefits for at least two of the plans they select. In the meantime, Access Health CT offers a calculator on its website at www.accesshealthct.com/how-to-save/ to give consumers an idea of what they can expect to pay based on their income and the federal subsidies available. The Henry J. Kaiser Family Foundation also has provided a subsidy calculator at this website: kff.org/interactive/subsidy-calculator/.
Kevin Counihan, CEO of Access Health CT, said the rates released Monday indicate “residents in Connecticut may actually see their insurance rates go down, while for those who may see increases, they will be far less than was predicted even just a few months ago.”
“These rates are a clear signal that the introduction of a competitive marketplace works, and gets us one step closer to our goal: access to quality, affordable health care, with freedom to choose from a variety of high quality plans for the people in Connecticut who currently don’t have it,” he said. “Our staff will be examining these rates closely in the days ahead, and look forward to providing more information on what residents can expect when they come to Access Health CT.”