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Two insurers trim D.C. small-group exchange rates

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The District of Columbia Health Benefit Exchange Authority says its 2014 rate chart has inspired two carriers to cut their small-group rates.

Aetna Inc. (NYSE:AET) has agreed to cut its 2014 small-group exchange rates about 5 percent, and UnitedHealth Group Inc. (NYSE:UNH) has agreed to cut its initial small-group rates about 12 percent, authority officials said.

The authority, the manager of the district’s Patient Protection and Affordable Care Act (PPACA) exchange known as DC Health Link, has attracted carriers for its individual exchange program and four for its Small Business Health Options Program (SHOP) exchange program.

The carriers selling through both programs are Aetna, CareFirst and Kaiser. UnitedHealth is selling coverage only through the small-group exchange.

Oppnents of PPACA are still fighting to block or delay implementation of the law. If the law takes effect on schedule and works as backers hope, it will require federal regulators to work with states and the District of Columbia to make exchanges, or health insurance supermarkets, available to consumers throughout the country. 

The insurers that sell “qualified health plans” (QHPs) through the exchanges must help consumers compare the plans by covering standardized percentages of the actuarial value of a standardized benefits package.

The four metal levels range from about 60 percent of the value of the “essential health benefits” package for a bronze plan, 70 percent for a silver plan, 80 percent for a gold plan and 90 percent for a platinum plan.

CareFirst has announced plans to offer both preferred provider organization (PPO) QHPs and health maintenance organization (HMO) QHPs four all four metal levels in both the individual exchange program and the SHOP program.

Kaiser is offering HMO plans only at all metal levels in both the individual and the small group market.

Aetna is listing both PPO and HMO plans at the bronze, silver and gold levels on both the individual and SHOP exchange programs. Aetna will not be offering platinum-level coverage through the exchange.

UnitedHealth intends to sell both PPO and HMO coverage at all metal levels, but only through the SHOP program.

CareFirst is offering the lowest rates in most of the market slots, but Kaiser has come in with lower rates for some slots, such as the slots for gold-level group coverage.

The initial exchange rate charts showed that Aetna would offer the highest rates in some slots and UnitedHealth would offer the highest slots in others.

In the bronze category, for example, CareFirst is offering the cheapest small-group option on the charts — a bronze plan that would cost the employer of a 27-year-old $144.23 per month.

For a month of comparable coverage, the original charts showed that Kaiser would charge $170.77, Aetna $176.84 and UnitedHealth $205.61.

The most expensive plan on the initial charts is a small-group rate of $1,037.08 per month for small-group platinum coverage for a 55-year-old.

In the comparable slot, Kaiser would have no product, and CareFirst would charge $900.38 per month. 

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