Some state insurance regulators have already started posting significant numbers of 2016 major medical insurance rate filings.
Not Vermont. That state’s Green Mountain Care Board was one of the rate-posting speed demons for 2014 and 2015. The agency has a rate review blog entry URL that promises “rates_coming_April.” But the agency now says in the text on that page that it anticipates getting the rate filings on May 15 and posting the filings within five days of receiving them.
The Connecticut Insurance Department has published a collection of individual and small-group 2016 rate filings, both for exchange and off-exchange business. Proposed average changes range from an average decrease of 7.15 percent for Anthem on-exchange small-group plans to an increase of 33 percent for off-exchange individual plans sold by a unit of UnitedHealth Group Inc. (NYSE:UNH).
The Oregon Insurance Division has posted a collected of 2016 rate filings with average proposed changes ranging from a decrease of 1.95 percent for Kaiser Foundation Health Plan of the Northwest individual plans, to be sold on and off the exchange, to a 52 percent increase proposed by a company that apparently is leaving the market.
Some carriers have made a point of saying they have little interest in the off-exchange market, and would like to be rid of the “transitional” coverage written before the major Patient Protection and Affordable Care Act (PPACA) product rules took effect, in January 2014, as quickly as possible.
We focused on searching for clues about 2016 in individual, on-exchange filings.
For some of the interesting bits we found, read on.
1. For at least some carriers, claims were much higher than expected.
Drafters of PPACA created a new group of nonprofit, member-owned plans, the Consumer Operated and Oriented Plan (CO-OP) carriers, in an effort to boost competition. They also created risk-management programs that were designed to encourage the CO-OPs and other insurers to focus on taking high-risk enrollees, then do a good job of holding down those enrollees’ claims.
In the real world, one of the PPACA risk-management programs, a risk corridors underwriting margin protection program, appears to be missing in action, and claims have been much higher than the CO-OPs expected.
In many cases, those CO-OPs and others annoyed bigger carriers by winning market share on the exchange system with rock-bottom prices.