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June 02, 2015 at 06:30 AM
The issuer of a typical individual or small-group major medical plan that’s going through a Patient Protection and Affordable Care Act (PPACA) rate review process may be asking for a rate increase of about 15 percent to 20 percent for 2016.
About half of the hundreds of 2016 PPACA-compliant plans in the RateReview.HealthCare.gov health rate filing database around 3 p.m. on Monday, June 1, were asking for a bigger increase, and about half were asking for smaller increases.
See also: Feds firm up health rate filing calendar
The range of proposed 2016 rate changes for real plans seems to be a decrease of 25.82 percent, for a plan sold by a unit of Aetna Inc. (NYSE:AET) in Nebraska, up to some for more than 70 percent for new products filed by a unit of Assurant Inc. (NYSE:AIZ). Assurant had to classify the new rates as increases based on comparisons with PPACA-compliant “metal level” plans that are available this year. Assurant has said it will withdraw from the major medical market in 2017.
The Centers for Medicare & Medicaid Services (CMS) made 2016 rate filing information public on Monday, June 1, 2015. The 2016 data now available includes information from states with PPACA rate review programs administered by CMS and some states with state-based review programs.
PPACA requires health insurers to have large rate increase proposals reviewed for reasonableness. The U.S. Department of Health and Human Services (HHS) has adopted regulations requiring proposals for increases over 10 percent to go through rate reviews.
Many states posted complete, or nearly complete, versions of the rate filings insurers submitted through the official System for Electronic Rate and Form Filing (SERFF).
The CMS rate review database redacts, or blacks out, many tables and financial numbers that state SERFF public viewing systems leave in plain sight.
