Are your health insurance rates at risk? Insurers eyeing big increases on federal marketplace

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INDIANAPOLIS (July 8, 2015) – A number of Indiana health insurance companies want to increase rates for Hoosiers buying insurance on the Federal Marketplace as part of the Affordable Care Act

Proposed rates for 2016 are currently being analyzed by the Indiana Department of Insurance.

“Increases requested in Indiana are typically smaller than those seen in others states,” Jennifer Groth said in a statement, director of communication and outreach for the Indiana Department of Insurance.

Half of Indiana’s health insurers offering Obamacare plans are asking state regulators to increase rates, anywhere from Anthem’s 3.8 percent proposed increase, to 14.5 percent from Physicians Health of Northern Indiana.

In a statement, a spokesperson for Anthem, the largest seller of plans in Indiana, said its request “reflect the claims experience we’ve seen from those who purchased insurance on the exchange, as well as the rising cost of health care, new taxes and fees.”

Experts say companies are still dealing with a lot of moving parts in determining premiums on the federal marketplace.

“They have to balance being profitable and sustainable with being priced in a way that they’re affordable,” Karl Ahlrichs said, a senior consultant at Gregory and Appel Insurance in Indianapolis. “The people who are in the areas where the coverage is going up double-digits are going to have to work on their own strategies.”

Reversely, though, four of Indiana’s insurers are looking to drop rates in 2016, anywhere between a 5 percent decrease from CareSource Indiana to a 19 percent drop from MDwise Marketplace.

“A lot of the difference is the basic structure of insurance,” Ahlrichs said. “Understand that insurance works with a pool of people who are sharing a risk, and if you have a bigger pool of people, then the ripples are smaller.”

Click here to view the 2016 Federal Marketplace filings. 
Note: The Indiana Department of Insurance says Time  Insurance Company is exiting the market. This page will be updated to reflect that change soon.

PROPOSED INCREASE

PROPOSED DECREASE

Anthem: 3.8% CareSource Indiana: -5.05%
All Savers: 6.5% Celtic Insurance Co.: -7.44%
Southern Indiana Health Org.: 8.1% IU Health Plans: -16.5%
Physicians Health Plan of Northern Indiana: 14.5% MDwise Marketplace: -19%

 

Nationwide health insurance companies are seeking rate increases between 20 percent and 50 percent, many saying new patients under the Affordable Care Act are more expensive than first predicted.

President Obama is pressuring state insurance regulators to highly-scrutinize requests.

“I’m hoping that what we can do is now focus on how we can make it even better,” the president said a recent stop in Tennessee.

Experts say it’s not surprising to see the range of requests nationwide.

“We understand the real driver of a health care increase or decrease is based on a couple simple things,” Ahlrichs said. “The size of the pool, the healthiness of the pool – are they getting sick or not? How sick are they? Are they expensive cases? Because we’re sharing the risk.”

Indiana’s proposed rates are still open for public comment and must be finalized by August 25.

Click here for the Indiana Department of Insurance Rate Watch to comment. 

Plans will be available beginning November 1 and take effect January 1, 2016.

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