The Harver Group - Most state health insurers seek rate boost: Proposals compared

Proposed rate changes for 2015 individual health plans are all over the map, but most companies are keeping up with tradition by requesting increases in premiums.

If approved, rate increases for 2015 individual health plans proposed by 12 insurance companies may affect most policyholders, whether they bought their plans through Washington Healthplanfinder’s online marketplace or in the outside market.

Washington is one of the first states to see proposed rate changes for 2015 individual health-insurance plans.

The proposed rate changes range from a decrease of 6.8 percent — from Molina Healthcare of Washington — to an increase of 26 percent from Time Insurance, a national company with relatively few Washington policyholders.

Most rate-change requests, particularly from larger insurers, were in the middle ground, with most asking for increases from about 2 to about 11 percent.

To anyone who has had individual insurance, premium increases are not surprising: Records show that, on average, insurers have proposed rate increases for individual plans from about 9 percent to more than 18 percent every year from 2007 to 2013. After review by the Office of the Insurance Commissioner, the average rate increases imposed were lower — in most cases, only slightly lower. But in one year, rate-increase requests were cut by more than 3.5 percentage points.

With the exception of relatively few grandfathered plans, all individual plans were new in 2014 to comply with provisions of the Affordable Care Act (ACA), which set certain standards for coverage and barred insurers from excluding people with pre-existing conditions.

Some insurers offer plans only inside the Healthplanfinder exchange; some offer plans only in the outside market. Five are proposing plans both inside and outside the exchange. Any rate- change proposals for those insurers would affect both inside and outside plans.

The rates do not become final until they pass review.

Spokeswoman Stephanie Marquis said it likely would be a tough review this year because insurers have only a few months’ worth of actual claims data, so they must use other data sources to justify rate increases.

There didn’t appear to be differences between proposed rates for plans sold only inside the Healthplanfinder exchange market and those sold only outside.

BridgeSpan Health, whose exchange plans picked up a relatively small portion of the market this year, asked for a 1.7 percent increase; its affiliate, Regence BlueShield, which offers only outside-the-exchange plans, asked for 5.1 percent.

Coordinated Care Corp., with exchange-only plans, asked for 11.2 percent, as did Group Health Cooperative, which has plans both inside and outside the exchange. Group Health Options, with plans offered only outside the exchange, asked for 14.2 percent.

Premera Blue Cross, offered both inside and outside the exchange, and Community Health Plan of Washington, with only exchange plans, asked for 8.1 and 8.4 percent, respectively.

In the small group market, insurers on average proposed smaller rate increases, with at least four insurers asking to decrease rates. That may be because insurers expect to pick up younger members now insured by association plans that have been discontinued because they did not meet the requirements of the ACA, Marquis said.

Four new companies have submitted proposals for individual plans to be sold inside Washington’s Healthplanfinder exchange. Because the plans are new, there are no rate changes proposed. Those companies are Columbia United Providers, Health Alliance Northwest Health Plan, UnitedHealthcare of Washington, and Moda Health Plan. Moda currently has individual plans in the outside market but plans to replace all existing plans.

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