2017 Rate Changes

Like most states, Vermont does have an account with the SERFF database system for insurance rate filings. Until today, I assumed that they just hadn't posted the 2017 filings yet, since there's only one unrelated listing there at the moment.

However, thanks to an anonymous tipster for reminding me that Vermont also has their own, in-house rate review website...and the state is pretty easy to run the math on due to the fact that....

  • There's only 2 carriers in the state even offering individual or small group policies at all,
  • Under state law, all individual/small group policies have to be sold on the ACA exchange anyway, and
  • Unlike most states, Vermont is apparently requiring that the risk pools for individual & small group policies be merged, so there's only 1 set of rate changes his year (last year they did have slightly different average rate hikes for the two markets).

Anyway, here's the deal:

A few days ago, I noted that Premera Blue Cross was asking for a 19.6% average rate hike for ACA-compliant individual policies in Washington State, while also pulling out of several WA counties entirely.

Today, the Washington Insurance Commissioner issued a press release with the full, weighted average rate hike requests for the individual market (including both on and off-exchange carriers):

13 health insurers file 154 plans for 2017 - 13.5 average requested rate change • May 16, 2016

OLYMPIA, Wash.– Thirteen health insurers have filed 154 individual health plans for 2017 both inside and outside of the Exchange, Washington Healthplanfinder. The average requested rate change based on enrollment is 13.5 percent.

Last year, Maryland's individual market saw rate hike requests average roughly 20% overall. For 2017, it doesn't look quite as bad on a percentage basis (although obviously the actual dollar increase is still on top of last year's):

Health insurers seek rate increases in Maryland as United Healthcare quits market

...United Healthcare, the nation's largest insurer but a bit player in Maryland, was not included on a list released Friday by state regulators of companies seeking rate increases for 2017.

Insurance Commissioner Al Redmer confirmed that the company was leaving the exchange created under the Affordable Care Act, as it has in most states across the country. It will continue to offer plans in the small-business market.

The dominant carrier on the individual market in Iowa is Wellmark BCBS, which had 137,000 enrollees (something like 75% of all the market) last year.

However, there were two important caveats to that: First, Wellmark isn't currently participating on the ACA exchange; all of those enrollees were off-exchange only. Secondly, at the time I had no idea how many of them were ACA-compliant and how many were "grandfathered" or "transitional" policies, which aren't ACA compliant and which, more significantly, aren't part of the same risk pool.

Well, Wellmark just announced that they will finally be jumping onto HealthCare.Gov for 2017. This is great news, not just because they're the dominant carrier in the state but also because it'll help fill the hole created by UnitedHealthcare dropping out.

HOWEVER, I suspect that today's news may also help explain their reasoning (I'll get to that later):

As with California, there's no actual individual carrier rate/market share breakdown available, but the source is the DOI itself, so I'm assuming "average" means weighted average:

Fifteen health insurers want an average 17.7 percent increase in premiums for Affordable Care Act individual plans, Florida officials said Thursday — higher than last year’s approved average of less than 10 percent.

...In Florida, 15 companies also asked for an average 9.6 percent increase for small group plans, said Amy Bogner, spokeswoman for the state’s Office of Insurance Regulation.

The companies were not identified individually because they claimed trade secrecy, she said.

It sounds like BCBS of Florida is seeking around 9.8 - 11.6% hikes for the individual market, and 5.2 - 8.7% hikes for the small group market:

NOTE: SCROLL TO BOTTOM OF ENTRY FOR UPDATES!

Regular readers know that I spent countless hours last summer tracking down the requested average 2016 rate change filing forms for every single state in the country, and then compiling them into my best guesstimate about the overall, weighted average rate changes for the individual policy market in each state and nationally.

In the end, I came up with a national projected weighted average increase of 12-13%, although I also made sure to note that I expected the effective average to only be around 9% after the dust settled...due to people shopping around.

As it happens, I turned out to be pretty much dead on target: The "presumptive" average (ie, assuming every single enrollee stayed with the same policy whenever possible) ended up being 11.6% nationally, while the effective average ended up being 8%.

Thanks to JJGomez127 for the heads up:

Kansas health insurance marketplace may gain company offerings for 2017

TOPEKA, KS — Ken Selzer, CPA, Kansas Commissioner of Insurance, said today that Kansas health insurance consumers may have additional company options for coverage in the federallyrun marketplace for 2017.

“Health insurance options filed now for the individual market show that competition will likely continue for Kansans’ health insurance policies,” Commissioner Selzer said.

Filings with the Kansas Insurance Department as of May 2 show two additional carriers may participate in the marketplace. Medica, a non-profit, Minnesota-based company, and Coventry Health and Life are companies that have filed for the 2017 open enrollment period.

Medica Insurance Company is set to offer a number of plans, and Coventry is proposing Exclusive Provider Organization (EPO) Network plans. Both companies have filed to offer plans off the federally-facilitated marketplace as well.

This year, Washington State has a total of 16 carriers offering policies on the individual market: 13 via the ACA exchange, plus another 3 selling off-exchange only (one of them, Regence Blue Shield, seems to be selling both on and off exchange, but I might be misunderstanding something there):

2016 insurers with plans approved to be certified by the Exchange, Wahealthplanfinder:

  • Bridgespan Health Company
  • Columbia United Providers
  • Coordinated Care Corporation
  • Community Health Plan of Washington
  • Group Health Cooperative
  • Health Alliance Northwest Health Plan, Inc.
  • Kaiser Foundation Health Plan of the Northwest
  • LifeWise Health Plan of Washington
  • Moda Health Plan, Inc.
  • Molina Healthcare of Washington, Inc.
  • Premera Blue Cross
  • Regence BlueShield
  • United Healthcare of Washington, Inc.

Off-exchange only (?):

Don't get me wrong, this is great news from a transparency pov...

Coalition cheers Health Insurance Rate Review bill passage

The House followed the Senate’s unanimous approval of SB 865, sponsored by Sen. David Sater, with a 140-6 vote, moving the “Health Insurance Rate Review” bill to the Governor’s desk on Tuesday.

In addition to rate review, the bill will modify provisions regarding licenses issued by the Board of Pharmacy and covered prescription benefits, delineates procedures for PBMs with regards to MAC lists, and requires health carriers to offer medication synchronization services.

The advancement was cheered by Missouri Health Care for All (MHCFA), who believe the bill will bring more transparency to insurance premiums.

As numerous sources have already indicated, after 2 years of (relatively) low average premium rate increases on the individual market (around 5.6% in 2015 and 8.0% in 2016...compared with the 10-12% average rate hikes over the previous decade), it looks like 2017 will finally see the higher rate hikes that ACA critics have been screaming about every year.

So far, Virginia and Oregon have reported requested rate increases of 17.9% and 27.5% respectively, while California may be looking at 8.0% increases (which is high for them).

Chad Terhune reported today that Covered California, the largest state-run ACA exchange in the country, released their 2016-2017 fiscal year projected budget, which includes a mountain of useful enrollment data...some of which is positive, some negative and some of which depends on your POV:

California’s health insurance exchange estimates that its Obamacare premiums may rise 8 percent on average next year, which would end two consecutive years of more modest 4 percent increases.

The projected rate increase in California, included in the exchange’s proposed annual budget, comes amid growing nationwide concern about insurers seeking double-digit premium hikes in the health law’s insurance marketplaces.

...Insurers in California have submitted initial rates for 2017, but the final figures won’t be known until July after state officials conduct private negotiations.

Almost exactly 1 year ago over at healthinsurance.org, I posted the following:

May 15 officially marked the start of the 2016 rate review season. What that means for Americans is that over the next month or so, newspapers and web sites across the country will start running stories with scary-sounding headlines like this:

Some Oregonians could face major insurance rate hikes next year

Health plans request double-digit premium increases

… or, more reassuringly, like this:

Lower rate increases, more plans proposed for state’s health exchange in 2016

The articles will throw a bunch of numbers around, saying that the “average” premium rate increase for a given state is expected to be X percent, followed by examples of the highest and lowest increases. There may even be a few “Company Y will actually be reducing their rates!” thrown in.

Before you freak out, there are a few important things to look for.

A few weeks ago, I got a heads up that Virginia was the first state out of the gate with their 2017 Rate Request filings. There were some confusing numbers which took awhile to sort out, but once the dust settled, the overall weighted average rate hike requests for Virginia's entire ACA-compliant individual market came in at around 17.9%.

Some states make it next to impossible to track down this info. Others hand it to you on a silver plate. And then there are states like Oregon, who provide the average rate hike requests in a simple, easy format, but don't necessarily include the market share of those companies, making it difficult to compile a weighted average:

So, yesterday I posted my first 2017 Weighted Average Rate Hike entry, using Virginia, since they appear to be the first state to post their requested rate changes for 2017.

As you can see, while the requested rate increases stayed consistent throughout the various updates, the number of enrollees changed dramatically depending on which filing source I used. Case in point: Anthem/HealthKeepers Inc.

The first filing I found for Anthem HealthKeepers made it pretty clear that they're asking for a 15.8% average rate hike next year which is expected to potentially impact up to 122,581 policy holders:

Pretty cut & dry, right? Note that according to the filing that number covers current Anthem HealthKeepers enrollees both on and off the exchange, so it should cover all ACA-compliant policies.

In light of today's confirmation that the average 2016 premium rate increase ended up only being appx. 8% nationally on the individual market (as opposed to the headlines screaming about 40%, 50%, 60%+ rate hikes being "typical"), I've decided to get a jump on the 2017 rate changes. Someone gave me a heads up that Virginia appears to be first out of the gate this year, with requested 2017 rate filings having already been submitted by at least 8 carriers.

Now, for 2016 there are actually 13 carriers offering individual policies in Virginia (although some of these are available off-exchange only). I'm don't know if the 5 missing carriers have decided to drop out of the VA market or if they simply haven't submitted their 2017 filings yet (it looks like in Virginia the carriers technically have until July 15th to get their requests to the HHS Dept. in states which have their own rate review process, but the state itself presumably has an earlier deadline). It's also possible that some additional carriers might join the exchange and/or start offering policies in the state which don't this year.

In any event, here's what I've found so far for Virginia:

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