Year Two: More competition, new premiums all over the map

In spite of all the hand-wringing that people have had about the insurance company premium rates for the 2nd year of the exchanges (this is the main reason for all the freaking out about how many "young invincibles" there would be, etc etc), the truth is...the new premium levels appear to be all over the place:

May 15--A first-glance snapshot of the lowest premium rates being proposed for individual health-insurance plans to be sold in the Washington Healthplanfinder exchange marketplace reveals spirited competition and more choices for consumers.

These rates are not yet approved, and it's likely the number of plans requested will decline, according to the Office of the Insurance Commissioner.

That office is now reviewing rate changes the companies requested.

Changes proposed by companies asking to sell plans on Healthplanfinder ranged from a nearly 7 percent decrease in one case to an increase of more than 11 percent in others.

That's right. Some companies are indeed throwing "double digit" premium increases out there (not exactly shocking...our own BCBSM premiums skyrocketed from around $400/month back in 2008 up to double that only a couple of years later, before the exchanges opened here in Michigan), in other cases they're actually lowering their rates. I have no idea whether this has ever happened in the history of the health insurance industry before or not, but it wouldn't surprise me.

In addition, the number of insurance companies competing on the exchanges is set to increase substantially for the 2nd go around--part of that whole "invisible hand of the free market" thing that conservatives are always going on about:

(Bloomberg) -- UnitedHealth Group Inc. (NYSE:UNH) -- a company that was leery of the new Patient Protection and Affordable Care Act (PPACA) health insurance exchange system – may sell plans through exchanges in several states for the first time in 2015.

The company has filed exchange “qualified health plan” (QHP) forms in Washington state and Virginia.

United also could sell coverage through the Indiana exchange, under the Allsavers brand name, according to the Indiana Department of Insurance.

UnitedHealth now sells QHPs through just five exchanges.

Some other insurers also seem likely to sell QHPs through exchanges where they are now off the menu.

In Washington state, three of UnitedHealth’s competitors are planning to sell QHPs through the exchange for the first time.

In Virginia, a local health plan owned by a hospital and physicians in Lynchburg is planning to sell coverage through that state’s exchange, which is run by the U.S. Department of Health and Human Services (HHS).

In Indiana, another state with an HHS-run exchange, the number of carriers selling exchange QHPs could increase to eight, from four this year.

In fact, looking at Washington State specifically (which, of course, may or may not end up being representative nationally), the overall number of choices (including both exchange-based and off-exchange plans) is massive:

Seventeen health insurers filed more than 230 health plans for 2015 – average proposed rate change 8 percent

OLYMPIA, Wash. – Seventeen health insurers have filed more than 230 individual health plans for 2015 both inside and outside the Exchange, Washington Healthplanfinder.

The average proposed rate change for the individual market is 8.25 percent. This represents the lowest requested average rate change in seven years.

The plans, provider networks, and rates are currently under review. Because the insurers have limited claims experience with these plans, they will have to use other data to justify any rate changes.

“I’m pleased to see the health insurers show an increased interest in the individual market and to see rates come in relatively low,” said Insurance Commissioner Mike Kreidler. “Consumers certainly deserve more choices, but we will scrutinize the proposed rate changes very carefully. It’s on the health insurers to justify any rate change and they know our review will be thorough and complete.”

Twelve insurers filed 114 individual health plans for sale inside the Exchange, Washington Healthplanfinder. If approved, the number of Exchange plans would increase from 46 to 114. Eight insurers currently have plans inside the Exchange.

Also, 10 insurers filed 119 individual health plans for sale outside of the Exchange, raising the potential number of non-Exchange plans from 51 to 119. If all are approved, the number of insurers will stay the same. The total number of plans available may change during the review process.

All proposed individual health plans and their rates must be reviewed within 60 days. The review may take longer if Kreidler’s office requests additional information. The Health Benefit Exchange selects the deadline for certifying all plans for sale in Washington Healthplanfinder. Once approved, all rates take effect Jan. 1, 2015.

Once the final rates are approved, premium will vary depending on where someone lives, their age, whether or not they smoke, and which plan they select.

Between all of these changes and additions, as well as the shortened open enrollment period (November 15 - February 15), plus the addition of 2 new state-run exchanges (Idaho and New Mexico) and the reduction of either one or two (Oregon and possibly Massachusetts), the 2nd year looks to have a completely different landscape than the first one.