Regulators told health insurance companies selling plans both on and off the state’s insurance exchange that it was okay to increase their premiums, but, in most cases, not as much as requested.
Insurance Department regulators made changes to eight of the 11 proposals for plans offered in the individual market. At least three carriers were told their rates were “excessive” and they should recalculate them and resubmit them by Sept. 3.
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Many of the carriers were asked to lower their proposed increases, while at least one carrier — HealthyCT — was told to increase its rates.
HealthyCT, a co-op that launched two years ago, requested a 13.96 percent rate increase and later revised their request down to 3.43 percent. Regulators changed it to an increase of 7.2 percent. But depending on which plan an individual has, their rates could increase from 10.5 percent to 14.3 percent.
Regulators felt the increase in medical costs for its 23,485 customers would be steeper than HealthyCT estimated.
Meanwhile, another carrier, ConnectiCare Benefits, was told to decrease its rates by an average of 1.3 percent. ConnectiCare Benefits had requested a 2 percent increase for its more than 39,000 customers, but later revised the request to 0.7 percent.
Anthem Blue Cross and Blue Shield, which is Connecticut’s largest insurance company with 55,000 customers, was told to recalculate the rates based on the findings of regulators and to resubmit them to the department by Sept. 3. Insurance Commissioner Katharine Wade wrote that the rate requested, which on average was an increase of 4.7 percent, was “excessive.”
Part of what regulators objected to was the per member cost per month of a new state mandate that requires insurance carriers to cover infertility treatment for women over the age of 40. Anthem had estimated the cost at $2 a month per member, but regulators asked it and other carriers to lower that to 25 cents a month per member.
UnitedHealthcare Insurance Company, the fourth company to offer plans on the exchange, requested an average rate increase of 12.4 percent and later revised that request to an increase of 11.4 percent. After an actuarial review, regulators lowered it to 5.5 percent.
Regulators are only allowed to make sure the rates are “neither excessive, inadequate nor unfairly discriminatory.” They are not allowed to take affordability of monthly premiums into consideration.
There are four carriers offering plans on the exchange and seven offering plans off the exchange in the individual marketplace. There are 96,966 individuals who purchased policies through Connecticut’s exchange.
In addition to Anthem, Golden Rule Insurance Company and ConnectiCare Insurance Co., two off-exchange plans, were asked to recalculate their rates and resubmit them to regulators. Two other off-exchange plans saw their rates approved as submitted. ConnectiCare Inc., which has 435 members, and Celtic Insurance, which has no members, saw their respective 5.1 percent and 15.95 percent rate requests approved.
In requesting the rate hikes, carriers told the regulators that they anticipated the cost of care will increase in 2016. Carriers said the price of expensive new drugs, such as injectable cholesterol medication, would increase the cost of care for its members, but regulators disagreed and lowered the request on average by more than half a percentage point.
The finalized rates won’t go into effect until Jan. 1, 2016. The rate increases also don’t necessarily mean consumers will see their rates increase. Rates are based on a person’s age, county, and plan design. Customers participating on plans in the exchange may get a subsidy from the federal government, if they qualify.