Courtesy Access Health CT

HARTFORD, CT — Consumers who purchase their health insurance through Access Health CT may see either a decrease or an increase in their premiums if they are allowed to automatically renew their coverage from last year.

The 50% of consumers who will see a decrease in their premiums are those who receive a federal subsidy, according to Wakley, an actuarial consulting firm whose data was included in the presentation at the Access Health CT board meeting on Thursday. Premiums are what consumers pay on a monthly basis that gives them access to insurance.

Officials with Access Health CT warn that premiums are not the only thing consumers should consider when purchasing health insurance. There’s also the deductible, co-pays, and co-insurance that impact the overall cost of health insurance for consumers.

Healthcare Advocate Ted Doolittle pointed out that the Wakely report on consumer premium impact is incomplete because it does not include those out-of-pocket costs.

Access Health CEO James Michel said they’ve been looking at how exactly to figure out the entire impact on consumers. He said they have to work with the carriers to get better information on the true cost to consumers.

“Right now the information available to us is just premium dollars,” Michel said. “We do have some information, but it’s not conclusive.”

Doolittle said he believes the information is available in the rate filings that the carriers provide to the Insurance Department.

Paul Lombardo, director of the Life and Health Insurance division at the Insurance Department, said what claims each carrier allows, and what they pay for claims is available in the rate filings, but it’s not available by plan design. The difference between allowed claims and paid claims is the cost-sharing.

Doolittle responded to Lombardo by saying that Access Health needs to ask the carriers for the information by plan, if Access Health doesn’t already have the information.

Based solely on premiums, the report by Wakely found a majority of consumers who are not eligible for federal subsidies and are in gold plans will see an average $116-per-month increase. Those in silver plans will see an average $66-per-month increase, and those in bronze plans will see a $59-per-month increase. A small number of those consumers who don’t receive subsidies will receive a slight reduction in rates.

Depending on which of the 17 plans consumers choose, about 56% of those enrolled in silver plans who receive federal tax subsidies will see a decrease of $94 per month, and 98% of those in bronze plans will see a $58-per-month decrease. About 44% in silver plans who receive subsidies will see a $16-per-month increase.

There are three metal levels and one catastrophic level plan offered by the two private carriers participating in the marketplace. There are no platinum plans and the metal level is determined by the actuarial value of the plans.

Brittney Phillips, a consultant for Wakely, said in 2019 there was a further shift of consumers into the bronze plans.

She said the weight average premium increase in the individual market is 10.2%. That’s before any federal premium subsidies are applied.

In 2019, 68% of consumers were eligible for premium subsidies.

Rate changes across all plans range from -7.3% to 27.5%.

The carriers, Anthem Health Plans and ConnectiCare, have discontinued some of their silver plans for 2020. Instead of offering six silver plans, they will offer two — one per carrier.

By county, average rates are increasing the most in Hartford and Middlesex, according to Wakely.

There are many factors that go into calculating insurance premiums for various consumers, but Phillips offered some examples to give Access Health board members a sense of how consumers will be impacted.

A single, 44-year-old male making just over $36,420 a year will see an average subsidy increase of 34% across all counties. He is around 300% of the federal poverty level, so the increase in premiums he’s likely to see could be between -7% and 8% depending on what plan he chooses.

Phillips pointed out that consumers could choose to pay more in cost-sharing and lower their monthly premiums in going from a silver plan to a bronze plan.

Access Health CT has been encouraging people to shop and compare their rates on an annual basis in order to avoid being automatically renewed in a plan that might not meet their needs and may cost more than it did the previous year.

A single, 56-year-old female who lives in Fairfield County and doesn’t receive any subsidies could see a $228-per-month premium increase if she is automatically renewed into a silver plan. In 2019, her premium was $855 per month. If she chooses to renew automatically, she will be paying $1,083 per month. She could choose to switch to the new lowest cost gold plan — a step up — for $1,050 per month, a bronze plan for $665 per month, or elect to buy an off-exchange silver option for $977 per month and minimize her rate increase in 2020.

That’s one example where there’s a gold plan that costs less than a silver plan.

Grant Ritter, an Access Health board member, wanted to know if the exchange filters plan offerings to people based on what would be better, a gold plan that’s cheaper off exchange, or a silver plan on the exchange. For the unsubsidized individual it might make sense, Ritter said.

Michel said the website doesn’t filter results in that way for consumers, but they encourage everyone to “shop, compare, and enroll.”