This year’s Individual Medical Insurance open enrollment which includes Covered Ca and the Federal Health Insurance Exchange will begin November 1st and is scheduled to end January 31st 2017.
Starting November 1st consumers will be able to enroll in new medical plans, renew their existing coverage or make changes to their plan’s benefits. These changes will take effect January 1st, 2017.
New plan rates will also take effect January 1st 2017. The average rate increase in California is expected to be 13.2%, over 3 times the average rate increase for 2016.
Rate increases will vary by region in California with San Joaquin, Stanislaus, Merced, Mariposa and Tulare counties experiencing the lowest average increase at 8.4% and Monterey, San Benito and Santa Cruz counties getting hammered with an average increase of 28.6%.
Southern California will see average increases of 14.4% in Orange County, 13% to 16% throughout Los Angeles Counties and the Inland Empire seeing a below average increase of roughly 10.%.
For consumers that are currently receiving subsidies it is important to note that as premiums rise so do the Federal subsidies. Consumers who receive a subsidy will experience average increase of 3.9% to 8.1 %
Rate increases will vary by carrier with both Blue Shield of California and Anthem Blue Cross taking the largest increase followed by Kaiser and Health Net.
The reason for the larger increase in 2017 beside the usual, over utilization, increased costs and increased spending on pharmacy related claims includes an end to the Affordable Care Act’s Reinsurance program.
The Affordable Care Act created a temporary, three-year reinsurance program to protect insurers during the early years of the new individual marketplaces. Insurers pay into the reinsurance pool, and those funds are then paid out to health plans that had members with extremely high medical claims. The reinsurance program was designed to help keep rates down during this period, help stabilize the market and attract more consumers to build a healthy mix of enrollees.
It’s estimated that the end of the Reinsurance program has added a one-time increase of about 4-6% to this year’s renewal rates.
While rates remain high and continue to increase. Plan deductibles and out-of-pocket costs are still higher than most pre-ACA plans we will see some plan designs reduce doctor visits costs and lower urgent care and emergency room co-pays.
Carrier will soon be sending consumer’s information on their specific plan increase.
I recommend that consumers be very proactive this renewal period. Consider your plan options. If you don’t see the doctor or take medications regularly consider a lower plan option. Consider a change in carriers. Review your current medical use and the costs associated and consider changes in medications to lower cost generics.
I will be available to help you review your plans and provide options throughout the upcoming Open Enrollment. Please don’t hesitate to contact our office to request a review of your current plan, other options or to review ways to reduce your overall costs.