When reviewing the rates a couple of interesting items stand
out. Note the disparity between what
some carriers wanted to charge and what they were allowed to charge. For example, Moda (formerly ODS), had minimal
changes in pricing while another had rates cut by nearly a third. The other
interesting items are the different prices.
One objective of the exchange is to pull together multiple health
insurance carriers and require them to sell identical insurance plans. There are at three standard levels of
coverage being offered through the exchange: gold, silver and bronze. All carriers selling a plan under a given
level will have the same levels of coverage (see benefit summary link
below). For example, when Company A
offers the gold plan, this gold plan will be exactly the same as the gold plan
under Company B. Thus carriers will
compete on service and price. Some of
the recently approved prices show significant differences between carriers for
the same coverage. More interestingly
the price between small group and individual policies is different for the same
levels of coverage with the same carrier.
Many small businesses that are not penalized under the Affordable Care
Act may elect to drop their small group plans and offer a pretax allowance for
insurance so their employees can buy coverage from the exchange. A word of caution to small businesses with
fewer than 25 employees who also receive a small business tax credit (article
link here) as you could lose that credit.
The small business tax credit offers up to a 50% credit towards employer
paid premiums in 2014. If you are considering this option I would suggest you
speak to a professional such as a CPA to best plan your strategy.
Benefit Summary link: http://www.oregonhealthrates.org/files/plan_summary.pdf
Is is true with growing risks to human health the insurance policies premiums are also increasing?
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William Martin
PPI Claims Made Simple
My general understanding is that the exchange rates in Oregon are based on the specific pool of people that will be insured in regards to their expected health care costs (plus a mark up for the insurance companies). What I do not know is how the actuaries factor in an allowance for theoretical risks like an increase in obesity rates or the chance of a flu pandemic. A more concrete example of a risk to human health that relates to health insurance premiums is the use of tobacco. The ACA allows up to a 50% increase in premiums for those regularly using tobacco.
ReplyDeleteWith the growing risks to human health, I hope policies are not going to increase as well. Small business owners are also taking the heat because other than acquiring a business insurance plan, providing their employees with proper health benefits should also be strictly dealt with.
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