Virginia ACA proposed rates give glimpse of market premiums for 2019
Faced with the lack of the individual mandate, insurers are narrowing networks, raising deductibles and out-of-pocket costs to contain rates.
Two of Virginia's Affordable Care Act insurers are requesting significant rate hikes for 2019, while a third has submitted a premium decrease.
BlueChoice, doing business as CareFirst BlueCross BlueShield, is requesting a base rate increase of 26.6 percent for its BlueChoice single risk pool, according to the rate filing.
Cigna has proposed a 15 percent premium hike.
[Also: ACA premium rate increase requests range from 6.7% to 59%]
Optima Health has proposed a slight decrease in premium rates for 2019. For its 250 plans on and off the exchanges, the current average annual premium per policy is $14,218. The proposed rate for 2019 is $13,955. The per member current rate is $9,951 and the proposed is $9,766.
Optima Health said it filed for a wide variety of plans with varying benefits in Virginia for 2019, including plans both on and off the ACA exchange and for small group coverage.
"We continue to develop products that serve Virginians and may further refine the number of plans ultimately offered during open enrollment," the insurer said by statement. "All plan offerings and rates will not be finalized until the fall, per the schedules set forth by the Virginia Bureau of Insurance and Centers for Medicare and Medicaid Services. We're pleased to see more insurers participating in markets across the state, providing Virginians with more choices."
While Optima didn't directly address how it managed to propose a reduction in premiums, the rate filings show insurers are getting creative to keep premiums from going even higher. This is first year insurers are proposing rates without having an individual mandate for consumers to buy health insurance or face a tax penalty.
Without the mandate, insurers are facing a drop in the number of healthy individuals who will buy ACA insurance, leaving in the market those with more costly chronic or other health conditions.
BlueChoice in 2017 collected $48.5 million in premiums and paid out $52 million in claims, according to the Virginia filing. It expects to receive about $9.8 million in risk adjustment payments.
One of the main drivers for the proposed rate increase is an increasingly older and sicker population, BlueChoice said.
To prevent even higher premium increases, BlueChoice said it had implemented benefit reductions through deductibles and out-of-pocket maximums.
Insurers also use narrow networks to help keep plans affordable.
Twitter: @SusanJMorse
Email the writer: susan.morse@himssmedia.com
No one at Optima could be immediately reached for comment as to how it has managed a rate decrease.
