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Health

Insurers gain rate approvals for health exchange

The dominant carrier on Maryland's health exchange, CareFirst BlueCross BlueShield, will raise premiums beginning in January, though not nearly as much as the company wanted, state regulators announced Friday.

CareFirst won approval to raise rates as much as 16 percent on the three plans it offers, while the Maryland Insurance Administration agreed to reduced rates requested from the three other companies that sell policies on the exchange — Evergreen Health Cooperative, Kaiser Permanente and UnitedHealthcare's All Savers Insurance Co.

The companies made their pitches, and won approvals, based on information from the first open enrollment on the state's exchange, formed under the federal Affordable Care Act. The rates would not apply to most Marylanders, who get health insurance through their employers.

Regulators and exchange officials said the new rates reflect a strong exchange, which also will offer new plans from UnitedHealthcare and Cigna Health and Life Insurance Co.

"With new companies offering plans and a number of premium rates dropping, Maryland's individual insurance market is robust and competitive," said Therese M. Goldsmith, the state's insurance commissioner.

Carolyn Quattrocki, the exchange's executive director, said: "New carriers are entering the market, competition has increased, and there are more options for consumers."

It is unclear whether enrollees would stick with CareFirst, which enrolled most of the nearly 79,000 people who bought plans through the exchange.

CareFirst had requested increases of up to 30 percent on its three plans but was allowed increases of about 10 percent to 16 percent, making the plans more expensive than others in many cases.

"We are evaluating what these changes mean to the actual rates," the company said in a statement. "We believe we will remain very competitive."

The premiums do not reflect out-of-pocket charges, such as deductibles and co-pays. They also do not take into account federal subsidies that most people receive. To continue receiving the subsidies, people will have to sign up again through the exchange during the next open enrollment period, which begins Nov. 15.

Those who do not re-enroll would be automatically rolled over into a similar plan, if one exists, but would not receive subsidies.

Enrollees will be able to compare prices on new and existing plans on the new exchange website in November, but insurance regulators posted sample rates on the administration's site using the newly approved rates.

For example, a 40-year-old with a mid-range "silver" plan would pay $226.38 a month before subsidies for a Kaiser plan, $234.95 for an Evergreen plan, $340.08 for a Cigna plan or $272.77 for a CareFirst plan.

The rates will drop on plans by existing carriers on average by 6.7 percent at All Savers, 10.3 percent at Evergreen and 14.1 percent at Kaiser.

Dr. Peter L. Beilenson, founder and CEO of Evergreen, said CareFirst's rate increases will be an opportunity for the other insurers.

Evergreen enrolled just over 400 people in individual plans, partly because the new insurer lacked name recognition and because the exchange didn't work properly and consumers could not readily see all out-of-pocket costs, Beilenson said.

Evergreen offers a network of doctors or direct care through clinics, as does Kaiser. Evergreen signed up mainly small businesses through its own marketing during the last open enrollment but plans to be more aggressive to lure individuals.

"We're vastly more competitive this time," Beilenson said. "And we're far better known, without question."

Other insurers said they too expect to expand choice in Maryland.

Julia Huggins, Cigna president for the Maryland market, said, "Cigna's Maryland individual and family plan offerings are designed to deliver on the promise of health care reform: affordable access to quality health care from a broad network of local doctors and medical facilities, easy to understand plans and the information, resources and service to improve the health, well-being and sense of security of individuals and their families."

meredith.cohn@baltsun.com

Average rates by plan*

Insurers' average monthly premiums for a 40-year-old in a mid-range "silver" plan in the Baltimore region before subsidies:

Cigna Health and Life Insurance Co. $340.08

CareFirst BlueChoice $244.06

CareFirst of Maryland $272.77

CareFirst Group Hospitalization and Medical Services $272.77

UnitedHealthcare of the Mid-Atlantic $253.39

Kaiser Permanente $226.38

Evergreen Health Cooperative $234.95

Insurers' average monthly premiums for a 21-year-old in a low-range "bronze" plan in the Baltimore region*:

Cigna Health and Life Insurance Co. $221.93

CareFirst BlueChoice $129.39

CareFirst of Maryland $172.62

CareFirst Group Hospitalization and Medical Services $172.62

UnitedHealthcare of the Mid-Atlantic $162.39

Kaiser Permanente $136.99

Evergreen Health Cooperative $141.33

*Rates may vary depending on your age, family composition, part of the state where you live and the type of plan

Copyright © 2015, The Baltimore Sun
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