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Old 08-30-2014, 08:57 AM   #41
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Does your catastrophic policy include any preventive, like once a year physicals?

Do you pay the full doctor's bill until you meet the physical or is there also a high copay.

The Bronze copays I've seen are like $75 for a doctor's visit IIRC.
This article compares bronze to catastrophic, ACA Bronze Tier Health Insurance vs. Catastrophic Plans - US News

Mostly the same, Catastrophic has additional eligibility requirements and no subsidy support.

There was thread last year where someone posted a spreadsheet to compare plans. Generally if you don't use a lot of medical services the bronze came out ahead. If you have ongoing conditions and always meet your deductibles a silver might be better.

And it depends what is offered in your area. There are no catastrophic plans in my area.
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Old 08-30-2014, 09:01 AM   #42
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The spreadsheet, by Animorph, which many found very helpful, is here, and was added to the PPACA FAQ last year
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Old 08-30-2014, 04:25 PM   #43
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I'm not really much into the politics of this thing and my measurement stick is really short - how does this thing impact me? It looks like for the first time in history health insurance rates in Oregon will actually decrease from the prior year. Amazing! State releases Oregon's 2015 health insurance rates for individuals, small businesses | OregonLive.com
Arkansas and Connecticut will also be seeing lower prices.
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Old 08-31-2014, 11:45 AM   #44
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Arkansas and Connecticut will also be seeing lower prices.
Not according to data from OP's link.
As of Aug 15 update, ave 2015 rates AR +11.7% and CT +5.4%

ACA state exchanges
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Old 08-31-2014, 05:22 PM   #45
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Originally Posted by ERhoosier View Post
Not according to data from OP's link.
As of Aug 15 update, ave 2015 rates AR +11.7% and CT +5.4%

ACA state exchanges


The 11.7% increase for Arkansas in that PWC graph is not consistent with more recent reports. Looks like the Arkansas exchange rates will decrease by 2% for 2015. Good for the folks of Arkansas.

Arkansas, home to key Senate race, announces rate decreases on Obamacare exchange - Washington Times

I'm very happy with how the rates for 2015 are shaping up in California where I am.
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Old 08-31-2014, 06:19 PM   #46
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Connecticut

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Not according to data from OP's link.
As of Aug 15 update, ave 2015 rates AR +11.7% and CT +5.4%

ACA state exchanges
Connecticut rejected Anthem's (the state's largest insurer) 12%+ initial proposed rate hike and the revised number was an average decrease of .1%. I don't think the PWC graph includes that update, but I couldn't find any links to the source material on the PWC graph.

After rate hike rejected, Anthem to decrease premiums next year | The CT Mirror

Prior to the ACA, even a 5.4% increase would be pretty good news. But that was then...and I was promised...etc. etc.
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Old 08-31-2014, 10:06 PM   #47
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Connecticut rejected Anthem's (the state's largest insurer) 12%+ initial proposed rate hike and the revised number was an average decrease of .1%. I don't think the PWC graph includes that update, but I couldn't find any links to the source material on the PWC graph.

After rate hike rejected, Anthem to decrease premiums next year | The CT Mirror

Prior to the ACA, even a 5.4% increase would be pretty good news. But that was then...and I was promised...etc. etc.
I could not find source material for PWC link either. IIRC, PWC only lists it's own research as source material so we do not know precisely how they calc their figures.
As is the case for some other states/regions, the rate change analysis in CT is complicated by the fact that important features are changing in 2015 for some of the more popular Plans. For example deductibles and OOP max are rising significantly for Bronze Plans. Bronze 1 deductibles will rise from $3200indiv/$6500 family to $5,000/$10,000. Other features are changing as well. Exchange actuaries estimated that net effect of these Bronze Plan design changes for 2015 (EXcluding inflation) would decrease premiums by 2.9% vs 2014. Considering that the CT Ins Dept approved a decrease of 0.1%, these rates are actually a net ~2.8% INcrease when corrected for changes in coverage features (e.g. increased deductibles/OOPmax's). CT's Gold Plans had no coverage design changes, but rates still increased 1.5-4.2%. So not a real 'apples-to-apples' rate decrease in CT, but still better than the figures PWC has posted on their site.

Access Health CT’s 2015 plans: See what’s changing | The CT Mirror
After rate hike rejected, Anthem to decrease premiums next year | The CT Mirror
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Old 08-31-2014, 11:41 PM   #48
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Note that the Standard Connecticut Bronze plan continues to be HSA eligible, with maximum deductibles and max out of pocket amounts for individuals and families meeting the nationwide 2015 HSA eligibility limits.

ERhoosier's numbers are for Access Health CT Bronze Non-Standard Plans, specialty low rate plans.


http://www.irs.gov/pub/irs-drop/rp-14-30.pdf

  • HSA Contribution Limits. The 2015 annual HSA contribution limit for individuals with self-only HDHP coverage is $3,350 (a $50 increase from 2014), and the limit for individuals with family HDHP coverage is $6,650 (a $100 increase from 2014).
  • HDHP Minimum Required Deductibles. The 2015 minimum annual deductible for self-only HDHP coverage remains $1,300 and for family HDHP coverage remains $2,600.
  • HDHP Out-of-Pocket Maximum. The 2015 maximum limit on out-of-pocket expenses (including items such as deductibles, co-payments, and co-insurance, but not premiums) for self-only HDHP coverage is $6,450 (a $100 increase from 2014), and the limit for family HDHP coverage is $12,900 (a $200 increase from 2014).
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Old 09-01-2014, 12:41 AM   #49
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As is the case for some other states/regions, the rate change analysis in CT is complicated by the fact that important features are changing in 2015 for some of the more popular Plans. For example deductibles and OOP max are rising significantly for Bronze Plans. Bronze 1 deductibles will rise from $3200indiv/$6500 family to $5,000/$10,000. Other features are changing as well. Exchange actuaries estimated that net effect of these Bronze Plan design changes for 2015 (EXcluding inflation) would decrease premiums by 2.9% vs 2014. Considering that the CT Ins Dept approved a decrease of 0.1%, these rates are actually a net ~2.8% INcrease when corrected for changes in coverage features (e.g. increased deductibles/OOPmax's). CT's Gold Plans had no coverage design changes, but rates still increased 1.5-4.2%. So not a real 'apples-to-apples' rate decrease in CT, but still better than the figures PWC has posted on their site.

Access Health CTís 2015 plans: See whatís changing | The CT Mirror
After rate hike rejected, Anthem to decrease premiums next year | The CT Mirror
I don't think you can fairly use the .1% decrease across the Anthem plans (all medals) to conclude that the expected 2.9% decline for a Bronze Plan shows that there's a net increase of 2.8% in the cost of that Bronze Plan. The Standard Bronze $5,000 deductible plan that you've highlighted has an approved decrease of 7.3% (not .1%). Using your methodology, 2015 will bring a net 4.4% decrease in the cost of that bronze plan accounting for benefit changes. For standard Silver, the decrease is 1.67% (2.7% expected increase versus 1.03% increase). There is a increase for Gold of less than 1% (.7% expected versus 1.5 approved).
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Old 09-01-2014, 08:12 AM   #50
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I could not find source material for PWC link either. IIRC, PWC only lists it's own research as source material so we do not know precisely how they calc their figures.
As is the case for some other states/regions, the rate change analysis in CT is complicated by the fact that important features are changing in 2015 for some of the more popular Plans. For example deductibles and OOP max are rising significantly for Bronze Plans. Bronze 1 deductibles will rise from $3200indiv/$6500 family to $5,000/$10,000. Other features are changing as well. Exchange actuaries estimated that net effect of these Bronze Plan design changes for 2015 (EXcluding inflation) would decrease premiums by 2.9% vs 2014. Considering that the CT Ins Dept approved a decrease of 0.1%, these rates are actually a net ~2.8% INcrease when corrected for changes in coverage features (e.g. increased deductibles/OOPmax's). CT's Gold Plans had no coverage design changes, but rates still increased 1.5-4.2%. So not a real 'apples-to-apples' rate decrease in CT, but still better than the figures PWC has posted on their site. .....
IMO even if we accept your point, annual rate changes of 1.5-4.2% are not something to complain about.

I suspect that the PwC data was based on year-to-year comparisons of total premium from insurer filings available at the date the analysis was done and has not been updated for subsequent filings and changes.

While I see your point on the change in benefits. I wonder if there are other changes in benefits that offset the increase in deductible because an extreme change in benefits would cause a plan to no longer be able to be in its medal category. In any event, at least in my state, a good portion of the increase in 2014 related to ACA changes (and IIRC the same could be said for a significant portion of the increases in 2014 and 2013).

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Significant medical price increases were partially offset by favorable membership assumptions and reductions in ... administrative expenses. Combined, these factors produced a 3.3 percent increase in rates. The remainder of the 9.8 percent increase was driven by changes related to federal and state health care reforms, including an increase in the federal fee that is included in Exchange pricing, a reduction in federal subsidies of the premiums on (the) new Exchange, and a modest expansion of dental benefits for children.
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Old 09-01-2014, 12:51 PM   #51
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We should see a 25% reduction in my region per this report.

Mississippi: Rates to fall by 25% & increase 6.5% respectively (UPDATED) | ACASignups.net
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Old 09-01-2014, 02:33 PM   #52
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I'm not really much into the politics of this thing and my measurement stick is really short - how does this thing impact me? It looks like for the first time in history health insurance rates in Oregon will actually decrease from the prior year. Amazing! State releases Oregon's 2015 health insurance rates for individuals, small businesses | OregonLive.com
Not withstanding the claims made by one political ad alleging huge increases for next year in Oregon. Oh, oops!
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Old 09-01-2014, 03:50 PM   #53
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If we keep the politics out, this could be a helpful thread.
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Old 09-01-2014, 10:14 PM   #54
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Old 09-01-2014, 10:27 PM   #55
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IMO even if we accept your point, annual rate changes of 1.5-4.2% are not something to complain about.
Agree 100%. I would LOVE to see only that annual % increase in my already hi-cost region. It appears my state's insurance commission may approve rates close to the 9-30+% increases being requested by the bigger carriers, or even worse than PWC's link suggests

My main point was not whether 2015 CT HI premiums were going slightly up or down. It was that press claims of 'averages' in HI market are often far too simplistic. The reality is that there is only ONE $$ increase or decrease for 2015 that truly matters. What will YOUR total cost of HC be. Two families with the same Bronze plan (no subsidies) may benefit or be hurt by the same 2015 plan design changes. The lucky, healthy family using minimal HC will clearly benefit from a lower premium, but the family with chronic serious conditions will get financially slammed by the higher deductibles & family OOP max. One family may view 2015 as a great success, while the other may curse those same politico's and bureaucrats for driving them towards medical bankruptcy. There will always winners and losers. Press pieces which insist upon 'simplifying' the HI market to 'aves' are useless at best, and can be quite misleading. Such pieces may even be harmful. They may lead folks to assume the 'ave' applies to them and so quit shopping for the plan which best fits their specific needs.
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Old 09-02-2014, 06:59 AM   #56
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I agree health insurance is a bit like politics, local and how you are affected is what counts.

If a family has serious chronic conditions they may be better off with a silver or gold plan rather than a bronze. My HI provider has a neat tool where you put in your estimated visits to primary care and specialists and how many prescriptions you are on and it gives you the minimum, expected and maximum annual costs for each type of policy based on the information you provided which I think is quite helpful.
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Old 09-02-2014, 07:08 AM   #57
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If a family has serious chronic conditions they may be better off with a silver or gold plan rather than a bronze.
Is it possible for one family member to get a bronze plan (healthy) while the other gets a silver plan (significant medical history)? And if you can, can the subsidy for out of pocket costs still be applied to the silver plan (assuming your income is below the level required)?
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Old 09-02-2014, 07:35 AM   #58
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Is it possible for one family member to get a bronze plan (healthy) while the other gets a silver plan (significant medical history)? And if you can, can the subsidy for out of pocket costs still be applied to the silver plan (assuming your income is below the level required)?
If only a married couple with no children, yes. Each can have a separate plan, different metal level, and subsidy still applies. The cost of two individual policies is equal to one "joint" plan. If there are children, however, one family plan will probably be less expensive.
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Old 09-02-2014, 09:15 AM   #59
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The key issue in all of this is what's happening to copays and deductibles. The bronze/silver/gold levels are simply reflecting what's happening to HI in private companies. My employer drove almost everyone to their high deductible option ($3,200 per family) except the really sick. The non-high deductible plan available is really only increases the cost of insurance to pay out the $3,200 deductible over the year. The max-OOP are the same. Based on reimbursement levels, there is a very small window where the high cost HI has a slight advantage if the total OOP is just a few thousand $$ below the max-OOP. When I looked over the B/S/G plans, it looked very similar.

The one given is that all the plans require a substantial financial contribution from the insured even if receiving the subsidy. Other than the "manipulators" on this forum, many of the subsidy recipients have difficulty paying their copays. The jury is still out on how many of the previously uninsured have now stepped up to buy insurance if they didn't get it at no/low cost either through Medicaid expansion or with subsidies.

As I see it, the big cost increases built into the ACA insurance requirements have already gone into effect prior to 2015. These would be the elimination of maximum coverage, up to age 26 on parents' plan, required coverage with pre-existing conditions, mental health coverage and required maternity care. These impact the plans from employers and the exchanges. Different companies implemented different rate increases for these. I suspect 2015 will heavily reflect these costs as premiums are readjusted. I suspect it will take years for all this to work out.

I've never understood the whole rate approval process with different states. Are these to make the pols look like they are protecting their citizens or drive heath insurers from their states? If I ran an insurance company and my calculations showed I needed a 5% rate increase to maintain my profits, a state "pushing back" will cause me to either reduce payments to providers (probably shrinking my networks) or to stop writing policies in the state. I can't imagine the state regulators somehow "showing" the insurance company how to reduce costs without impacting payments.
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Old 09-02-2014, 09:36 AM   #60
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If only a married couple with no children, yes. Each can have a separate plan, different metal level, and subsidy still applies. The cost of two individual policies is equal to one "joint" plan. If there are children, however, one family plan will probably be less expensive.
Thanks! This is our situation, no kiddos. It would definitely be better for us to have separate deductibles/max out of pockets, given my medical history. I will have to compare all the options. Getting closer to pulling the trigger on FIRE...but still have lots of details to work through first!
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