Anthem CT 47% Rate Increase on Individual

[dgoldenz]

Anthem Approved For Health Insurance Rate Hikes As High As 47 Percent - Connecticut Insurance

 

[FinanceDude]

Wait a dang minute, our bills are supposed to go DOWN, Nancy Pelosi said so!!!

 

[ziggy29]

Please note that this thread is not in the Politics area, so please refrain from potshots at individual politicians or political parties here. Thank you.

 

[FinanceDude]

SHoulda been posted there?

 

[M Paquette]

Translation: No longer allowing that lifetime cap of $5,000 means that those Giga-Life & Health policies are much more expensive, but they now provide actual catastrophic medical coverage.

Makes for a scary headline, though.

My insurance costs for medical coverage for a family of four look like about $17,000 for this year for all the policies combined assuming no surprises the next few months, and I'll probably see a 6-7% rise next year.

I have no lifetime cap, though, and the coverage exceeds the minimums for the new legislation (as does all my primary carrier's policies).

 

[chinaco]

You can bet that companies and people will be looking for ways to reduce those costs.

It would not surprise me to see HMOs make a resurgence in popularity if they can cut the premium cost.

 

[heardoc]

You can bet that companies and people will be looking for ways to reduce those costs.

It would not surprise me to see HMOs make a resurgence in popularity if they can cut the premium cost.

Sure are! Reducing provider and hospital reimbursements by 20- 30 %.
See how long that lasts. and HMO's cost cutting ways are fine if you don't care to see physicians. I like PAs and NP's/APRNs as well as the next guy, but I'd pay to see an MD/DO and with HMOs you won't get that choice until you've spent hours being seen by physician extenders.

 

[valsdad]

Well, we couldn't have insurance reform when we had few politicians with the guts to do it. We'll piddle along paying more than almost any other country in the world the same way we pay more for drugs, send our jobs overseas, and send our young people to prop up crooks in the name of "national security". Why? Because we're "exceptional".

 

[keegs]

My employer switched from Cigna to Anthem this year and my annual contribution to the plan (a PPO) dropped by approx $300.

My plan covers my wife and neither of us use the insurance very often but those at work who do (mostly those with children) report that the new Anthem plan is more trouble to use.

 

[dgoldenz]

My employer switched from Cigna to Anthem this year and my annual contribution to the plan (a PPO) dropped by approx $300.

My plan covers my wife and neither of us use the insurance very often but those at work who do (mostly those with children) report that the new Anthem plan is more trouble to use.

Never had a problem with Anthem on the claims side....but your rates for group coverage have nothing to do with rate increases in the individual market.

 

[ziggy29]

My employer switched from Cigna to Anthem this year and my annual contribution to the plan (a PPO) dropped by approx $300.

My plan covers my wife and neither of us use the insurance very often but those at work who do (mostly those with children) report that the new Anthem plan is more trouble to use.

The real problem today is the individual market, not so much the employer group market. I won't know what will happen to my share of the premiums in open enrollment starting in two weeks, but right now we're getting a better deal in my HDHP/HSA than in 2008 -- the premium is about the same and the company contribution to our HSA rose.

The reason usually cited is that with an employer group plan everyone generally gets enough of a subsidy to make participation almost universal (at least for those who don't have better spousal coverage). Plus, by definition just about all of the people in the employer plan are, well, still employed and can pay the premiums (those on COBRA being the exception).

With an individual plan you pay it all, so a lot of the younger and healthier folks are deciding to "go naked" in this economy (particularly those who are unemployed or underemployed), leaving the pool of insureds as being older and sicker than before -- hence the huge rate increases. In other words, adverse selection is hitting the individual market much harder than in the employer group market.

Now I don't know that I buy this as *all* of the reason, but it is indisputably a factor.

 

[MichaelB]

Lets see. My premium in 2007 $900.89. For the same policy, my premium in 2010 $1933.45.

So, what else is new?

 

[dgoldenz]

Lets see. My premium in 2007 $900.89. For the same policy, my premium in 2010 $1933.45.

So, what else is new?

Yikes. One of my clients I'm working on right now is paying $3000/month for a HDHP with a $6k deductible. That's $42k out of pocket before any benefits kick in.

 

[MichaelB]

The real problem today is the individual market, not so much the employer group market. I won't know what will happen to my share of the premiums in open enrollment starting in two weeks, but right now we're getting a better deal in my HDHP/HSA than in 2008 -- the premium is about the same and the company contribution to our HSA rose.

The reason usually cited is that with an employer group plan everyone generally gets enough of a subsidy to make participation almost universal (at least for those who don't have better spousal coverage). Plus, by definition just about all of the people in the employer plan are, well, still employed and can pay the premiums (those on COBRA being the exception).

With an individual plan you pay it all, so a lot of the younger and healthier folks are deciding to "go naked" in this economy (particularly those who are unemployed or underemployed), leaving the pool of insureds as being older and sicker than before -- hence the huge rate increases. In other words, adverse selection is hitting the individual market much harder than in the employer group market.

Now I don't know that I buy this as *all* of the reason, but it is indisputably a factor.

Well, our agent suggested that there is much less competition in the small and individual markets and insurance companies are engaging in “unspoken collusion”. To support this he showed us pricing charts of plans with similar benefit and coverage levels but different group sizes. The differences were minimal between insurers but substantial between group size – easily 50%. He went on to say the high profit in the small and individual policies was being used to subsidize a much more competitive large group marketplace.

 

[MichaelB]

Yikes. One of my clients I'm working on right now is paying $3000/month for a HDHP with a $6k deductible. That's $42k out of pocket before any benefits kick in.

Ours is HSA with $2500 in / $5000 out per person deductible.

 

[dgoldenz]

Well, our agent suggested that there is much less competition in the small and individual markets and insurance companies are engaging in “unspoken collusion”. To support this he showed us pricing charts of plans with similar benefit and coverage levels but different group sizes. The differences were minimal between insurers but substantial between group size – easily 50%. He went on to say the high profit in the small and individual policies was being used to subsidize a much more competitive large group marketplace.

I think your agent may have his tin foil hat on. The claims variation in the small group and individual market is much higher than the large group market. The larger the group, the greater the spreading of risk. The smaller the group, the greater the chance a few claims can have a massive impact on the overall group loss ratio for the year. A group of 5 people with one person having $1 million in cancer treatments will be a big loss for the insurance company. A group of 50,000 people with one person having $1 million in claims won't even make a dent in the loss ratio. Unless you're looking at the 60+ age range, individual market premiums are almost always lower than group.

 

[ziggy29]

He went on to say the high profit in the small and individual policies was being used to subsidize a much more competitive large group marketplace.

Not surprising. I think the employer group market is definitely more competitive and functional than the individual market. The individual market is largely broken and fractured. At best, it's very inefficient.

 

[dgoldenz]

Ours is HSA with $2500 in / $5000 out per person deductible.

Have you looked at raising your deductible? Sometimes raising it to $5k can reduce the premiums by more than the difference in deductibles. That's a pretty high rate for a $2500 deductible per person HSA plan unless it's a group policy or one or more people is on a HIPAA rate.

 

[sailor]

Sure are! Reducing provider and hospital reimbursements by 20- 30 %.
See how long that lasts. and HMO's cost cutting ways are fine if you don't care to see physicians. I like PAs and NP's/APRNs as well as the next guy, but I'd pay to see an MD/DO and with HMOs you won't get that choice until you've spent hours being seen by physician extenders.

I'm curious how prevalent this practice is - At Georgia & California Kaiser facilities you can schedule your appointment either with MD or NP/PA/CNM.

 

[ziggy29]

I'm curious how prevalent this practice is - At Georgia & California Kaiser facilities you can schedule your appointment either with MD or NP/PA/CNM.

Kaiser is a fairly unusual setup in the U.S. health care market. People either love its model or they hate it. (I had it when I lived in California.)

For what it's worth, Kaiser fully covered my wife's jaw surgery in 2000 to correct an overbite likely to lead to TMJ problems down the road. Many other plans wouldn't cover that, but a consultation with a Kaiser doctor led him to decide the surgery was medically necessary, and that was the end of it.

 

[MichaelB]

I think your agent may have his tin foil hat on. The claims variation in the small group and individual market is much higher than the large group market. The larger the group, the greater the spreading of risk. The smaller the group, the greater the chance a few claims can have a massive impact on the overall group loss ratio for the year. A group of 5 people with one person having $1 million in cancer treatments will be a big loss for the insurance company. A group of 50,000 people with one person having $1 million in claims won't even make a dent in the loss ratio. Unless you're looking at the 60+ age range, individual market premiums are almost always lower than group.

I get that. The risk of any individual small group of 10 is quite high. Therefore, each group is priced to that high risk.

The risk profile of insuring one million people is similar as one group, one thousand groups or one million groups. Insurance companies can define the groups any way they want to, and then price accordingly. The fact that the large insurers have all chosen the same method with the same pricing structure point to collusion. The fact that there are such large differences between big group and small group policies point to oligopolistic practices. I don't think there is any tin foil here, just insurance companies acting freely in a poorly regulated area.

 

[dgoldenz]

I get that. The risk of any individual small group of 10 is quite high. Therefore, each group is priced to that high risk.

The risk profile of insuring one million people is similar as one group, one thousand groups or one million groups. Insurance companies can define the groups any way they want to, and then price accordingly. The fact that the large insurers have all chosen the same method with the same pricing structure point to collusion. The fact that there are such large differences between big group and small group policies point to oligopolistic practices. I don't think there is any tin foil here, just insurance companies acting freely in a poorly regulated area.

If we got rid of group insurance altogether would be a step in the right direction...fat chance though.

 

[keegs]

Never had a problem with Anthem on the claims side....but your rates for group coverage have nothing to do with rate increases in the individual market.

my understanding is that under the new healthcare reform bill, everyone should have the advantage of accessing insurance at group rates...of course that's if it's not repealed.

I'm wondering whether the reduced premium had something to do with Anthem getting the account. I think we're 80k employees.

 

[dgoldenz]

my understanding is that under the new healthcare reform bill, everyone should have the advantage of accessing insurance at group rates...of course that's if it's not repealed.

I'm wondering whether the reduced premium had something to do with Anthem getting the account. I think we're 80k employees.

Large groups like that are usually negotiated instead of having prices set already. Everyone will have the advantage of accessing insurance at group rates, but that doesn't mean everyone can afford it. Group rates are very expensive compared to individual in most states outside the 60-64 age bracket. Most of my clients would drop their coverage altogether if they had to pay $1000+/month for a family plan. They struggle paying $400-500/month as it is.

 

[MichaelB]

If we got rid of group insurance altogether would be a step in the right direction...fat chance though.

You mean just one large risk pool? That would make everything a lot simpler. I think that's one of the reforms we're trying to pass, although it seems we're going about it the same way a drunk walks home from the bar - staggering every which way with sudden lurches left and right. We also may end up like the drunk ... in a ditch somewhere.