2014 preliminary individual health insurance rates announced in Vermont

[pb4uski]

Vermont Health Connect put out preliminary rate filings today. To the best of my knowledge they are the first state to publish preliminary rates.

Preliminary Rate Filings for Vermont Health Connect

Vermont Health Connect is the marketplace for individuals, families, and small businesses to compare and purchase qualified private health insurance plans, determine eligibility for and enroll in public health insurance plans, and access tax credits and financial assistance. In October 2013, Vermont Health Connect will open for Vermonters to enroll in health coverage that will take effect in January 2014.

see Preliminary Rate Filings for Vermont Health Connect | Department of Financial Regulation

and http://www.dfr.vermont.gov/sites/default/files/Filed QHP rates.pdf

These rates broadly seem to be about $100 a month more than what I currently pay but it is hard to make a direct comparison because my deductibles are higher.

The rates are significantly lower than those suggested by the Berkeley calculator but California has much higher costs in general than Vermont so perhaps there is some hope that the dramatic increases we have been fearing are overstated.

 

[Mulligan]

Interesting info PB. I wonder what age bracket these figures are referring to? Numbers appear more reasonable until I look at $300 for an under 30 catastrophic plan, and a bronze plan only being $70 more. Makes me wonder these numbers aren't for younger people? I couldn't imagine some 29 yr old paying $300 for a catastrophic plan and a 50 year old being able to pay $370 for a bronze plan. As the data leaks out it gets more interesting.

 

[pb4uski]

I'm trying to understand that. I pulled up the proposed rates for the BCBS and page 50 of the filing has proposed rates by tier and the rates used in the summary seem to tie back to the Tier 1 rates.

The only thing is that at this point I don't know what each Tier means and what Tier I would fall into.

See http://www.dfr.vermont.gov/sites/default/files/Filed QHP rates.pdf

Edit: Found out Tier 1 is single, Tier 2 is couple, Tier 3 is head of household with one or more children and Tier 4 is family with two parents and one or more children

 

[pb4uski]

Interesting info PB. I wonder what age bracket these figures are referring to? Numbers appear more reasonable until I look at $300 for an under 30 catastrophic plan, and a bronze plan only being $70 more. Makes me wonder these numbers aren't for younger people? I couldn't imagine some 29 yr old paying $300 for a catastrophic plan and a 50 year old being able to pay $370 for a bronze plan. As the data leaks out it gets more interesting.

From what I can tell the premiums are not age rated. On page 38 of the BCBS filing I found the following reference:

BCBSVT developed the table of rates without regard to age, tobacco use or geographic area, as required under the Vermont community rating law, and so the requirements listed in 45 CFR 154.301(a)(4)(v) and (xiv) do not apply.

which suggests that the rates don't vary by age. IIRC they do currently. I'm not sure whether that has been changed or if the premiums by age will follow later. I suspect the former.

Edit: My current rate is a small group rates and does not vary by age. I think what I recalled was when I was shopping for individual coverage the premium did vary by age.

 

[Mulligan]

Once I turned 55, I could certainly swallow those premiums until Medicare and not be disappointed.

 

[MichaelB]

Great link. Thanks!

+1 @ mulligan. I too could live with those rates.

 

[dgoldenz]

We'll see how long those rates last when all of the young people refuse to pay that much for health insurance. There is no way I could even sell the "catastrophic" plan to younger families @ $700-800/month. Thanks for the link though.

 

[NoOneGetsIt]

assume these rates are before subsidies?

 

[pb4uski]

assume these rates are before subsidies?

Yes.

 

[Calico]

I'm trying to understand that. I pulled up the proposed rates for the BCBS and page 50 of the filing has proposed rates by tier and the rates used in the summary seem to tie back to the Tier 1 rates.

The only thing is that at this point I don't know what each Tier means and what Tier I would fall into.

See http://www.dfr.vermont.gov/sites/default/files/Filed QHP rates.pdf

Edit: Found out Tier 1 is single, Tier 2 is couple, Tier 3 is head of household with one or more children and Tier 4 is family with two parents and one or more children

Thank you for posting this information; it is very helpful. If the rates in my state end up looking anything like those in Vermont, it will be encouraging.

Last week my employer announced they "can't make any promises" that we will have our jobs in a few months, so my interest in the eventual PPACA rates has suddenly skyrocketed.

 

[marko]

I would gladly pay these rates!! (a third of what I'm paying now)

Factor in a subsidy and....Gee...and VT is only 110 miles away....hmmmmmmm.

 

[gerrym51]

I would gladly pay these rates!! (a third of what I'm paying now)

Factor in a subsidy and....Gee...and VT is only 110 miles away....hmmmmmmm.

Marko,
you live in mass. unless you move the only thing that counts is the mass connector.

 

[pb4uski]

I would gladly pay these rates!! (a third of what I'm paying now)

Factor in a subsidy and....Gee...and VT is only 110 miles away....hmmmmmmm.

Plenty of room up here for LBYMers!! Certainly lower cost of living than MA IMO.

 

[marko]

Marko,
you live in mass. unless you move the only thing that counts is the mass connector.

I either mis-read or mis-understand the chart. I was looking at a $739 monthly premium for a couple on a BCBSVT Bronze.

I have BCBS now and ... don't I wish it were $739!!! Even if I drop down to a bronze type plan, it looks like it would set me back about $1500 (unless, of course, I'm reading that chart incorrectly as well...which seems to happen more and more often)

 

[Live And Learn]

See page 39 of this doc http://www.dfr.vermont.gov/sites/default/files/BCVT-128957017.pdf

Seems the coinsurance is 40% for the Silver plan. I believe both the Kaiser and the Berekely site said that silver would be 30% (or did I dream that up ?? I can't find it anymore !)

 

[Midpack]

Once I turned 55, I could certainly swallow those premiums until Medicare and not be disappointed.

I too could live with those rates.

I would gladly pay these rates!!

+1. I'd be thrilled to pay those rates too, what I've seen has been much higher (more like $1500-1700/mo w/o subsidies for a couple) from a calculator link in an earlier thread here. Glad we have DW's employer coverage into summer 2014 or so, assuming we'll all have a better idea how this will shake out (at least to start).

 

[pb4uski]

See page 39 of this doc http://www.dfr.vermont.gov/sites/default/files/BCVT-128957017.pdf

Seems the coinsurance is 40% for the Silver plan. I believe both the Kaiser and the Berekely site said that silver would be 30% (or did I dream that up ?? I can't find it anymore !)

I haven't been paying much attention to plan definitions but I think the difference between gold, silver, bronze is based on a measure that they call Actuarial Value or AV that looks at the net effect of all of the plan's cost sharing features (not just co-pays). Further, there is an independent actuarial certification included in the filing where an independent actuary certifies that the AV satisfies the criteria for the level of the plan.

Also see http://www.kff.org/healthreform/upload/8303.pdf

 

[Live And Learn]

40% coinsurance is ridiculous high - we'll be hitting those out of pocket maximums more often then we thought !

 

[gerrym51]

40% coinsurance is ridiculous high - we'll be hitting those out of pocket maximums more often then we thought !

i think its 40 percent for bronze,30 percent for silver,20 percent for gold, 10 percent for platinum

 

[pb4uski]

40% coinsurance is ridiculous high - we'll be hitting those out of pocket maximums more often then we thought !

For that plan, you would need $8,125 in covered medical costs (at the negotiated rates) to hit the medical OOPM. I know that DW and I haven't come close to that amount in the last few years, but we have been relatively healthy. That said, if one had any major illness you could get to the OOPM pretty quick.

 

[Mulligan]

For that plan, you would need $8,125 in covered medical costs (at the negotiated rates) to hit the medical OOPM. I know that DW and I haven't come close to that amount in the last few years, but we have been relatively healthy. That said, if one had any major illness you could get to the OOPM pretty quick.

That would be my plan as I currently have a $5500 deductible anyway, so I am used to rolling the dice on OOPM. I am more worried about the premium as Lipitor, Flomax, and Viagra will all be generic soon enough. What else could a typical guy currently not on meds need down the road?

 

[gerrym51]

That would be my plan as I currently have a $5500 deductible anyway, so I am used to rolling the dice on OOPM. I am more worried about the premium as Lipitor, Flomax, and Viagra will all be generic soon enough. What else could a typical guy currently not on meds need down the road?

lipitor and flomax are already generic have been for at least two years.

 

[Mulligan]

lipitor and flomax are already generic have been for at least two years.

That's good to know! Now I just need the other one, and I may never reach my deductible. Wait, I bet they won't even count the other one as part of my deductible.

 

[Live And Learn]

For that plan, you would need $8,125 in covered medical costs (at the negotiated rates) to hit the medical OOPM. I know that DW and I haven't come close to that amount in the last few years, but we have been relatively healthy. That said, if one had any major illness you could get to the OOPM pretty quick.

Doesn't need to be a major issue. I had carpel tunnel outpatient surgery, a 15 minute procedure. The negotiated rates for everything needed was $3500.

 

[pb4uski]

Doesn't need to be a major issue. I had carpel tunnel outpatient surgery, a 15 minute procedure. The negotiated rates for everything needed was $3500.

Isn't that absolutely bloody ridiculous!