Health Insurers Propose “Affordable Care Act” (ACA) Premium Rates for 2020

[Editor]

BALTIMORE – Health insurance carriers are seeking a range of changes to the premium rates they will charge consumers for plans sold in Maryland’s “Individual Non-Medigap” (INM) and “Small Group (50 or fewer contracts)” (SG) markets in 2020. The rates submitted by the carriers for the INM market include the estimated impacts from the state-based reinsurance program (SBRP) enacted in 2019 via a 1332 State Innovation Waiver (approved by the Centers for Medicare & Medicaid or “CMS”).

The Maryland Insurance Administration (“MIA”) has posted rate filing documents at www.healthrates.mdinsurance.state.md.us. On that website, consumers can review filings and submit comments, as well as find answers to frequently asked questions about the rate review process. A detailed set of exhibits are attached that outline all proposed rates submitted by carriers, to include stand-alone dental coverage.

“We are pleased with the rates that have been requested. It is obvious that the federal waiver and reinsurance plan crafted by Governor Hogan and the legislature have provided the positive results as intended,” said Insurance Commissioner Al Redmer, Jr. ”It’s important to remember that these rates are what companies have requested, and not necessarily what will be approved. There will be a thorough review of all the filings. As in years past, we may require changes.”

In Maryland, for health benefit plans, only those rates approved by the Insurance Commissioner may be charged to policyholders. Before approval, all filings undergo a comprehensive analysis of the carriers’ analyses and assumptions. Public comments are considered as part of the review process. By law, the Commissioner must disapprove or modify any proposed premium rates that appear to be inadequate or excessive in relationship to the benefits offered, or are unfairly discriminatory. The MIA expects to issue decisions about rates for 2020 INM and SG products no later than mid-September. A public meeting will be held on July 16, 2019 from 2 p.m. – 4 p.m. at the Maryland Insurance Administration to seek comments on the proposed rate filings; a notice will be forthcoming.

SUMMARY OF PROPOSED RATES FOR 2020

For the INM market, carriers filed an average annual rate decrease of 2.9% affecting 202,400 members. Despite the average rate decrease, preliminary estimates indicate that subsidies could still increase. Carriers proposed the following average rate changes in the (INM) market:

• CareFirst BlueChoice Inc. HMO – a -8.9% decrease;
• CareFirst of Maryland Inc. and Group Hospitalization and Medical Services Inc. (GHMSI) (both CareFirst companies) PPO – a +9.1% increase;
• Kaiser Foundation Health Plan of the Mid-Atlantic States HMO – a +3.9% increase.

Exhibits 1 and 1A provide further detail and context.

For comparison purposes, below are the proposed monthly premium rates, before any subsidies, for a 40-year-old, non-smoker in the Baltimore metropolitan area who buys the lowest-cost Silver plan, Off-Exchange.

CARRIER	CareFirst BlueChoice	CareFirst of MD and GHMSI	Kaiser
Monthly Proposed Premium	$364	$693	$366
Type of Network	HMO	PPO	HMO
lndividual Deductible	$2250	$3000	$6000

For the SG market, carriers filed an average annual rate increase for the full year of +4.3% affecting 267,827 members. Rates can change on a quarterly basis and some employers contribute towards their employees’ premiums. The proposed average rate changes below are for plans that begin in the first quarter of 2020.

• Aetna Health Insurance Inc. HMO – a +15.5% increase;
• Aetna Life Insurance Inc. PPO – a +14.5% increase;
• CareFirst BlueChoice Inc. HMO – a +0.6% increase;
• CareFirst of Maryland Inc. and GHMSI PPO – a +8.4% increase;
• Kaiser Foundation Health Plan of the Mid-Atlantic States Inc. HMO – a +10.0% increase;
• MAMSI Life and Health Insurance Co. (a UnitedHealthCare company) EPO – a +12.4% increase;
• United Healthcare Insurance Co. PPO – a +10.9% increase;
• UnitedHealthcare of the Mid-Atlantic HMO – a +6.9% increase; and
• Optimum Choice (a UnitedHealthCare company) HMO – a +12.3% increase.

Exhibits 2 and 2A provide further detail and context.

For comparison purposes, below are the proposed monthly premium rates for 1Q20, before any employer contributions, for a 40-year-old, non-smoker in the Baltimore metropolitan area who buys the lowest-cost Silver plan, On or Off-Exchange.

Carrier	Aetna Health	Aetna Life	CareFirst BlueChoice	CareFirst of MD and GHMSI	Kaiser	UHC MAMSI	United HealthCare	UHC Mid-Atlantic	UHC Optimum Choice
Monthly Proposed Premium	$493	$525	$328	$437	$281	$327	$345	$281	$296
Type of Network	HMO	PPO	HMO	PPO	HMO	EPO	PPO	HMO	HMO
Individual Deductible	$6000	$6000	$3000	$2000	$4000	$5000	$5000	$5000	$4500

Rates being reviewed by the MIA do not affect health insurance plans offered by large employers or employees who self-insure, “grandfathered” plans purchased before March 2010, or federal plans such as Medicare, Tricare and federal employee plans.

About the Maryland Insurance Administration

The Maryland Insurance Administration (MIA) is an independent State agency charged with regulating Maryland’s $28.5 billion insurance industry. For more information about the MIA, please visit www.insurance.maryland.gov or follow us on Facebook at www.facebook.com/MDInsuranceAdmin or Twitter at @MD_Insurance or LinkedIn at https://www.linkedin.com/company/432297/admin/ or Instagram at @marylandinsuranceadmin.

 

[vraiblonde]

They're pricing health insurance so that people can't afford it. Oh! Hey! Let's make "the government" pay for our health insurance!!

 

[GWguy]

Wow. I feel really fortunate to have retiree plans available to me. I just contracted to CareFirst high deductible ($2200) Medigap plan for $28/mo.

On the downside, I have to pay Medicare Part B premiums at $185/mo.

 

[stgislander]

An 8.9% decrease is better than an increase. I wouldn't be surprised though if my deductible increased to offset the rate decrease.

 

[David]

Keep in mind that the example rates cited are for a 40-year-old, non-smoker in the Baltimore metropolitan area who buys the lowest-cost Silver plan, Off-Exchange. The rate cited above for BlueCross is $364/mo with a $2250 deductible.

I am older, non-smoker, non-drinker, healthy BMI living in a rural area and the 2019 rate for a Bronze plan (the cheapest) is almost $700/mo with a $7900 deductible. It was around $80/mo higher the year before, but they increased the deductible from $6900 (I think) to $7900 because of the outrage over the then proposed 90% premium increase that would have come otherwise.

Before ObamaCare, I had a nice catastrophic care policy which provided everything I needed, and an HSA account, for $183/mo with a $5000 deductible. And of course, in the government's wisdom, you can't contribute to a tax deductible HSA to fund your own healthcare unless you also buy ObamaCare.

 

[David]

Let's make "the government" pay for our health insurance

Well, when they do manage to get Medicare for all, I guess the premiums will automatically be drafted from your taxes, so you'll have a say what-so-ever. I imagine it would have to be based on a percentage of your income, like the current Social Security and Medicare taxes. So, the less you make the less you pay and conversely.

However, with current SS taxes, the estimate I found is that it takes 2.8 taxpayers to fund each current retiree. But, since the new tax would be funding you and those who get it for free, I imagine the new tax would have to be at least 3X the current SS tax rate...probably more. I am on the right track here? Of course, presumably you won't have to pay your current premiums anymore, for those who don't get it 100% provided by the employer. But, I have to imagine that our fine politicians will bastardize things further and embed all kinds of insurance gaps that require additional "private" policies, similar to the current Medicare mess.

 

[David]

I wouldn't be surprised though if my deductible increased to offset the rate decrease.

That's exactly what they did in 2019, at least with Bronze. Went up $1000.

 

[stgislander]

I almost signed-up for a medical cost sharing program last year. The only reason I didn't was both the wife and my premiums went down this year. Unfortunately she also lost her separate prescription deductible, so since January she's racked up over $1000 in prescription drugs.

 

[stgislander]

I just have to make it to 60 then Tricare (or whatever it is called now) kicks in.

 

[Gilligan]

I just have to make it to 60 then ...

It's a good plan...