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STATE’S LARGEST INSURER SEEKS 9.8 PERCENT INCREASE IN HEALTH EXCHANGE PREMIUMS

Vermont’s largest health insurer is asking state regulators to approve an average 9.8 percent increase in premiums for plans it offers through the state’s federally mandated exchange.

Blue Cross Blue Shield of Vermont said Monday the increase is needed to cover rising medical and pharmaceutical costs for their members and increased federal fees charged to insurers as part of the Affordable Care Act.

If the Green Mountain Care Board, which is responsible for reviewing and approving the exchange rates, signs off on Blue Cross’ request, monthly premiums for the six standard plans it offers on Vermont Health Connect would go up between $20 and $70 in 2015.

In last year’s rate review process Blue Cross’ requests for exchange plan prices were revised down an average of 4.2 percent by the board.

MVP Health Care, the other insurer offering coverage through the exchange, did not provide its rate request filings or return calls for comment by publication time Monday. The filings are public record and had to be submitted to the Green Mountain Care Board by Monday. The filings for both companies will be posted on the board’s website Tuesday, said Susan Barrett, the board’s executive director.

Don George, CEO of Blue Cross and Blue Shield of Vermont, supported the decision to extend existing health care plans beyond Jan. 1. Photo by Andrew Stein/VTDigger
Don George, CEO of Blue Cross and Blue Shield of Vermont. VTDigger file photo

“We recognize that this increase is likely to be difficult to absorb for many members who receive their coverage through Vermont’s new exchange products, and we have done everything we can to reduce it,” Blue Cross CEO Don George said in a statement released Monday.

“We also understand the importance of adequately funding our health care system, to keep it strong and accessible. And since the factors driving this rate increase are almost entirely related to federal policy changes and increases in prices paid to medical providers in Vermont, there is no way to further reduce these rates without underfunding the health care coverage on which Vermonters rely.”

According to a breakdown of the rate request provided by Blue Cross, almost 5 percent of the overall 9.8 percent increase is to cover federal charges associated with the Affordable Care Act. Some of those charges are used to pay for the subsidies provided through the new law, which make exchange insurance products more affordable for low-income people.

Payments to providers are expected to increase 4.8 percent in 2015, according to Blue Cross, an increase that flows directly to premiums. That increase is regulated, in part, by the state because the Green Mountain Care Board must approve hospital budgets.

Another 1.3 percent of the requested increase is to cover additional child dental services required by the state and to keep other costs associated with a health plan from rising. The out-of-pocket costs, such as co-pays, coinsurance and deductibles associated with exchange plans will not go up, said Kevin Goddard, vice president of external relations for Blue Cross.

Goddard said that Blue Cross reduced its administrative fees as a percentage of premiums to keep the rates from going up further.

The company used “very aggressive assumptions” in compiling its rates, and went with the lower end of the acceptable rate increase range developed by its actuaries, Goddard said. The rates assume that people new to the individual and small group market will be healthier and use less health care services, he said.

The Green Mountain Care Board has 90 days to review, possibly adjust and then approve the rate requests of the two carriers. The new rates will take effect in January.

Blue Cross covers close to 200,000 Vermonters – almost one-third of the state’s population – and covers just over half the individual and small group market enrolled in private insurance through Vermont Health Connect exchange.

There are 35,037 people who bought exchange health plans from Blue Cross, covering 57,876 lives. The total number of commercial health plans purchased during the exchange’s first year of operation was 60,835.

The state does not report coverage through Vermont Health Connect in lives covered, so the total population covered through the exchange can’t be known without numbers from MVP.

MVP was able to compete with Blue Cross in the exchange marketplace, possibly because the company was able to offer a less expensive standard bronze plan. Blue Cross offered lower rates for the other five standard plans.

Twenty percent of plans purchased on the exchange were bronze, making it the most popular after the silver, which accounted for 52 percent of purchased plans, according to figures from the state.

The standard plans are platinum, gold, silver and bronze, with two high-deductible plans at the silver and bronze levels. The platinum plans have the highest premiums and provide the best benefits, and scale down to bronze, with lower premiums and fewer benefits.

http://vtdigger.org/2014/06/02/states-largest-insurer-seeks-9-8-percent-increase-health-exchange-premiums/
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Avatar universal
VT's second insurer (out of 2)

Where are the savings?
The second insurance provider participating in Vermont’s health exchange has requested a 15.4 percent increase in its average annual premiums for 2015.

MVP Health Care submitted the rate request in a filing with the Green Mountain Care Board on Monday. Blue Cross Blue Shield of Vermont, the other participant in Vermont Health Connect, requested a 9.8 percent average increase.

MVP’s proposal would increase the monthly, unsubsidized premium for a single person buying its silver plan by $76.84, or 18 percent, over the 2014 rate. The monthly cost of MVP’s lowest-cost plan, the bronze, would increase $61.59, or 18.3 percent, under the proposal.

The cost of MVP’s two high-deductible plans, silver HD and bronze HD, would go up the least at 10.7 percent and 10.8 percent, respectively.

MVP’s request cited the cost of prescription drugs among the reasons for the sharp increase, as did Blue Cross’ filing.

“We understand that a premium is more than a number, and that any increase will directly affect individuals who purchased coverage on Vermont’s health insurance exchange. Sadly, the rapidly-rising price of health care services in Vermont, coupled with a sharp hike in prescription drug costs, federal taxes, and an enormous slash in federal reimbursement rates, make the economics of providing coverage unsustainable in 2015 without premium increases,” MVP Interim CEO Karla Austen said in a statement. “In the next few months, MVP is committed to working with the Green Mountain Care Board to review our proposal in depth.”

The Green Mountain Care Board has 90 days to review and adjust the rate requests, which take effect Jan. 1.
http://vtdigger.org/2014/06/03/mvp-seeks-15-4-average-increase-2015-health-exchange-premiums/
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Not making that nut?
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