Last week Covered California announced the 2015 plan rates. Good news: prices stayed low with a modest 4.2% increase statewide and even rate decreases in some area.
The price changes vary across regions. San Francisco and Orange will see higher rate increases (6.6% and 6.3%, respectively), while Alameda (2.8%) and Santa Clara (1%) will see lower increases that the state average. The San Joaquin, Stanislaus, Merced, Mariposa, and Tulare region even gets a rate decrease of 1.9%.
The new prices will impact consumers differently, particularly given that subsidy amounts will shift for many individuals. When premium assistance is factored in, prices actually decreased for some consumers between 2014 and 2015. For example, in Napa County, the average cost of a silver plan for a 40-year-old individual at 200% FPL decreased from $131 to $123.
It’s clear that carriers used different strategies in bidding this year. Case in point: Los Angeles, region 16. Anthem HMO, Health Net HMO, and Molina Healthcare average rates stayed roughly flat with minimal increases up to 3.4%. Blue Shield and Health Net EPO increased moderately (6 and 8.4%, respectively), while Anthem EPO and L.A. Care increased substantially (11.5% and 12.5%). The curve ball is Kaiser, which decreased rates on average by 8.5%, up to 14% for some consumers! These changes could prompt current enrollees to reexamine their choices and competitive options, weighing price with continuity of care.
Here are Covered California’s estimates for the rate changes on consumers who stick with their current plan:
- 16% of consumers will see their premium of their current plan stay the same or decrease
- 35% will see premiums increase less than 5%
- 35% will see premium increase between 5-8%
- 13% will see premium increase 8%+
Not much will change in benefits in 2015. The carrier options will remain the same, with the exception of the departure of Contra Costa Health Plan due to federal regulations requiring insurers to offer the same plans inside and outside the Exchanges. Anthem Blue Cross’ EPO is now a ‘multi-state plan’ in Silver and Gold and Health Net will offer an EPO in Bronze & Catastrophic. The tier structure will be virtually unchanged, with slight decreases in the copay for generic drugs and the out-of-pocket maximum for Bronze, Silver, and Gold plans.