Proposed Marketplace Premiums Spike; Individual Plans Vary

Four out of the six insurance companies planning to offer coverage to Hoosiers through the federal healthcare exchange next year are proposing double-digit rate increases for individual premiums, according to proposals filed with the Indiana Department of Insurance.

However, the proposals vary widely. For example, Celtic is proposing a 5 percent drop in prices, and Anthem wants an almost-30 percent increase.

Those scattered numbers are partly a reflection of the marketplace right now, says Tony Nefouse of Indianapolis brokers Nefouse & Associates. He says insurance companies still haven’t balanced the federal insurance mandate with the fact they can’t deny coverage.

The rate increases, he says, are based on “the last couple years of the insurance industry learning how to navigate with the government programs. So you have only a few years of claims that the insurance industry is basing off what the premiums should be.”

However, what the actual rates will be is still up in the air. After all, an average is just that…an average.

For example, Nefouse says within Anthem’s 29-percent price hike proposal, individual policy prices could go up much more…or less.

“You’ll see that they can range anywhere from 19 to 41 percent depending on county depending on plan design, so your averages really do not show the whole picture,” he says.

Earlier this month, health consultant agency Avalere released a report that says many Hoosiers buying health coverage through the federal market won’t see a big change, with those receiving coverage through the low-cost Silver plans looking at something closer to a 6-percent average increase.

Two companies dropped out of the federal exchange for Indiana this year, but one large insurer, Aetna, has submitted proposed rates to the IDOI, indicating they’d like a seat at the table.

In a federal report disputing the reasoning behind insurance companies’ 2016 double-digit rate increases, US Health and Human Services officials say premium spikes might not be so high for the typical consumer who’s vigilant about shopping around for the best plan and receiving tax credits. 81-percent of Hoosier marketplace consumers receive such credits.