Health Insurance Premiums


CA Insurance Commissioner: Insurers Fear Prop. 45, Will Keep Health Rates Low

(Getty Images)

(Getty Images)

A new analysis from the Department of Insurance confirms what has been reported since the Covered California exchange opened last October: Some people saw steep premium increases after the rollout of the Affordable Care Act.

According to the department’s analysis non-subsidy eligible individuals saw average increases ranging from 22 to 88 percent, depending on their age and where they lived. The review was done of all health plans — including those managed for the Department of Managed Health Care — and looked at premiums from California’s four largest carriers, Anthem Blue Cross, Kaiser, Blue Shield and Health Net.

The release appeared to be politically timed. Covered California’s rates for next year are due on Thursday, and the rumble is that new premiums will show only modest increases. Continue reading

Why Some Don’t Pay Their Covered California Premium: It’s Not What You Think

(Getty Images)

(Getty Images)

A new analysis finds that many people who signed up for a Covered California plan are likely to drop the coverage for a good reason: they found insurance elsewhere.

Researchers at the U.C. Berkeley Labor Center released estimates Wednesday showing that about 20 percent of Covered California enrollees are expected to leave the program because they found a job that offers health insurance. Another 20 percent will see their incomes fall and become eligible for Medi-Cal, the state’s insurance program for people who are low income.

In addition to the 40 percent of enrollees who move to Medi-Cal or job-based insurance, between 2 and 8 percent of those who sign up for Covered California are estimated to become uninsured, the analysis noted.

20 percent of Covered California enrollees are estimated to move to job-based insurance over the year.
This process — “churn” to those who study health insurance — is well-known in the Medi-Cal and individual insurance market.

Between 53 and 58 percent of Covered California enrollees are expected to stay in a Covered California plan for 12 months, according to the report. This analysis is consistent with a Kaiser Family Foundation study published earlier this year which found that of people who enrolled in an individual insurance plan in 2010, about 48 percent were still in the individual market two years later. Continue reading

Health Insurers Extend Deadline for February Premiums, Too

(Getty Images)

(Getty Images)

Covered California says that yesterday was the deadline to pay your February premiums. But some of California’s biggest insurers have extended their deadlines.

Here are new dates for three major carriers:

  • Blue Shield: deadline is Friday, Feb. 14 for people who signed up for coverage starting Feb. 1.
  • HealthNet: For people who signed up for coverage beginning Feb. 1, you have until Feb 15 to make your first premium payment. You can pay by phoneContinue reading

Anthem Blue Cross, Kaiser Extend Deadline to Pay Insurance Premiums

(Getty Images)

(Getty Images)

By April Dembosky and Lisa Aliferis

If you signed up for a Covered California plan by the Dec. 23 deadline, Wednesday is the official deadline to pay your January premium.

That is, unless you are an Anthem Blue Cross or Kaiser Permanente customer — in which case you have a little more time.

  • If you’re a Kaiser member, you have until Jan. 22 to pay your January premium
  • If you’re an Anthem Blue Cross customer, you have until Jan. 31 (Update: On Jan. 16, HealthNet also extended its deadline to Jan. 31.)

If you’re in one of the other nine plans available statewide, you must pay your premium by midnight Wednesday night. Continue reading

Some Covered California Plans Narrow Your Choice of Doctors, Hospitals

(Joe Raedle/Getty Images)

(Joe Raedle/Getty Images)

By Pauline Bartolone, Kaiser Health News

When Diane Shore got a letter that her health policy would be canceled, the small premium increase for a new plan didn’t bother her that much. What she’s really troubled by is: “My physicians will no longer be in this network of physicians, or the hospitals won’t be as well.”

“There isn’t something that says: ‘Alert. Be aware. Take action now to be sure this works for you.”

Sixty-two year old Shore owned an IT consulting business in the San Francisco Bay Area, and retired when she sold her business in 2000. She says she wants to stick with the providers that she’s had for years, including the surgeon who operated on her for breast cancer in 1998.

“I have full confidence in her,” she says. “And my primary care doctor has been my primary care doctor for 20 years.”

In Shore’s case, the problem is that the Blue Shield of California plan being offered limits her choice of doctors and hospitals just to Marin County, where she lives, just north of San Francisco. But, she says, “All my doctors are in San Francisco. I live 20 minutes from San Francisco. In fact, it’s more convenient for me to go to San Francisco than to the hospital here in Marin County.” Continue reading

How the Affordable Care Act Is Supposed to Pay for Subsidies


(Getty Images)

(Getty Images)

By John Ydstie, NPR

The new health care law will provide around $1 trillion in subsidies to low- and middle-income Americans over the next decade to help them pay for health insurance.

Johanna Humbert of Galien, Mich., was pleasantly surprised to discover that she qualifies for an insurance subsidy, since her current plan is being canceled. Humbert makes about $30,000 a year, so she’ll get a subsidy of about $300 a month. The new plan is similar to her current one, but it will cost $250 — about half of what she pays now.

But where will the money come from to pay for subsidies like these?

On his show last Friday, liberal comedian Bill Maher called the Affordable Care Act a “Robin Hood” plan. “It does take from the rich to make better the poor,” he said.

You can certainly make a case for that, says economist Joseph Antos of the American Enterprise Institute. “In a general sense, the rich, of course, subsidize the poor. The rich pay more income taxes,” he says. “So, yes, absolutely, that’s how subsidies are supposed to work.” Continue reading

Why California’s Obamacare Premiums Are Lower Than Expected

Dan Diamond, California Healthline

(Getty Images)

(Getty Images)

No Aetna. No United.

No Cedars-Sinai.

Covered California’s list of participating health care providers and insurers is out, and it’s possibly more notable for who isn’t partaking in the state’s new health insurance exchange rather than for who is.

The reasons for the big-name absences are manifold, ranging from payer strategy to high hospital prices to even accusations of gamesmanship. And they help explain the caution that — despite news that premiums will be far lower than expected — the exchange transition may be bumpier than some early, optimistic reports suggest.

Why Top Payers are Absent

According to representatives for Aetna, United and Cigna, the firms are sitting out California’s exchange because they’re taking a wait-and-see approach.

“We are simply taking the time to carefully evaluate and better understand how the exchanges will work to ensure we are best prepared to participate meaningfully in their development,” a United spokesperson told Chad Terhune at the Los Angeles Times. Continue reading

Calif’s Health Insurance Exchange Sets Plans, Premiums; No Apparent ‘Rate Shock’


(Joe Raedle/Getty Images)

Update: Aug. 7, 2013: Covered California announced Wednesday that 12 insurance companies have formally signed contracts with the agency to offer plans on the new marketplace. Since the initial announcement (below), one company, Ventura County Health Plan, has withdrawn from offering coverage on the marketplace. The following companies will offer plans on the marketplace, although not all companies will offer plans in every region of California:

·      Alameda Alliance for Health

·      Anthem Blue Cross of California

·      Blue Shield of California

·      Chinese Community Health Plan

·      Contra Costa Health Plan

·      Health Net

·      Kaiser Permanente

·      L.A. Care Health Plan

·      Molina Healthcare

·      Sharp Health Plan

·      Valley Health Plan

·      Western Health Advantage

Last week, Covered California announced tentative plans and premiums for its small business marketplace, also called SHOP.


The state’s health insurance exchange, Covered California, announced Thursday morning the plans and premiums that will be available to millions of Californians.

And what everyone wants to know is: how much will it cost. Experts had warned of “rate shock,” that premiums might skyrocket for all kinds of reasons. That has not happened.

Covered California says that individuals will pay an average premium of $321 per month for a “silver” plan. (More on silver plans below.) Many people will be eligible for subsidies to reduce that cost further.

Across the state, people who had been working toward this day seemed to heave a collective sigh of relief.

“This is a home run for consumers in every region of California,” said Peter Lee, executive director of Covered California, in a release to reporters. “Californians should be proud of how not only health plans in this state, but doctors, medical groups and hospitals have stepped up — creating a market that will allow millions of consumers to enroll in affordably priced products.”

Charles Bacchi, executive vice president with the California Association of Health Plans called it an “important day” and commended both insurance companies and providers for working together “to deliver quality, affordable health care. We couldn’t have done this without providers willing to join us to make the Affordable Care Act a success,” he said in a reference to provider groups working to keep rates low.

The plans on the exchange are required to offer a standard set of comprehensive benefits. It’s hard to compare premiums next year to what’s in place this year, since there is no standard set of benefits at present. Covered California chose as the best comparison the average premium for a small business plan. The rates in Covered California range from 2 percent above to 29 percent below that benchmark. Continue reading

No ‘Rate Shock’ in Vermont, First State with Proposed 2014 Premiums

By Phil Galewitz, Kaiser Health News

Vermont may not see rate shock, but its insurance market is strikingly different from that in California. (herzog/Flickr)

Vermont may not see rate shock, but its insurance market is strikingly different from that in California. (herzog/Flickr)

After years of anticipation, Vermont became the first state Monday to publish proposed 2014 individual health insurance rates under the federal health law. Despite Republican and insurers’ predictions, there was no “rate shock” in the new premiums, according to the Vermont governor’s office and insurance representatives.

That state may not be the best barometer of the impact of the heath overhaul on premiums, however, because it already prohibits insurers from using health status to determine an individual’s premiums. It is one of only seven states in the country which have so-called community rating regulations.

Unlike California, Vermont already prohibits insurers from using health status to determine an individual’s premiums.
California does not currently have community rating regulations. A major study last week concluded that individual premiums will likely go down substantially for many Californians and up for others on the individual market, once the new online marketplace for health insurance opens later this year. Premiums are expected to be announced for California in several weeks.

Vermont also requires prices to be the same regardless of person’s age. Two of the health law’s biggest changes include prohibiting insurers from using health status to determine premiums and prohibiting insurers from charging older people more than three times the rates of younger people.

Continue reading

Health Care Overhaul to Dramatically Reduce Premiums for Many Individuals, Study Finds

(Caroline_1: Flickr)

(Caroline_1: Flickr)

A major new analysis shows that hundreds of thousands of Californians will see their monthly insurance premiums fall an average 47 percent under President Obama’s health care overhaul, in large part due to tax credits and subsidies. It is the first detailed look at how health insurance premiums could change under President Obama’s Affordable Care Act, which goes into effect on Jan. 1, 2014.

Covered California, the agency charged with creating the state’s new health insurance marketplace, commissioned the analysis. The report looked at the individual market only and did not examine the small or large group market.

Under the ACA people with incomes up to four times the federal poverty level (about $94,000 for a family of four; $46,000 for an individual) will be eligible for subsidies from the federal government. That’s about 570,000 people, Covered California said.

Major findings from the study include:

  • Individuals with incomes less than four times the poverty level are “likely to pay” 47 to 84 percent less for their monthly premium compared to this year
  • Premiums would have increased 9 percent in 2014 because of health care inflation, even without the ACA Continue reading