Insurance coverage firms are proposing important charge hikes in CT. Right here’s what to know

Insurance coverage firms that promote insurance policies on and off Connecticut’s Inexpensive Care Act alternate surprised advocates in July after they requested for a median enhance of 20.4% on subsequent yr’s particular person well being plans.

The proposed charge hikes, revealed by the state’s insurance coverage division final month, additionally embrace a really helpful enhance of 14.8% on small group well being plans.

The requests are considerably larger than what insurers sought final yr for 2022 well being insurance policies. Carriers in 2021 requested for a median hike of 8.6% on particular person plans and 12.9% on small group plans.

“It’s jaw dropping,” Lynne Ide, program lead for communications outreach and engagement on the Common Well being Care Basis of Connecticut, mentioned final month. “Taking a look at these charge requests, the ranges are off the charts.

“Our huge concern proper now’s, coupled with inflation and the fallout from COVID, these proposed will increase spell hassle. Our concern is that folks will check out this and resolve to go with out well being protection, as a result of they simply can’t afford it.”

The insurance coverage division is weighing the requests and is predicted to challenge a choice in September. Earlier than that occurs, the general public could have an opportunity to make feedback on the urged charge hikes.

The insurance coverage division has scheduled a public listening to for Aug. 15, starting at 9 a.m. on the Legislative Workplace Constructing (300 Capital Ave. in Hartford).

The general public can testify in individual or just about. Join in-person testimony opens at 8:30 a.m. on the Legislative Workplace Constructing on the day of the listening to.

The cutoff to join digital testimony is at the moment (Aug. 12). Anybody who desires to testify just about can join by sending an e-mail to with their identify and written remarks by midday.

Representatives of the insurance coverage firms will probably be allotted time to elucidate their charge hike requests, and officers from the insurance coverage division can ask questions. The listening to will probably be broadcast on CT-N.

Right here’s what to learn about proposals.

What are insurance coverage firms asking for?

Three insurers are promoting insurance policies on Connecticut’s alternate: Anthem Well being Plans, CTCare Advantages Inc., and ConnectiCare Insurance coverage Firm Inc.

Anthem requested a median enhance of 8.6% for particular person insurance policies that cowl 27,698 individuals. The proposed modifications vary from a lower of 1.8% to a rise of 16.1%, relying on the plan.

The corporate additionally sought a median hike of three.6% on small group insurance policies that cowl 19,271 residents. The urged modifications vary from a lower of 1.2% to a rise of 26.3%.

CTCare Advantages requested for a median hike of 24.1% on particular person plans that cowl 75,003 individuals. Proposed modifications vary from a rise of 18.7% to 33.2%, relying on the coverage.

It additionally sought a median hike of twenty-two.9% on small group plans that cowl 3,476 residents (will increase vary from 20% to twenty-eight.9%).

ConnectiCare, which solely sells particular person insurance policies on the alternate, requested a median enhance of 25.2% for plans that cowl 8,782 individuals. Steered hikes vary from 17.1% to 32.2%.

An entire checklist of plans on and off the alternate, together with charge hike requests, could be discovered right here.

Why are insurers in search of larger charges?

Kimberly Kann, a spokeswoman for ConnectiCare, mentioned medical and pharmaceutical prices had been two of the components driving the corporate’s requested charge enhance.

“Our proposed charges are primarily based on a number of components, together with medical and pharmacy price tendencies, together with the continued impacts of COVID-19 on our members’ utilization of providers, together with acquiring delayed care,” she mentioned.

“Additionally, the legislative and regulatory environments proceed to current market challenges outdoors of the corporate’s management, together with the lack of the improved Superior Premium Tax Credit supplied by the American Rescue Plan Act set to run out in 2022, and state-mandated advantages.”

Alessandra Simkin, a spokeswoman for Anthem, mentioned: “Our submitting displays our expertise and skill to ship on behalf of customers on this market and we stay up for working with the state as we proceed the regulatory course of.”

The insurers will ship representatives from their firms to a public listening to in August, the place they are going to be questioned in regards to the proposed will increase in higher element.

What occurs subsequent?

Actuaries with the insurance coverage division will evaluation the requested will increase. As a part of the evaluation, they are going to take a look at tendencies in unit price (complete expenditure incurred by the corporate), utilization of providers, and anticipated severity of claims. The division will challenge inquiries to the insurers and search clarification if wanted. It would additionally maintain a public listening to to get enter from the carriers, well being care advocates and the general public.

After the evaluation, the division can approve the total requested enhance, reject it or amend it to a unique quantity. The ultimate modifications are anticipated to be revealed in late August or early September.

Are the proposed charge hikes all the time authorised?

No. Final yr, for instance, the state insurance coverage division authorised a median charge enhance of 5.6% for 2022 particular person well being plans, although the carriers had requested 8.6%.

The division licensed a median charge hike of 6.7% for small group insurance policies, although insurers had requested for 12.9%.

In 2020, Anthem Well being Plans had requested for a 9.9% common enhance in its particular person plans, which served 22,071 individuals by the alternate. The insurance coverage division authorised a rise of 1.9%.

The identical yr, ConnectiCare Advantages Inc. sought a median hike of 5.5% in its particular person plans on the alternate, which on the time lined 75,174 clients. The insurance coverage division signed off on a lower of 0.1%.

What has response been like?

Well being care advocates have criticized the proposed will increase, saying they concern extra individuals will go with out protection as a result of costs are too excessive.

“My jaw hit the ground, clearly,” Ted Doolittle, the state’s well being care advocate, has mentioned. “I’m deeply involved that folks will go with out protection due to these excessive costs. It’s incumbent on the insurance coverage firms and the suppliers to elucidate to the individuals within the state why that is inevitable and there’s no different.”

Ide, from the Common Well being Care Basis of Connecticut, mentioned the proposed will increase “don’t appear to make any sense.”

“Why one provider can be asking for 8.6% within the particular person market on common, and three.6% within the small group market, and the opposite provider is asking for a 24% and 22% in these two markets – it seems like they pulled the numbers out of a hat,” she mentioned.

State Lawyer Normal William Tong requested for a particular listening to that might enable officers to gather proof and scrupulously query insurers about their proposed will increase. Officers would be capable to cross-examine witnesses and current their very own proof in a public setting.

The insurance coverage division didn’t conform to the formal listening to.

“Well being care prices and insurance coverage premiums are already unaffordable for a lot of Connecticut households, companies and people, and these double-digit charge hikes demand rigorous scrutiny,” Tong mentioned.

When does open enrollment start?

Open enrollment for 2023 well being insurance policies begins on Nov. 1.

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