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Whats the reality of the increases for indivdiual health plans this year?

10-27-2016 by Colleen King

Okay, it's hit the news, yes my phone is ringing, and yes the email volume is definitely up. Nightly news came out yesterday talking about how rates were going to be going up 25% in 2017. This is true, and some are going up more--I have clients whose rates are going up as much as 35%. So now what?

Covered California, the health benefits exchange here it the Golden State, has been saying that the average rate increase is just over 13%, but that's okay, because about 90% of consumers received financial assistance. That's not what I'm seeing, nor my peers. While Covered CA is putting out a good effort, the reason why there's such a high number of enrollees that are subsidized is that most agents only put cases through Covered CA if their clients are potentially eligible for assistance. Otherwise, it's a more lengthy application to do, and there have been problems. Definitely an improvement over the fall of 2013 when this insanity started, but there are problems.

I'm being challenged on that statement by some, about subsidies, but I know how I do things, and a lot of my agent peers. And I've not seen the math on this 13% 'average' number. Is that factoring in the new MediCal enrollees, most of whom don't have a payment, not sure. But when you have a plan that is offered both on and off Covered CA, by state law, it has to be 'the same'--meaning same benefits, same network and same rate. So why are the 'off exchange' plans so high? Whether they are on and off exchange plans, or off exchange only, things are shooting up.

Long story short, you have to 'shop' your plan. We have fewer choices, but check with an independent agent in order to be sure you aren't paying more than you have to.


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