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"OMG, have you seen my rates?" Yes, I have, and it's ugly.

11-15-2017 by Colleen King

This year, individual plan rates have exploded this year, and it's awful. And that's on top of increases the past 3 years that each year have shocked people. There are a couple of things that are happening that are contributing to this.

1. Anthem Blue Cross has pulled out of most of the California individual market. Their management said they were losing money in the California market so the pulled out of most California. There are 3 regions of Northern California they remain and there are 2 reasons for it (In my opinion). First, they are trying to be good eggs and help services an under served area. Not sure if those 3 regions were more profitable or not. The other reason, which I think is a big part of a strategic move, if they had totally pulled out, it would have been five years before they could come back into Covered California. You can choose your preference as to what happened, I think it's a combination.

2. Blue Shield is statewide, and in many areas they were the only PPO. PPOs versus EPOs are an issue because EPOs don't have out of network coverage unless it's an emergency. Lots of doctors and other types of providers are dropping their insurance contracts, so having out of network coverage is important to many people. But when they take advantage of that, this drives carrier costs way up. So that's why this year, not only are Shield's rates going up but their out of network coverage, the deductibles and out of pocket maximums are shooting up sky high. Shield has been hit according to what they have said, with a lot of higher dollar claims because of their situation.

So I just keep churning out quotes. I'm being asked for bronze level plans more than usual because of the rate increases. I try to steer people toward silver because of the huge deductibles on Bronze ($6300+) but people got to eat too. Sure hope Washington figures something out quickly....


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