I can only speak for my market, but I am going to say that the network will be a major factor. I want to qualify that with the current uninsured, this won't be for obvious reasons, however with the IFP clients I am meeting with today, keeping their doctor is very important. If the right network will cost significantly more, they may be willing to compromise however if their responsibility difference is under $50 per month, I suspect they will be willing to pay that difference.
My Musings on Silver Plan Pricing Stratergies
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I was referring to on exchange only. I know how the subsidy system works. I am referring to different metal plans having different networks. On exchange IFP will sell similarly to how we sell MAPD by largely being network driven.
The point I was trying to make is that I have MAPD clients that are willing to accept a much higher MOOP to keep their current doctors. So far here in Iowa, there is only one known carrier that has submitted their papers plus the Co-Op. If the Co-Op has the lower premiums but the small network doesn't include their doctors, people likely won't sign up for that plan and choose to have a higher personal responsibility with Coventry to include their current doctor.
The point I was trying to make is that I have MAPD clients that are willing to accept a much higher MOOP to keep their current doctors. So far here in Iowa, there is only one known carrier that has submitted their papers plus the Co-Op. If the Co-Op has the lower premiums but the small network doesn't include their doctors, people likely won't sign up for that plan and choose to have a higher personal responsibility with Coventry to include their current doctor.
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After meeting with our Blues rep, it appears they are running 2 on exchange network options: skinny, and "skinnier" (EPO). We will be comped for on exchange biz, amount unknown. Also, our rep told us that on exchange are all individual-only coverage policies.
Again, SC is an FFE state- I brought up my concerns about the 3rd highest silver plan pricing - my rep seemed aware of the potential problem, and basically confirmed that, yes, all the carriers were in the dark until the curtain comes up on rates. She also brought up the very good point that the "real" rates will not be seen until 2015...and used that as a good example to not pull an older person off a grandfathered policy in 2014, if it appears they can get a lower rate due to age band compression.
Other good stuff to think about - as far as small group goes - we spent a fair amount of time discussing the issues surrounding EEs with affordable group coverage where spousal group coverage is unaffordable (and spouse cannot get a subsidy due to EE only group coverage being affordable). Apparently, some agents are telling business owners to not offer coverage to spouses in 2014 (or sooner). All fully insured contracts have spousal coverage written in here in SC, and presumably most other states, too....ASO/self funded may be a way around this (by offering only EE & dependent, but no spousal coverage) but I would want reread ERISA before going down that path.
Again, SC is an FFE state- I brought up my concerns about the 3rd highest silver plan pricing - my rep seemed aware of the potential problem, and basically confirmed that, yes, all the carriers were in the dark until the curtain comes up on rates. She also brought up the very good point that the "real" rates will not be seen until 2015...and used that as a good example to not pull an older person off a grandfathered policy in 2014, if it appears they can get a lower rate due to age band compression.
Other good stuff to think about - as far as small group goes - we spent a fair amount of time discussing the issues surrounding EEs with affordable group coverage where spousal group coverage is unaffordable (and spouse cannot get a subsidy due to EE only group coverage being affordable). Apparently, some agents are telling business owners to not offer coverage to spouses in 2014 (or sooner). All fully insured contracts have spousal coverage written in here in SC, and presumably most other states, too....ASO/self funded may be a way around this (by offering only EE & dependent, but no spousal coverage) but I would want reread ERISA before going down that path.
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January 1, 2016
I'm starting to sense a problem in Illinois, because our second lowest cost Silver plan is from a company (LOLH Co-op) that stopped selling all its plans on the HealthCare.gov marketplace 2 days ago.
Does removal of plans from the marketplace instantly affect the subsidy, if one of those plans was the 2nd lowest cost Silver? The 3rd lowest cost Silver plan (from Aetna) is 9% more expensive than the withdrawn LOLH Silver.
Something behind the scenes is happening, because HealthSherpa suddenly isn't able to run subsidized quotes in many Illinois zip codes. Everyone gets $0 APTC. Since this is Friday, New Year's Day, it will likely be broke until Monday at the earliest.
This is what happens when the overly complicated ObamaScrew system experiences one unexpected change.
For us in TN on January 15th 2015 I went to heathcare.gov that morning and put the stuff in to get a general quote (was not using HS at the time). No co-op. Like poof, never existed.
The prices of the remaining plans had adjusted to where the new SLPSP was 9.5% of household income for subsidy eligible people. The subsidy available increased, but only for people who had not signed up for coverage yet.
I ran identical numbers on hc.gov on the quoter from a couple that had signed up a few day's earlier. Sure enough, the subsidy eligibility had now increased 20% from their original application.
The people who had signed up early and stayed with the co-op did not get their subsidies raised automatically even though the SLPSP was technically higher from February on.
I did not have any clients move from the co-op to another carrier during open enrollment, so not sure how that would work with subsidy. I had a few special elections who were termed from the co-op due to problems with docs who had to sign back up with another carrier as an SEP. The new carrier cost about the same as their original carrier so I know a subsidy redetermination was done because there was a 20% price difference between the old and new benchmark plan.
The only way that people who signed up with a more expensive carrier pre January 15th could get more subsidy would be to go in and report a life change and get a new determination letter. Otherwise original subsidy stood for them. I guess it will get sorted out on their 1095 though, and they will get back some on their taxes.
The prices of the remaining plans had adjusted to where the new SLPSP was 9.5% of household income for subsidy eligible people. The subsidy available increased, but only for people who had not signed up for coverage yet.
I ran identical numbers on hc.gov on the quoter from a couple that had signed up a few day's earlier. Sure enough, the subsidy eligibility had now increased 20% from their original application.
The people who had signed up early and stayed with the co-op did not get their subsidies raised automatically even though the SLPSP was technically higher from February on.
I did not have any clients move from the co-op to another carrier during open enrollment, so not sure how that would work with subsidy. I had a few special elections who were termed from the co-op due to problems with docs who had to sign back up with another carrier as an SEP. The new carrier cost about the same as their original carrier so I know a subsidy redetermination was done because there was a 20% price difference between the old and new benchmark plan.
The only way that people who signed up with a more expensive carrier pre January 15th could get more subsidy would be to go in and report a life change and get a new determination letter. Otherwise original subsidy stood for them. I guess it will get sorted out on their 1095 though, and they will get back some on their taxes.
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