Sample Premiums From Washington State

[AllenChicago]

Every time a state exchange releases sample premiums, the headline is the same... "Rates Lower Than Expected"... and someone high up in the Exchange, or State Government, is "Pleased". Give me a break! I would be out of business as a health insurance broker if all I had available were these $6,000 O.O.P. Exchange health plans, with their anorexic provider networks, to individuals at the prices you see below.

Story: Washington Health Insurance Exchange - Rates Lower Than Expected

Excerpt: "Washington Health Insurance Exchange - Sample of Individual Plan Rates. According to the OIC, sample mid-range (Silver) individual plan premiums from three carriers include:

Bridgespan: $239/month for a 21-year old, $305/month for a 40-year old, and $648/month for a 60-year old.

Premera Blue Cross: $228/month for a 21-year old, $292/month for a 40-year old, and $620/month for a 60-year old.

Group Health Cooperative: $210/month for a 21-year-old, $268/month for a 40-year old, and $569/month for a 60-year-old.

These are gross premium rates before any applicable individual health insurance tax subsidies are applied. If eligible for the tax subsidies, the actual amount a person would pay would be reduced at the time of purchase. The tax subsidies are available for consumers with income four times the federal poverty line (making up to ~$45,900 for an individual and ~$94,200 for a family of four in 2013)"

-ac

 

[medsuptage]

I don't work indy health, but I've been keeping a close watch on this.

Am I missing something? I can see the premiums are through the roof and the OOM, but I don't see anything to do with networks.
Have any of the companies released any of that information yet in WA?

 

[NWBenefitProvider]

You can review the filings here: http://www.insurance.wa.gov/health-rates/Search.aspx

Most of the carriers already have their networks established for their current plans. Regence, Group Health, etc. What I find particularly disturbing is:
1. The cost of the plans is considerably higher than what is available today.
2. Most plans make everything except preventive care visits and generic drugs subject to the deductible. This creates a double whammy of high premiums and then high out of pocket costs to use the plan.
3. Carriers are adding much higher deductibles and out of pocket maximums to the "out of network" benefits.

This is just going to hit the middle class like a load of bricks.
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I would be out of business as a health insurance broker if all I had available were these $6,000 O.O.P. Exchange health plans, with their anorexic provider networks, to individuals at the prices you see below.

ac

Allen, what are you seeing in your state for OOP maximums? This is actually a reduction in OOP maximums for a lot of the individual plans. Many currently go upwards of $10,000-$12,500!

Just curious. I also here we get the shaft on individual commissions at 5-7.5% of premium. What are they where you are?

 

[AllenChicago]

NWBenefitProvider, because Illinois is a Federal-State partnership exchange (which actually means Federally Run), no information is being disseminated. Nothing about plans, premiums, or even the companies participating.

All I know is that Blue Cross of Illinois will be on our state's exchange. They already have 70% (est) of all Illinois. Yet they're not telling agents anything of value. I called today and got 2 completely different answers from 2 BCBS-IL individuals regarding what's going to happen with customers who buy individual/family health insurance this year. Very frustrating.

Count your blessings for at least having SOME info, my friend.
-Allen

 

[medsuptage]

You can review the filings here: http://www.insurance.wa.gov/health-rates/Search.aspx

Most of the carriers already have their networks established for their current plans. Regence, Group Health, etc. What I find particularly disturbing is:
1. The cost of the plans is considerably higher than what is available today.
2. Most plans make everything except preventive care visits and generic drugs subject to the deductible. This creates a double whammy of high premiums and then high out of pocket costs to use the plan.
3. Carriers are adding much higher deductibles and out of pocket maximums to the "out of network" benefits.

This is just going to hit the middle class like a load of bricks.
- - - - - - - - - - - - - - - - - -

I agree 100%. Even ourselves as agents, or "small business owners" this will be a very hefty expense. My premium is looking to more then double for considerably worse coverage then I currently have.

Thank you for posting that link, but maybe I'm just missing the boat here. Are you saying that the current networks that Group Health and Regency have setup now, will be identical for the plans for 2014? Or are the networks going to be different?

I was looking for a place I could go with like a provider list or something for the 2014 plans.

I'm not experienced with Indy health at all, so I apologize if I'm being completely clueless here.

 

[NWBenefitProvider]

I'm just suggesting that at this point, we have no indication of them changing their network structure. GH for example, offers care at any GH facility or contracted provider covered at in-network rates. If you go outside their contracted network you are covered (depending on plan) at a different out-of-network level.

Regence uses a 3 tier system of preferred / participating and non-contracted providers. How much Regence covers depends on the contract level.

The networks insurance carriers don't change very often, however, the providers working within those networks are more volatile. Therefore, one will really need to just check the online provider directories to make sure that the physician or facility they want to use is current on their contracting.

I don't forsee much of a big change, with the exception of GH maintaining a strong price competitive edge with their HMO model. Other carriers so far just can't compete.

 

[medsuptage]

.

Thanks for responding, I'm very new to the indy health model.

We still don't have an idea of what commission is going to look like in Washington either huh?

 

[NWBenefitProvider]

Not really. Regence is probably going to continue with the per member per month compensation. Group Health has a big broker meeting in September and I'll know for sure then. I'll post back, but it will be a while. There really isn't much money to make on individual sales unless you have lots of them and can handle them efficiently.

 

[medsuptage]

Not really. Regence is probably going to continue with the per member per month compensation. Group Health has a big broker meeting in September and I'll know for sure then. I'll post back, but it will be a while. There really isn't much money to make on individual sales unless you have lots of them and can handle them efficiently.

That's kinda what I was thinking but if it will match a medsup's monthly renewal, it just might be worth it, the only difference is, it needs to be a lower cost per sale and less time consuming, which I don't think is going to happen.

I look forward to hearing back from you. Thanks for all the great info!