Tag Archives: premiums

Rate relief for resort areas…

New Obamacare map could cut insurance costs | AspenTimes.com.

Redrawing the maps will still leave resort county residents with some of the country’s highest Obamacare premiums.

Salazar said the new lineup of insurance regions could bring cost down between 4 to 8 percent in resort areas. That’s about $20 a month. Other rural areas in Colorado would see their costs go up 4 to 6 percent, also about $20 a month to about $366 a month.

The current premium for a 40-year-old non-smoker in the resort counties is $483 a month.

Ouch! It appears to me the whole Westerm portion of Colorado, Mesa County excepted (think Rocky Mountain Health Plans), will now have some of the highest rates in the nation.


Enrollment in Obamacare Exchanges: How Will Your Health Insurance Fare?

Enrollment in Obamacare Exchanges: How Will Your Health Insurance Fare?.

Source Report: How Will You Fare in the Obamacare Exchanges?

The following states will see decreases.

Colorado, New Jersey, New York, Ohio, Rhode Island

For the most part, these states will see decreases because they have already adopted some version of health care regulations that include mandates similar to Obamacare. One blue state, California, has pushed heavy mandates and yet will see its rates rise from 3.4% to 23.6%, with older Californians seeing half the hike that younger Californians will suffer.

Color me unconvinced on the Colorado reporting. The factual data I do have shows substantial increaes but that’s only on a few cases so there is no conclusion that can be drawn.  I will run some young invincibles this evening and add to this post.


Hospitals reject six ObamaCare plans

Be careful out there – Hospitals reject six ObamaCare plans | New York Post.

While most people have only 4 classes of plans to choose from, Bronze, Silver Gold and Platinum the big issue is the completeness of the network. Many plans on the Colorado Marketplace are classified as HMO’s. That translates into reduced networks.

The bottom line, if you want a larger network, especially if you travel, you should seriously consider a higher priced plan with a PPO network.


An annonymous clients encounter with Obamacare premiums

I had a conversation with a client today. This family of 4 has an Anthem HSA plan with a $5500 deducticle then 100% coverage.  This is a family deductible, so all medical expenses go into a single deductible bucket. The maximum out of pocket for the year is the same as the deductible, $5500. There present premium is approimately $850/mo.

The lowest premium available to them on the exchange is approximately $1230 and the plan has a maximum out of pocket of $6300 for an individual and $12,600 for the family. A $480 increase in premium and a $7100 increase in maximum out of pocket. Talk about higher pricing and lower benefits. I believe that’s called a “lose lose”!

Additionally, at first glance it appeared the family income was just above the subsidy cutoff level. If they were to lower their annual income a few thousand dollars an $8400 subsidy would become available. Further investigation showed that their income would be adjusted upword for the purpose of subsidy determination and that was not a reasonable strategy.

That said, I have a problem with a government subsidy providing an incentive to be less productive, fudge or hide income, etc.  Beam me up!


Study: Insurance costs to soar under Obamacare

Study: Insurance costs to soar under Obamacare – CBS News.

New research from the Manhattan Institute estimates that insurance rates for young men will rise by 99 percent. Rates for younger women will rise between 55 percent to 62 percent, according to the right-leaning New York think tank.

The precise impact of the new health law is likely to vary markedly from state-to-state, however. That’s largely because different states have had different requirements for what had to be included in health insurance policies in the past. The Affordable Care Act, commonly known as Obamacare, overrides these rules and sets a federal overlay that demands a wide array of mandatory coverages. The Manhattan Institute has drawn up an interactive map that may help forecast the rise in cost for individuals.

Avik Roy of the Institute and Forbes magazine columnist notes…

“You hear all these excuses from the [Obama] administration — that people are exaggerating the effect of the law,” he says. “But real people are getting notices from their insurers now. My blog is flooded with comments from people saying that they just got a huge premium hike.”

Then there’s the “keep your policy promise…

Additionally, the promise that you could keep your old policy, if you liked it, has proved illusory. My insurer, Kaiser Permanente, informed me in a glossy booklet that “At midnight on December 31, we will discontinue your current plan because it will not meet the requirements of the Affordable Care Act.” My premium, the letter added, would go from $209 a month to $348, a 66.5 percent increase that will cost $1,668 annually.

The conclusion…

“This is a redistribution of wealth from the healthy to the sick, from the young to the old, from the people who have always had insurance to the uninsured,” Roy said.

A standard policy for wellness and catastrophic coverage for an unexpected, unavoidable ailment or accident could have been provided for a fraction of what Obamacare coverage costs, Roy added. “Obamacare forces insurers to offer products that carry all sorts of bells and whistles that most people don’t want but everyone will now need to pay for.”

Of couse the overriding question is: “Why don’t these people have insurance”? And there are a wide variety of answers….

  • Once they see even todays rates, many people decide their fortune telling crystal ball is very clear and they can see the future. Their vision of the future tells them there is no need for insurance. Translated: They don’t see the value.
  • There is certainly a group that can’t afford the premiums
  • The “pre-existing conditions” issue. Keep in mind almost all states have (or had) state risk pools to cover those who couldn’t qualify for private individual plans. Of course affordability could still be an issue.
  • There is a group of people who decide that using the ER is the best way to receive medical care and purposely don’t have insurance.
  • And finally the group that expects the government to provide it.

The solution for all of these people is apparently Obamacare which provides:

  • Extensive up front coverage, although deductibles can be fairly high
  • Guaranteed issue with no medical underwriting
  • The 10 “essential” health benefits
  • Subsidies for applicants with household incomes in the 133% – 400%  range of the Federal Poverty Level (FPL)
  • Does very little if anything at all to lower the cost of medical care
  • Has led to Hospitals buying private practices leading to higher costs of medical treatment. (For example, if your doctor prescribes an MRI, that send you to the hospital he’s associated with. Any idea what the most expensive facility to get an MRI or CT scan is? Yep, you guessed it.

One man’s ObamaCare nightmare… (perhaps)

One man’s ObamaCare nightmare | Fox News.

“When I saw the letter when I came home from work,” Andy said, describing the large red wording on the envelope from his insurance carrier, “(it said) ‘your action required,benefit changes, act now.’ Of course I opened it immediately.”

It had stunning news. Insurance for the Mangiones and their two boys,which they bought on the individual market, was going to almost triple in 2014 — from $333 a month to $965.

The insurance carrier made it clear the increase was in order to be compliant with the new health care law.


This article is misleading with an good dose of the truth.

Yes, a metal plan from Humana in the region of Kentucky will cost the Mangione’s what the article states IF they elect to purchase it today. However, here are the “buts”….

  • What do plans from other carriers cost?
  • Are the Mangione’s eligible for a subsidy? If so, they can most likely purchase the same plan from the health insurance marketplace for a lessor cost starting October 1st.
  • In general, Humana is offering their clients the option to stay with the plan they have until December 31st, 2o14

This type of reporting is not helpful, although it IS a counterbalance to the MSM. That said, it sure isn’t “fair and balanced”.



Obamacare alert: Warning young invincibles

Obamacare Is Really, Really Bad For You, Especially If You’re Young – Forbes.

Starting next year, the Affordable Care Act will severely weaken the link between health insurance premiums and age-related risks. Health insurance companies won’t be allowed to charge older people any more than three times what they charge younger people for premiums. This is bad news for the young.

Preventing health insurers from fully accounting for age will not change the reality that, in general, the older you are, the greater your medical expenses (six times greater, when you compare 64-year-olds to 18-year-olds). These are costs that someone has to pay.

If I was a young person, I’d click on the link! If I was an “old” person, I’d hope the young invicibles did NOT click on the link!

Here’s the conclusion but you’re missing the meat and potatoes…

The health law’s age-related rate restriction milks the hard-earned income of young people—those just starting out in life—for the sake of those older, sacrificing in the process a young person’s own goals and dreams. If they were honest, supporters of the law would admit this openly, instead of adding insult to injury by calling their immoral scheme a benefit to the young.

Oh and thanks for supporting my social security too.


Health plans drop working spouses or add surcharges

Health plans drop working spouses | TribLIVE.

A growing number of companies are looking to clamp down on rising health care costs by dumping coverage for their employees’ working spouses.

Others are requiring their workers to pay extra money to cover a spouse who could get health insurance elsewhere. And some may even consider making employees pay the full cost of insuring their children.

This is happening, not only because of cost but due to Obamacare itself…

More employers are taking a look at the strategy because Obamacare doesn’t specify that family health plans cover spouses, said James McTiernan, health care consultant with Triad Gallagher, a Downtown benefits firm.

A couple of points. Paying full cost for very young children is very expensive. That’s sure to cause some pushback. Also, I thought you could keep your plan!?

Another item not m


But nobody needs a federal bureaucrat to tell him what health insurance to buy…

Examiner Editorial: Obamacare is a 19th-century answer to a 21st-century question | WashingtonExaminer.com.

The Wall Street Journal’s Daniel Henninger captured it well with this observation last week: “Even if you are a liberal and support the goals of the Affordable Care Act, there has to be an emerging sense that maybe the law’s theorists missed a signal from life outside the castle walls. While they troweled brick after brick into a 2,000-page law, the rest of the world was reshaping itself into smaller, more nimble units whose defining metaphor is the 140-character Twitter message.”

Simply put, the digitization of social interaction, economic transaction, the political process and everything in between is decentralizing the world, moving it in the opposite direction of the massive centralization of Obamacare. But nobody needs a federal bureaucrat to tell him what health insurance to buy when anybody with an Internet connection can simultaneously solicit bids from thousands of competing providers, pay the winner via electronic fund transfers, manage the claims process with a laptop, consult with physicians and other medical specialists via email, and even be operated on remotely by surgeons on the other side of the globe. Rather than imposing a top-down, command-economy, welfare-state health care model with roots in Otto von Bismarck’s Germany of 1881, a 21st-century government would ask what is needed to apply to health care access the Internet’s boundless capacity to empower individual choice.

Well said. I read in the WSJ today about some exchange simulations that Blue Cross Blue Shield has been running in Rhode Island. For the number one issue in plan selection, by FAR price the most important factor at 48%. A distant 2nd at 11% was maximum out of pocket.

The problem with a top down design of Obamacare is it’s the elite behind the castle walls that know what’s best for us. Between the bumbling implementation, the increased cost, the family glitch subsidy (which I have many clients that fall into that category) they better hope they’re right.


‘Many People Will Pay More For Health Insurance’ Under Obamacare

Aetna Letter Warns Customers: ‘Many People Will Pay More For Health Insurance’ Under Obamacare | The Weekly Standard.


Aetna predicts expensive Obamacare plans


The Affordable Care Act (ACA) is changing health insurance. This includes adding preventive care and essential health benefits. The ACA also ends medical underwriting. Due to these and other changes, many people will pay more for their health insurance coverage in 2014 than they do today.


Additional Colorado exchange pricing from CCHI

The Colorado Consumer Health Initiative (CCHI) has done some analysis of Colorado exchange pricing filed with the state. Their dressed up conclusion in my opinion…

“Colorado consumers will be pleased they will have a enough health insurance plans from among which to choose, without being overwhelmed by too many choices – it looks like Goldilocks, just right,” said Dede de Percin, executive director of the Colorado Consumer Health Initiative. “Despite doomsday predictions, the state is not seeing ‘rate shock’, so many of the choices will be more affordable, especially with the subsidies.”

Here are some examples of pricing for “one Silver plan” from each of the 10 insurers…


Denver Individual Plans

  • 27 year old: $207 to $373 per month
  • 40-year old: $253 to $454 per month

Denver Family Plan (2 parents age 40, children under 18)

  • $756 to $1,360 per month

Durango Individual Plans

  • 27-year old: $207 to $504 per month
  • 40-year old: $253 to $615 per month

Durango Family Plan (2 parents age 40, children under 18)

  •  $756 to $1,840 per month

Fort Collins Individual Plans

  • 27-year old: $197 to $406 per month
  • 40-year old: $240 to $495 per month

Fort Collins Family Plan (2 parents age 40, children under 18)

  • $718 to $1,481 per month


Having sold numerous health policies in Colorado, I can assure you this most DEFINITELY WILL BE sticker shock. That said, of course many will be eligible for subsidies to defray the cost. Let’s hear it from CCHI:

Most consumers will not pay these prices since low and middle-income Connect for Health Colorado marketplace consumers will be eligible for advanced premium tax credits based on income.  For example, a 40-year old earning $29,000 a year, paying a premium of $350 per month would be eligible for a subsidy of up to $154 per month and would contribute $196 per month for his or her health plan.

Subsidies are not reduced in a straight line fashion as your income increases. If you are closer to 400% of the Federal Poverty Level (FPL) the amount of subsidy you will receive is substantially reduced. View a FPL spreadsheet vs. number of family members here.


Ohio reveals high exchange rates

Ohio reveals high exchange rates | LifeHealthPro.

Ohio officials said late Thursday that health insurance costs will increase “significantly” under the Patient Protection and Affordable Care Act.

The state’s department of insurance estimated the average individual premium will increase from $223 per month to $420 — an average of 88 percent — for policies under President Obama’s health care law.


A total of 14 carriers filed proposed rates for 214 different plans to the department for the newly formed exchange. Projected costs from the companies for providing coverage for the required essential health benefits ranged from $282.51 to $577.40 for individual health insurance plans, officials said.

Subsidies not included…

The analysis didn’t take into account the impact that government subsidies may have on what Ohioans could pay.

The federal government is running Ohio’s exchange, as the state chose not to run its own.

Ohio is among the first states to say PPACA will cause significant price hikes. Last month, California released its sample rates, touting the fact that premiums will be lower-than-expected under PPACA. For the most part, California’s rates emerged as less expensive than expected, with supporters of the law claiming it was a “home run” for consumers. Some critics, though, called out Covered California, the agency tasked with setting up the exchange, for making an apples-to-oranges comparison.

I’ve mean’t to do some posting on the CA rates. Two Forbes columnists have been battling it out with good information from each. My initial interpretation is the small group rates came in better than expected and individual rates are higher than they presently are.