Tag Archive: trend

CalPERS 7.2% HMO plan premium rate increase in line with historical utilization cost trend

Citing higher drug prices, the California Public Employees’ Retirement System said its HMO premiums are rising by 7.2% next year. Rates for PPO, or preferred provider organization, plans are going up even more at 10.8%, on average, for 2016.This marks a departure from two years of more modest increases of about 3% at the giant pension fund. The agency’s rate hikes are a key barometer since it’s one of the largest healthcare buyers nationwide after the federal government.

Source: CalPERS approves 7.2% increase in HMO rates as drug costs climb – LA Times

The 7.2 percent average premium rate increase for 2016 HMO plans — which cover two out of three CalPERS members — aligns with the underlying medical utilization cost growth trend of recent years of about seven percent. As the story notes, CalPERS health plan rates are viewed as a harbinger of the cost of health coverage in the coming calendar year given the large size of its pool of 1.4 million active and retired state and local government workers.

 


Need a speaker or webinar presenter on the Affordable Care Act and the outlook for health care reform? Contact Pilot Healthcare Strategies Principal Fred Pilot by email fpilot@pilothealthstrategies.com or call 530-295-1473. 

Double digit individual plan premium hikes seen for 2015

A senior executive of WellPoint predicts plan year 2015 premiums in the individual market could go up by double digits in some areas of the United States.

Larry Levitt, senior vice president at the Kaiser Family Foundation, predicts 2015 premiums could rise by 10 percent, based on a  5 to 6 percent medical services cost trend plus the effect of a reduction in payments to plan issuers under the Patient Protection and Affordable Care Act’s Premium Stabilization Programs to $6 billion in 2015.

via Will Premium Spikes Cause Another Round of Obamacare Bashing? – NationalJournal.com.

 


Need a speaker or webinar presenter on the Affordable Care Act and the outlook for health care reform? Contact Pilot Healthcare Strategies Principal Fred Pilot by email fpilot@pilothealthstrategies.com or call 530-295-1473. 

Double digit premium increases for California grandfathered plans

The “trend” as it’s known in health coverage refers to the underlying cost of providing medical services to policyholders or managed care plan members, an expense that is reflected in premium rates. That trend remains in the positive double digits for two of the Golden State’s biggest health plan issuers, Anthem Blue Cross and Blue Shield of California. Even for grandfathered plans in effect prior to the 2010 enactment of the Patient Protection and Affordable Care Act that may not include the full panoply of benefits and deductible limits required by the ACA. The Los Angeles Times reports Anthem Blue Cross will increase premiums for these plans effective April 1, 2014 by an average of 16 percent and as much as 25 percent for some plans. Blue Shield of California is upping premiums for grandfathered plans by an average of 10 percent, according to The Times.

If the trend is in the positive double digits even for grandfathered plans that are less generous than ACA-compliant plans, it could be even higher among richer ACA-compliant plans that must provide a broader scope of essential health benefits and more limited deductibles. That will put to the test the buy side market power of California’s health benefit exchange marketplace, Covered California, to exert downward pressure on premiums as it prepares this year to negotiate rates with health plan issuers looking to offer plans through the exchange in 2015. Covered California’s negotiating clout in those negotiations will turn on how many individuals it enrolls in 2014 plans during the initial open enrollment period that ends March 31, 2014. Rates negotiated by the exchange will also affect some plans sold outside the exchange marketplace. Health plan issuers participating in the exchange marketplace must market their exchange plans outside the exchange at the same premium rate.

 


Need a speaker or webinar presenter on the Affordable Care Act and the outlook for health care reform? Contact Pilot Healthcare Strategies Principal Fred Pilot by email fpilot@pilothealthstrategies.com or call 530-295-1473. 

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