May 9, 2013 – The Oregon Insurance Division today posted health insurers’ rate requests for small employer and individual health plans that start Jan. 1, 2014. The plans reflect new benefits and new rules under the federal Affordable Care Act.
Thousands of Oregonians are expected to gain private insurance in the coming year with federal financial help. Consumers will have more choices than ever before since federal law states that everyone qualifies for coverage, even if they have a pre-existing health condition. Also, the traditional insurers that make up Oregon’s already highly competitive health insurance market will be joined by several new entities.
The 2014 health plans for small employers and individuals will include new benefits and limit deductibles. While focusing on preventive care, all plans will include doctor visits, hospital stays, maternity care, emergency room care, prescriptions, and mental health/substance abuse coverage.
In addition to new benefits, federal reforms closed the gap between rates charged to older and younger people. The changes mean insurance costs may increase for some and decrease for others. For example, Oregonians with serious health issues who are now covered in government-operated high-risk pools can shop for competitive rates in the private market. They, along with many other Oregonians, may qualify for financial help that will lower premiums through Cover Oregon, the state’s new health insurance marketplace. Find information at www.coveroregon.com.
Rate filings
Along with 16 insurers, two Consumer Operated and Oriented Plans (CO-OPS) filed plans and proposed rates with the division.
The division’s rate review focuses on technical projections about future claims costs but is open to public comment. Shopping for coverage will be easier after the division makes rate decisions by early July and insurers and Cover Oregon provide consumer-friendly information about plan benefits and rates.
Insurance Division actuaries have started their thorough technical review of the filings to determine whether the proposed rates are justified and reasonable. Oregon Insurance Commissioner Lou Savage must approve any rates before they can be charged to policyholders.
The division posted examples of proposed rates in seven regions covering Oregon at http://www.oregonhealthrates.org/?pg=proposed_rates.html. The charts show examples of rates because the amount a particular person pays depends on age, location, how many family members are on the plan, and plan choice. Tobacco use can increase the price of plans, too.
The proposed rates are for small group and individual coverage, which will affect about 10 percent of Oregonians.
“Oregon has one of the nation’s most competitive health insurance markets, and one of its most rigorous and public rate reviews,” Savage said. “We will be looking closely at what rates are justified in this reset of the market with new plans and new prices.”
The division’s rate website at www.oregonhealthrates.org links people to key documents, including a schedule for public hearings. Also, people can sign up for email notifications that alert them to rate filings, public hearings, and rate decisions.
