Preliminary Insurance Rates Due Out Thursday

Consumers and insurance agents alike are waiting with bated breath to learn the preliminary rates for individual coverage next year. In a first for the nation, the Oregon Insurance Division is announcing preliminary rates – something that hasn’t happened anywhere else – with the announcement coming out Thursday afternoon ahead of the public hearings where Division officials expect to hear insurance officials clarify their rate requests.

In early July, the Division intends to announce the final rates for fall enrollment that gets underway November 1 and runs through January 31, 2016, according to Jake Sunderland, public information officer.

Initially, Jesse O’Brien, public health advocate for OSPRG, was concerned insurers would try to “game the system” during the public hearings, introducing new details not hitherto disclosed during the initial filing.

“They might have tried getting another bite of the apple, to get more power and challenge the Division’s decisions, saying here’s a bunch of new information that shows why you should have approved our rates as requested, ” O’Brien told The Lund Report. “But the Insurance Division put a stop to that.”

OSPIRG is keenly watching to see whether the final rate decisions change significantly after the public hearings, and, if so, the basis for such a change. “If it swings in the direction of what the insurers want, that’s a cause for concern,” O’Brien said.

Moda Health, which cornered 44 percent of the market last year – 100,805 members anticipates losing 20,00-30,000 members during open enrollment and has requested a 25.6 percent hike, on average, while the newcomer on the block, Zoom+ is hoping to attract between 4,500-10,000 people. If the higher rates proposed by insurers such as PacificSource (+42.7%) and Moda Health are approved, O’Brien urges consumers to shop around rather than bow out and paying the penalty for remaining uninsured. Currently, 226,230 Oregonians have coverage through the exchange.

LifeWise Health Plan, which has 37,412 members is asking for a 38.5 percent increase, Health Republic, with 5,895 members wants a 37.8 percent hike, while the Oregon Health CO-OP, which has 13,307 members is only asking for a 5.6 increase. Only one health insurer, Kaiser Foundation, wants to reduce its rates by -1.95 percent, and currently has 15,535 members.

O’Brien questioned how Kaiser managed to ask for a decrease when their competitors took the opposite stance, but acknowledged his organization did not conduct an in-depth analysis, focusing instead on insurers seeking higher rate increases.

“There are a lot of reasons why 2014 was pretty unique financially, but that isn’t indicative of a long-term trend,” he said. “Many Oregonians had been locked out of market for decades and had pre-existing conditions and some required upfront acute interventions. We have reason to believe that as more and more people come into the market over the next few years, the overall risk will go down. And, it appears that the most expensive people were the first to go into the market.”

Diane can be reached at [email protected].