The Department of Consumer and Business Services' Insurance Division has approved rates for 2015 individual and small employer health insurance plans, and on average, they are lower than 2014 rates.
Although the rate changes vary by insurer, the average monthly premium for an individual standard plan for a 40-year-old in Portland in 2015 is estimated at $250, compared to $262 in 2014. For a similar small employer plan, the average 2015 premium is an estimated $308 per month, compared with $327 in 2014. A table showing sample 2015 premiums can be found here: http://www.oregon.gov/DCBS/docs/Rate_filing_decision.pdf.
"Our rigorous review included public hearings and analysis to ensure rates are reasonable and support a sustainable market," said Insurance Commissioner Laura Cali. "Ultimately, the approved rates are lower on average than in 2014, reflecting the effect of competition and Oregonians' expanded access to health coverage."
The rates, which affect about 10 percent of Oregonians, are for plans for businesses with fewer than 50 employees and individuals who buy their own coverage rather than getting it through an employer. The Insurance Division must approve any rates before they can be charged to policyholders. The review included plans that comply with the Affordable Care Act, as well as "transitional" and "grandfathered" plans that existed before Jan. 1, 2014. Along with 14 insurers, two Consumer Operated and Oriented Plans (CO-OPS) filed proposed rates with the division.
During the review, the division's actuarial staff analyzed the justifications that insurers provided to support their proposed rates. Some insurers lowered their claims cost projections because of reductions in uncompensated care. Uncompensated care is a term for medical services that go unpaid by patients without insurance or who can't afford to pay their portion of the cost. With more Oregonians covered by insurance with enhanced benefits, providers are reporting less uncompensated care. If insurers did not account for this change in their rate proposal, the Insurance Division lowered their projected claims costs and factored it into the approved rate.
The issue of uncompensated care was also a focal point of analysis provided by Oregon State Public Interest Research Group (OSPIRG). The division uses federal grant dollars to contract with OSPIRG to represent consumers and participate in the rate review process.
"OSPIRG's role - as well as the comments we receive from the public - are very important in helping the division better understand the impact of rate changes on consumers," Cali said.
The division will provide more information on the reasoning behind each rate decision by mid-August when it posts decision summaries on www.oregonhealthrates.org. Premium examples by region also will be available on www.oregonhealthrates.org by mid-August. Changes to people's monthly premiums will vary depending on age, location, how many family members are on the plan, and plan choice.
