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Review of 2015 Health Insurance Rates Begins

June 10, 2014

Beginning today, Oregon consumers can weigh in on proposed health insurers' rates for 2015 small employer and individual health benefit plans. During this public process, consumers can also review insurers' cost and quality metrics, which insurers had to submit for the first time this year. Examples of cost and quality metrics are costs per member per month for emergency department visits and percentage of women who receive breast cancer screenings.

The Department of Consumer and Business Services, Insurance Division today posted health insurers' rate requests for small employer and individual health benefit plans. The division must approve any rates before they can be charged to policyholders.

"Oregon has a transparent and rigorous process for reviewing health insurance rates," said Insurance Commissioner Laura Cali. "Over the next two months, the division will conduct a thorough review of each rate request to ensure the rates are reasonable and justified."

Consumers have many options to participate in the public process:

The filings include plans that comply with the Affordable Care Act, as well as "transitional plans" and "grandfathered plans" that existed before Jan. 1, 2014. Along with 14 insurers, two Consumer Operated and Oriented Plans (CO-OPS) filed plans and proposed rates with the division.

The division posted examples of proposed premiums in seven regions across the state at http://www.oregonhealthrates.org/?pg=proposed_rates.html. The charts show examples of monthly premiums and the percentage change from the rates approved by the division for 2014. The amount of premium 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.

"We value and encourage the public to participate in the process and provide input," Cali said. "We continually strive to provide clear information to help consumers better understand our process and how we make decisions about health plans offered to Oregonians."

In addition, the division uses federal grant funds to contract with the Oregon State Public Interest Research Group (OSPIRG) to represent the public by choosing certain rate filings to review and participating in public hearings.

The division will make decisions on rates by early August and post consumer-friendly documents that describe the decisions. Plans will be available starting Nov. 15, 2014, to purchase through Cover Oregon, agents, and insurers.

The proposed rates are for plans for businesses with fewer than 50 employees and individuals who buy their own coverage rather than getting it through an employer, which affects about 10 percent of Oregonians.

To search rate filings and find more information about the rate review process, visit http://www.oregonhealthrates.org/.

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