Rates Could Yo-Yo as Insurance Exchange Heads into 2015

Email a Friend
People newly insured through the Affordable Care Act should not get too used to their monthly premiums. Many rates are poised to change.

New Yorkers who bought insurance from the state health exchange could see big price hikes next year.

Empire Blue Cross Blue Shield is seeking up to an 18 percent increase from state insurance regulators. And Health Republic, a new non-profit company with the top market share in New York’s new exchange, is applying for a similar premium raise.

Customers who chose Health Republic for its low costs are grumbling.

"When you increase rates that quickly, I think that shows bad faith," said Elizabeth Mitchell from Brooklyn. She currently pays $515 a month for a platinum plan and received a letter this week saying it could go up by 16 percent next year.

Health Republic in an online statement says the proposed hike is "due to increasing medical costs, declining federal support, and to ensure our organization achieves long-term sustainability.”

Fidelis and MetroPlus, two other non-profit insurers with relatively cheap prices are also poised to increase prices. MetroPlus has proposed hikes from 13 percent to 28 percent, depending on metal tier. Fidelis refused to share its proposed rates with WNYC, but a notice Fidelis sent to one individual member featured an 8-percent premium jump.

For some policy-holders, the actual premium increase could be less dramatic than it initially appears. The before-and-after 'sticker price' on rate notices is not what many people pay. The majority of exchange participants are low-income and qualify for federal subsidies that lead to deep discounts in the listed price.

United Health Care and North Shore-LIJ CareConnect, two costlier plans with much smaller market shares, have requested rate decreases.

State regulators evaluate applications to see if insurance carriers’ claims justify their price changes.

There is a 30-day public comment period, and final rates will be released later this year.