Small businesses and individuals who buy their own health insurance can now see the Division of Financial Regulation’s final rate decisions for 2019 health insurance plans. The division reviews and approves rates through a detailed and transparent process before they can be charged to policyholders.
The final decisions are based on the result of a rigorous review, which included public hearings and public comment. The division published preliminary decisions last month before the hearings. These hearings provided an opportunity for the public, health insurance companies, and the division to further review and analyze the preliminary decisions.
“Despite federal actions that continue to inject instability into our market, 2019 rates look to be even lower than initially requested,” said Insurance Commissioner Andrew Stolfi. “The positive effect of the Oregon Reinsurance Program provides relief for Oregonians and helps reverse some of the rate increases caused by actions at the federal level.”
Open enrollment for 2019 plans is from Nov. 1 to Dec. 15, 2018.
Individual market
The division has issued final decisions for seven companies in the individual market with average rate changes ranging from a 9.6 percent decrease to a 10.1 percent increase. Under the decisions, Silver Standard Plan premiums for a 40-year-old in Portland would range from $415 to $486 a month.
The final decisions include a 1.1 percent reduction of the preliminary approved rate of Providence, which was lowered from 10.6 percent to 9.5 percent due to updated loss experience data. Its initial rate request was 13.6 percent. The only other change was to Kaiser Foundation Health Plan. The individual rate was adjusted slightly from an increase of 9.2 percent to 9.4 percent. Kaiser’s initial rate request was 14.3 percent.
The rate changes are company-wide averages based on premiums for plans before financial assistance through Oregon’s Health Insurance Marketplace is taken into account.
All Oregonians who purchase their own insurance are encouraged to apply for assistance through the Marketplace for 2019, even if they did not qualify last year. In 2018, Oregonians who received help with the costs of their health insurance paid on average $138 a month.
Small group market
In the small group market, the division has issued final decisions for nine companies with average rates ranging from a 4 percent decrease to a 7.2 percent increase. Under the decisions, Silver Standard Plan premiums for a 40-year-old in Portland would range from $295 to $387 a month.
Final rates include significant reductions from the preliminary decisions for several plans based on updated loss experience data. Providence’s small group rates decreased from 8.2 percent to 3.9 percent. UnitedHealthCare Insurance Company changed from 9.4 percent to 7.2 percent, and UnitedHealthCare of Oregon was reduced from 8.9 percent to 6.7 percent.
In 2019, all carriers will maintain their current service area, and two insurers are expanding with Kaiser moving into Lane County and PacificSource moving into Lane and Yamhill counties.
“We remain encouraged to see two carriers expanding into additional counties, and all carriers maintaining their current service areas,” said Stolfi. “We have done a lot of work to help steady the Oregon health insurance market, and continue to explore all avenues to help steady premium rates for Oregonians.”
Reasons for rate changes include:
- Medical costs continue to rise, driven by increased use and the cost of new specialized prescription drugs.
- The Oregon Reinsurance Program, which reduced individual market rates by 6.3 percent for 2019.
- Uncertainty in the individual market due to factors such as the elimination of the individual mandate penalty, and federal rules around association health plans and short-term/limited-duration plans.
See the chart at https://dfr.oregon.gov/healthrates/Documents/2019-fnl-prpsd-rates.pdf for the full list of decisions.
The division is not allowing any rate changes based on the temporary suspension of the federal risk adjustment program. Earlier this month, the Centers for Medicare and Medicaid Services temporarily suspended the risk adjustment program while it seeks a quick resolution to ongoing litigation in New Mexico. The program transfers funds from insurers with healthier enrollees to insurers who provide coverage for less healthy members. It is designed to help stabilize the market without additional costs to consumers.
Decision information for each carrier can be found at www.oregonhealthrates.org. Statewide premium comparison tables for ages 21, 40, and 60 will be posted online in August.
Source: Oregon Department of Consumer and Business Services