OHIC approves 2016 commercial health insurance rates

HEALTH INSURANCE COMMISSIONER DR. Kathleen C. Hittner released commercial health insurance premiums for 2016 on Wednesday. She said she approved lower rates than what was requested by most insurers. / COURTESY R.I. OFFICE OF THE HEALTH INSURANCE COMMISSIONER
HEALTH INSURANCE COMMISSIONER DR. Kathleen C. Hittner released commercial health insurance premiums for 2016 on Wednesday. She said she approved lower rates than what was requested by most insurers. / COURTESY R.I. OFFICE OF THE HEALTH INSURANCE COMMISSIONER

PROVIDENCE – Commercial health insurance rates have been approved for 2016 by the health insurance commissioner, and while all are higher than what was approved last year, the amounts are lower than what was requested by most insurers.
Dr. Kathleen C. Hittner, health insurance commissioner, said she listened to “hardworking Rhode Islanders and business owners struggling to keep up with the increasing cost of health insurance for their families and their employees.”
“My office’s review of premium requests balances affordability to the consumer with a legal obligation to guard the solvency of insurers. This year’s approved rates are lower than the insurers requested. However, there continues to be room for improved affordability for consumers by reforming the payment and delivery system,” Hittner said in a statement.
The rising cost of medical care continues to drive health insurance premium growth, according to a news release from her office.
The OHIC reviewed increases to premium rates for health plans sold to individuals, and small and large employers who purchase coverage through Blue Cross & Blue Shield of Rhode Island, Neighborhood Health Plan of Rhode Island, Tufts Health Plan and UnitedHealthcare of New England.
Because the process for BCBSRI’s individual plans are subject to a separate rate review hearing required by Rhode Island law, the process is still ongoing. Blue Cross requested a base rate of $389.59, which was 18 percent higher than its 2015 approved rate of $328.25.
In the individual and small group markets, the essential health benefits base rate represents the premium for a plan with no cost-sharing for a 21-year-old. Final rates differ based on a subscriber’s age and benefits chosen, the release stated.
On the individual side, a base rate of $312.20 was approved for Neighborhood Health, an 8 percent increase compared with 2015’s $288.99 rate. A rate of $320.28 was requested.
UnitedHealthcare received a $311.10 rate, a 4.1 percent increase over 2015, but lower than the $331.80 requested.
Small employer base rates are as follows:

  • BCBSRI: $376.94, 2.3 percent higher than 2015, lower than the $385.56 requested for 2016
  • Neighborhood Health Plan: $320.98, 1.9 percent higher than 2015, higher than the $315.97 requested
  • Tufts HMO: $398.13, 3.3 percent higher than 2015, lower than the $404.59 requested
  • Tufts PPO: $403.25, 3.7 percent higher than 2015, lower than the $409.85 requested
  • United HMO: $406.33, 7.2 percent higher than 2015, lower than the $430.26 requested
  • United PPO: $410.85, 7.2 percent higher than 2015, lower than the $435.04 requested

Large employer base rates are reviewed only as a change to the previous year, with the actual rates to employers weighted by their size. The rate changes for 2016 are as follows:

  • BCBSRI: 5.1 percent increase, after an increase request of 7.3 percent
  • Tufts HMO: 6.1 percent increase, after an increase request of 6.7 percent
  • Tufts PPO: 6.6 percent increase, after an increase request of 7.2 percent
  • UnitedHealthcare: 4.4 percent increase, after an increase request of 7.1 percent

“We will be coming together as a state to address the root causes of rising health care costs,” Secretary of Health and Human Services Elizabeth H. Roberts said. “By working together and building on initiatives such as OHIC’s affordability standards, our ‘reinventing Medicaid’ process and the efforts of the Working Group for Healthcare Innovation, we can spark innovation across our health care system to improve costs while providing the quality care that Rhode Islanders deserve.”

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