Obamacare Plans: Four Things the Health Connector Isn’t Telling You

by Andrew Walden

Acting as a salesman for HMSA and Kaiser, the State DCCA Insurance Division today pretended to reveal the alleged premium rates for Obamacare plans to be sold on the Health Exchange starting October 1. 

Here's what they didn't mention:

1. Deductibles
2. Family rates
3. Smokers' rates
4. What's not covered

Instead of talking about deductibles (They start at $6350--the co-pays start at 40%) the DCCA Insurance Division spoon-fed local media information about a $120/mo rate for a 21 year old non-smoker.  MDs and Hospitals will soon be wondering how that 21 year old will pay $6350 in medical bills when she has her first child. 

See this article for a clearer look at what’s really going on: HMSA 'Dumping' Thousands of Policies, Blames Obamacare

A video from ‘Opt Out’ questions privacy: Opt Out

And here is today’s ‘coverage’:

• PBN: Hawaii reveals rates for health insurance plans under state online exchange
• SA: State unveils plans' premiums
• WHT: Businesses get a glimpse of Affordable Care Act changes

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News Release from DCCA September 20, 2013

HONOLULU – The Department of Commerce and Consumer Affairs (DCCA) Insurance Division’s completed analysis of individual rates approved for the Hawaii Health Connector found that the plans are so far among the lowest in cost in the nation.

“The State of Hawaii continues to be a leader in our nation’s healthcare transformation,” said Gov. Neil Abercrombie. “Hawaii residents are seeing the benefit of collaboration between state government agencies, insurers and nonprofit stakeholders in the implementation of the federal Affordable Care Act. We are working together toward our shared goal of universal healthcare and ensuring access to quality health care for everyone in our state.”

Starting Oct. 1, the Hawaii Health Connector will begin offering plans approved by the Insurance Division. Those plans will be ranked by “metal” levels:

• platinum with a 90/10 cost share;
• gold at 80/20;
• silver at 70/30; and
• bronze at 60/40

Beyond that, the individual’s coverage will be adjusted for age, family size, and tobacco use.

Compared to the results of a study published by the Kaiser Family Foundation, Hawaii’s rates before tax credits and reimbursement estimates for a 40-year-old resident at $217 would be the third lowest.

1. Portland, OR $201
2. Albuquerque, NM $212
3. Honolulu $217
19. Burlington, VT $413

In a comparison of analysis done by Avalere Health, the Insurance Division’s actuaries found that Hawaii has the lowest average monthly plan rate in each of the four metal levels before tax credits and reimbursement estimates.

Those going to the Hawaii Health Connector to explore their health insurance options will be able to see if they qualify for tax credits and other reimbursements. Individuals under 400 percent of the federal poverty level ($52,920 for an individual and $108,360 for a family of four) can have their net out-of-pocket cost to purchase health insurance reduced.

These costs are averages, and individuals should go to the HawaiiHealthConnector.com or contact HHC’s marketplace assisters to get the best idea on what they can expect to pay.

“The Insurance Division put in many long hours to approve a high number of health plans that Hawaii residents will be able to choose from when they go to the Hawaii Health Connector,” Insurance Commissioner Gordon Ito said. “Our team approved 95 base plans for the HHC alone.”

“I am proud of the additional hard work the Insurance Division and Commissioner Ito put in to help Hawaii consumers,” DCCA Director Kealii S. Lopez said. “They overcame tight time constraints to approve the high number of plans. This is a more than 500 percent increase in the number of plans they approve in previous years.”

A key provision under the Protection and Affordable Care Act (ACA) is that everyone must have health insurance starting on Jan. 1, 2014. To accomplish this, ACA prohibits health insurers from denying the purchase of health insurance if a person had a preexisting medical condition. Everyone can purchase a policy regardless of your health status.

Small business with 25 employees or less could qualify for a small business tax credit of up to 50 percent of the cost of health insurance to help offset the cost of providing health insurance to their employees. Presently, the tax credit is up to 35 percent. The amount of the credit depends on the size of the business and the average wage of its employees.

On Oct. 1, 2013, individuals and small business owners can do their comparison shopping and check with the Hawaii Health Connector to see what benefits, tax credits and rates they will be eligible for. They can sign up for a plan but the insurance coverage will not start until Jan. 1, 2014.

The Hawaii Insurance Division oversees the state’s insurance industry; issues licenses; examines the fiscal condition of Hawaii-based companies; reviews rate and policy filings; and investigates insurance related complaints.