by Andrew Walden
Armed with the age 21 non-smoker rates which HMSA is sending out to thousands of individual clients as it cancels their existing plans, an Honolulu human resources manager has calculated a full spectrum of the non-smokers’ individual plan prices for all age groups which will become effective January 1, 2014.
Here is a link to the complete spreadsheet >>> LINK
Here is how he did it:
Age 21 has a factor of 1.000 which equals the base rate of the plan. With the base rate the entire age curve can be calculated.
The maximum amount on the age curve has a factor of 3.000. This compresses the ranges so that the result is an increase in the young age range to support the older individuals. At the high end of the table, the Platinum ‘rich’ plans, the age 64 premium is as high as $873 for the single rate. A couple at that age would be double--higher if they are smokers.
Kaiser plans will be similar but I do not have the actual amounts yet.
If the Hawaii Health Connector would have opened on schedule on Oct 1, all of the plans would be available to the public as they should be.
HHS has recently released all 17,000 plans in 36 states for the Federally Facilitated Exchanges on the mainland. This will drive us towards public disclosure, increased competition and lower rates.
With the individual plan spreadsheet, family rates can now be calculated. The pricing for HMSA's family plan is outlined on page 5 of its cancellation mailer sent out in September to individual insurance purchasers >>> See LINK
UPDATE: HMSA and Kaiser Oct 5 posted online calculators which allow you to find your age-based individual plan rates >>> HMSA -- KAISER
To calculate a family rate based on the spreadsheet, consider a hypothetical family:
- Husband and wife both age 44,
- 1st child age 24,
- four other children under 21
According to HMSA's sheet, everybody's age-based individual rate is added together -- except the 5th child is free. So the gross rate for Platinum PPO 100 for our hypothetical family would be:
(406.86 x 2)
+ 291.24
+ (184.94 x 3)
$1659.78
Any ACA subsidies, employer-provided coverage, and Medicaid coverage would then be subtracted to generate a net insurance premium.
HMSA, Kaiser, and the Hawaii Health Connector continue to refuse to make these rates public. Why?
The Health Connector claims to be incompetent to load the information onto its website and has suggested the info may not become available until the end of October. That rather pathetic excuse does not explain why the information is not available on a publicly accessible spreadsheet--or why Hawai'i Free Press can put a price list together and publish it online but the combined resources of HMSA, Kaiser and the Health Connector cannot. Our source has a theory:
HMSA and Kaiser both have said that they want to keep their rates confidential for competitive reasons. This goes counter to the basic objectives of ACA to get transparency in rate determination and to encourage competition. The state insurance division wants to have the rate fillings open to the public but the insurance companies have fought this.
Expect some legislation in this session that may make future filings open to the public. Rate filing requests are submitted by the insurance companies to the state insurance commissioner using an online system called SERFF. This system is open to the public and has a function to allow the public to comment and give feedback on each and every filling. Unfortunately, in Hawaii the posted filings have been edited so that no rates are shown. How is the public able to intelligently comment? Looking at other states on the SERFF system I see that most filings are complete with no important information redacted. Lucky we live Hawaii.
Other insurance companies here in Hawaii that are not on the Connector are anxiously waiting for the rates to become public in order to file their rates and plan how to compete against the two big guys. UHA, HMAA, and Family Health Hawaii all need to price their product at a level to compete with HMSA and Kaiser.
If you have received a letter from HMSA or Kaiser cancelling your current insurance or sharply increasing your rates, please email us a copy at editor@HawaiiFreePress.com. We are particularly interested in small business group rates and smokers’ rates. Your privacy will be protected.
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