Tuesday, June 18, 2013 | 11:22 p.m.
Hi, (not you?) | Member Center | Sign Out
Posted: 11:55 p.m. Wednesday, Jan. 9, 2013
By Chelsey Levingston
Health insurance premiums are rising this year for many Ohioans, and some will see larger double-digit percent increases than they’ve seen before, according to rate requests filed by health insurers.
The rate hikes come ahead of implementation in 2014 of key provisions of the federal health care law, which industry watchers expect to dramatically increase insurance costs for some people even though the law’s intention is to help make health care more affordable.
Some individuals could see their rates rise 55 to 85 percent next year, according to a recent study for the state.
Here’s a sampling of rate increases in Ohio according to www.healthcare.gov, a website managed by the U.S. Department of Health and Human Services:
The federal health care law requires scrutiny of health insurers who request annualized rate hikes of 10 percent or more.
Premium increases are larger for people who buy their own health insurance or work for small businesses because costs associated with large claims can’t be spread among a bigger group of participants. The expenses of large groups are also more predictable, insurance industry experts said.
Health insurance experts say some insurers are factoring higher future costs next year into their calculations this year.
What someone actually pays for health insurance depends on their plan, their benefits, age and health, so some people will pay less and some will pay more, experts said.
Ohio Department of Insurance reviews these rate requests, which carriers file throughout the year. The average rate increase in Ohio for individual and small group plans is still below 10 percent, according to the insurance department.
“We have seen rates or increases be up slightly this year over the last several months of filings we’ve seen compared to what they’ve been last year,” said Carrie Haughawout, assistant director for health policy of the Ohio insurance department. “Ultimately health insurance rates are just reflecting the cost of health care and the cost of health care (has been) going up for years, so the cost of health insurance has correspondingly been going up.”
Local restaurant business Milano’s Atlantic City Submarines operates three Dayton market restaurants with less than 100 total employees.
“I’m expecting and I’m hoping it’s going to be anywhere around the 5 to 8 percent range,” the status quo in recent years, said David Fisher, a partner in Milano’s.
Milano’s insurance plan renews in May, so Fisher hasn’t received his company’s rate increases yet. Companies are expecting a big jump in expenses to happen in 2014, Fisher said.
Milano’s goal is to continue to offer insurance because owners see it as a huge benefit to staff.
“The impact we don’t know is how many additional people will qualify for our plan,” Fisher said. “We’re bracing for both — for rates to go up and for more people to be on the plans.”
Insurers say rates are rising due to the cost of health care services. The national trend is for medical costs, including hospital stays, to rise 7 to 8 percent a year, according to the state insurance department.
“Our rates reflect the underlying health care costs and care consumption of our members as well as projections of future trends in the cost of care and its delivery,” said Mary Krutiak, spokeswoman for Celtic, in a statement.
Celtic said in its rate request it has a medical loss ratio of 128.4 percent, which means it’s spending more money from enrollees on health care services than it is on overhead. The standard is 80 percent on health care costs.
The largest part of a member’s rate is the cost paid for medical claims, said Anthem spokeswoman Kim Ashley in a statement.
“The rate increases in the individual market are not unique to Anthem, but rather represent an economic reality faced throughout the entire industry, indicating health care costs continue to escalate faster than the growth of premiums,” Ashley said.
Scot Roskelley, Aetna spokesman, said in a statement premium increases “are being propelled by the increasing prices of hospital care, prescription drugs, doctor’s visits, and other health care services. Other underlying cost pressures — from the underpayment for government insurance to the rising rates of obesity — also drive up premiums.”
U.S. Health and Human Services says the federal health care law is helping costs. Insurance rate reviews have saved $1.1 billion and medical loss ratio rebates have returned $1 billion to consumers and businesses, the department said.
The Patient Protection and Affordable Care Act requires insurers to stick to an 80/20 rule — that at least 80 percent of premiums paid by consumers be spent on health care and improving care quality.
A new report shows the nation’s health care tab was $2.7 trillion in 2011, up 3.9 percent from 2010, the third straight year of historically low increases in the United States, according to analysis by Health and Human Services.
“The health care law will help bring down costs and save money for American families and businesses. A number of provisions in the Affordable Care Act are already helping us to reduce the increase seen in health care spending over the past decade, keeping down costs for consumers, and ensuring better health and access to health care for millions of Americans,” said Fabien Levy, spokesman for Health and Human Services in a statement.
Still, health insurance experts said 2013’s rate increases are only a taste of what’s to come.
“I don’t think we’ve seen anything like what we’re going to see,” said Mike Suttman, president of Dayton employee benefits brokerage McGohan Brabender. “There might be a little bit of carriers preparing for what’s coming … to smooth out some of the rate shock.”
Insurers won’t be allowed to adjust rates based on health risk under the health care law the same way they have been.
“They’re trying to homogenize the rates so that everybody pays a similar rate and there’s not such wide swings from the lower, healthier end and the higher, older, sicker end,” said Haughawout of the state insurance department.
The effect of that will be so “those that have low risk are probably going to experience higher costs,” said Chris Brock, spokesman for state insurance department.
Health insurance premiums for individuals buying insurance in Ohio are poised to rise an average 55 to 85 percent in 2014, according to a study done by consulting firm Milliman Inc. on contract for the state. That estimates the impact of health care reform, and is in addition to the amount costs would increase to cover rising medical costs.
Employers with two to 50 employees are projected to see average increases of 5 to 15 percent in 2014 for the impact of the health care law, not including yearly medical trend increases, according to the Milliman study.
Key points on health insurance costs
Advertisers & Sponsors |
© 2013 Cox Media Group. By using this website,
you accept the terms of our Visitor Agreement and Privacy Policy, and understand your options regarding Ad Choices
.
Already have an account? Sign In
{* #registrationForm *} {* traditionalRegistration_displayName *} {* traditionalRegistration_emailAddress *} {* traditionalRegistration_password *} {* traditionalRegistration_passwordConfirm *}Already have an account? Sign In
{* #registrationFormBlank *} {* registration_firstName *} {* registration_lastName *} {* traditionalRegistration_displayName *} {* traditionalRegistration_emailAddressBlank *} {* registration_birthday *} {* registration_gender *} {* registration_postalZip *} {* traditionalRegistration_passwordBlank *} {* traditionalRegistration_passwordConfirmBlank *} {* agreeToTerms *}We have sent you a confirmation email. Please check your email and click on the link to activate your account.
We look forward to seeing you frequently. Visit us and sign in to update your profile, receive the latest news and keep up to date with mobile alerts.
Don't worry, it happens. We'll send you a link to create a new password.
{* #forgotPasswordForm *} {* forgotPassword_emailAddress *}We have sent you an email with a link to change your password.
We've sent an email with instructions to create a new password. Your existing password has not been changed.
To sign in you must verify your email address. Fill out the form below and we'll send you an email to verify.
{* #resendVerificationForm *} {* resendVerification_emailAddress *}Check your email for a link to verify your email address.

You're Almost Done!
Select a display name and password
{* #socialRegistrationForm *} {* socialRegistration_displayName *} {* socialRegistration_emailAddress *} {* traditionalRegistration_password *} {* traditionalRegistration_passwordConfirm *}Tell us about yourself
{* registration_firstName *} {* registration_lastName *} {* registration_postalZip *} {* registration_birthday *} {* registration_gender *} {* agreeToTerms *}