Division of Insurance releases preliminary 2016 plans
Final approval will be complete in September
DENVER (June 15, 2015) – The Colorado Division of Insurance (DOI), part of the Department of Regulatory Agencies (DORA), has released preliminary information regarding the proposed rates submitted by health insurers for Affordable Care Act (ACA) plans for the 2016 plan year.
The due date for 2016 ACA rate filings was May 29. Since then, DOI staff has been conducting initial reviews to check the filings for completeness, and to ensure that any confidential or proprietary information has been properly marked. It is important to note this information is preliminary, and has not undergone a complete review or actuarial analysis. DOI will complete its review in September. A total of 1,377 plans were submitted for review, including 1,221 medical plans and 156 dental plans.
Of the 1,221 medical plans, 425 are proposed to be offered through Connect for Health Colorado, the state’s health insurance exchange, with the remainder to be sold off the exchange. The medical plans consist of 239 individual plans and 186 small group plans. Overall, 23 carriers will be offering individual and/or small group medical plans in Colorado in 2016. Of these 23 carriers, 11 will be offering individual and/or small group medical plans through Connect for Health Colorado. Remember that even these plan counts for 2016 are preliminary and could change when final approval is completed in late summer. Lists of carriers and requested rates changes for individual and small group plans are also available on the page for DOI’s Online Search Engine for Rate Filings.
“As in 2014 and 2015, it is great to see so many carriers offering plans in Colorado,” said Commissioner of Insurance Marguerite Salazar. “We have such a competitive market, with many choices for Colorado consumers. When open enrollment comes this fall, folks should shop and carefully consider the plans that are best for their needs.” While some states have seen dramatic increases in proposed rates for 2016, some insurers in Colorado have requested lower rates, and others are looking to single-digit increases. Overall increases appear to be more than the average increases seen from 2014 to 2015, however these are just the premium rates requested by insurers, and are not the approved rates. Any requested rate has to be justified by the insurance carrier.
“The proposed increases are likely due to a couple of reasons,” said Tom Abel, head of DOI’s Rates and Forms section for life, accident and health insurance. “It looks like the number and types of claims are impacting the rates, as well as medical inflation. It’s also the first time carriers have a full year’s business experience under the ACA.” “A key factor in the cost of health insurance is something that the Division and insurance companies have no control over, and that’s the cost of health procedures and services,” said Commissioner Salazar. “We all need to work together to figure out how we bring those costs down.”
The rate review process requires that insurance companies justify the premiums and benefit packages included in their plans. During the summer, DOI staff will examine each plan to make sure it is in compliance with the requirements of the ACA and state and federal laws. DOI will review the information that carriers submitted to support and justify the proposed rates, including data regarding their past experience and future projections, to ensure the rates are not excessive, nor inadequate to pay claims. DOI will also verify whether the plans meet the federally defined metal tier coverage levels: bronze (60% of medical expenses paid by the plan), silver (70%), gold (80%) and platinum (90%).
These percentages are referred to as “actuarial value.” The filings are available for review on DOI’s Online Search Engine for Rate Filings. During this review period, Colorado consumers can submit public comments on the filings, which will be reviewed and considered by the Division. When viewing the filings online, there will be a section for comments within each filing.
Consumers would need to click on the “Add” link in the “Comments” column of the filing of interest, and will be prompted to enter their name, city and state of residence, email address, and the comment. The Division encourages consumers to submit comments no later than July 6, 2015, so they can be included as part of the Division’s review of the filings. After DOI completes its review and analysis in September, it will notify carriers and Connect for Health Colorado of the approved plans for 2016. At that time, DOI will also provide summary information and analysis regarding the carriers and plans for 2016, both on and off Connect for Health Colorado.
The Colorado Division of Insurance (DOI), part of the Department of Regulatory Agencies, regulates the insurance industry in Colorado and assists consumers and other stakeholders with insurance issues. Visit www.dora.colorado.gov/healthinsurance for more information
The Department of Regulatory Agencies (DORA) is dedicated to preserving the integrity of the marketplace and is committed to promoting a fair and competitive business environment in Colorado. Consumer protection is our mission. Visit www.dora.colorado.gov for more information or call 303-894-7855 / toll free 1-800-886-7675.