Health insurance rates in Ohio have increased for 2015, although the price hikes are relatively modest for most of the major companies with the largest market share. 2015 prices have been filed with the Oh Department of Insurance, and will be subsequently approved, or sent back for revision. The Department of Health And Human Services (HHS) must also approve any changes to Obamacare policies.
Free or low-cost medical coverage is still available in our state. With the availability of subsidized plans, dozens of policies from reputable carriers such as Medical Mutual, Anthem, Aetna, Premier, Ambetter, and UnitedHealthcare can be compared and purchased in minutes. It’s not unusual to find a family plan that costs between $40 and $150 per month.
Predicting Future Rates
There is great uncertainty when attempting to project the most appropriate price to charge consumers for their medical coverage here in the Buckeye state. There also is not a a substantial amount of data that is available from the 2014 Open Enrollment. And very few claims have been processed and studied. 16 carriers filed to do business in the Buckeye state for 2015. This represents one of the largest number of companies in any state.
Information on enrollee demographics, popularity of plans and market share can be easily studied. But the impact of offering every applicant guaranteed coverage may not be known for a few years. So although it’s not a crap-shoot, it’s safe to say it’s an educated guess when determining what rates to charge in 2015.
Are Higher Health Insurance Rates Making You Ill? There May Be Good News!
We researched all state filings and carrier information in predicting what to expect next year:
Anthem Blue Cross – Although their initial request is a 9% increase, many of the most popular plans will probably see lower price hikes. For example, although some Bronze plans will see double-digit increases, others will rise by less than 5%. The popular Silver plans offer the unique “cost-sharing” feature that substantially lowers your deductible if you qualify for federal subsidies.
The catastrophic option, one of Anthem’s cheapest plans in Ohio, and which is available to applicants under age 30, or anyone else that can show they can not afford other available options, will remain inexpensive, although benefits are limited and the deductible is above $6,000. In many situations, choosing a “Bronze-tier” instead of a catastrophic plan will actually save money.
The least expensive plans in each tier are: Pathway X PPO 6600/0% (Catastrophic), Pathway X PPO 6000/0% HSA (Bronze), Pathway X PPO 3500/25% (Silver), and Pathway X PPO 1250/10% (Gold).
Medical Mutual – Non-profit MM is asking for an increase just under 8% which brings its average monthly premium to about $400 for all plans. Of course Catastrophic and Bronze policies are the least expensive. The Northeastern portion of the state is where Medical Mutual is the most competitive. In may parts of Montgomery County (and South), MM is “in the ballpark,” but not one of the cheapest options.
Some enhancements for 2015 include better mental health and cardiac rehabilitation benefits. However, like many carriers, MM will discontinue covering ER visits that are not a true emergency or if the treatment occurs outside the US. Also, skilled nursing facility benefits will reduce.
Their cheapest options include: Market Young Adult Essentials (Catastrophic), Market HSA 4000 and 6000 (Bronze), Market Classic 2000 (Silver), and Market Classic 1000 (Gold). Fortunately, many less-expensive “grandfathered” plans are being renewed. Often, their premiums are as much as 20%-40% less than newly-offered policies.
UnitedHealthcare - UHC markets Ohio plans under the “Golden Rule” trademark, although they are back to using the UHC brand name for 2015 “on-Exchange” policies. In 2014, they did not participate in the Marketplace festivities. “Compass” is the brand name for their new policies.
Their “short-term” plan has been very popular for consumers that either forgot to enroll or simply wanted the cheapest option, regardless of non-compliance issues. They remain available for purchase throughout the year, regardless if you qualify for a special approved enrollment exemption.
Although UHC rates were a bit high in the Buckeye state for 2014, by sitting out a year and observing, they may have learned a few things. Their Bronze and possibly catastrophic offerings are the most popular. The new products are sold under the “All Savers” brand name. Recently, “Golden Rule” has been the brand used locally and in many other states. Golden Rule will still offer other plans (besides temporary) that are available as non-Marketplace plans.
UnitedHealthcare’s Compass Plans Are Very Affordable
The least expensive 2015 policies are Bronze Compass HSA 4900, Bronze Compass 5500, Silver Compass HSA 2600, Silver Compass 2000 and Silver Compass 3500. Plans are not available in all counties including much of the Dayton area. The Columbus area (including Franklin County) are well-represented.
HealthSpan – If you don’t recognize their name, you’re not alone. HealthSpan purchased Kaiser Permanante’s block of business last year and began selling products under their own name. They are projecting a 6%-8% price increase for the Northeastern portion of the state. Their HSA product is once again, one of their best available products.
Their most affordable options are: Bronze 4000-70 HSA, Bronze 5000-80, Silver 1500-70 HSA, Silver 3000 HSA, Silver 2500-80, and Silver 2000-70. In many areas South of I-70, their Silver-tier options are among the best choices. By adding the “cost-sharing,” you’ll enjoy low rates, low deductibles, and low copays. That’s a winning combination!
Aetna - Welcome back Aetna! For many years, especially from 2009-2011, Aetna was very active in the individual Ohio health insurance market, and featured very competitive rates. Smokers and females age 50 and over were their best niches. But they did not participate in the 2014 Exchange in most states including ours. However, they still maintain many “grandfathered” policies that were written in 2010 (or earlier) and are still in-force.
For 2015, they are concentrating on Cuyahoga County and the Cleveland area. Aetna is also reducing prices by approximately 6%-8% which should make it an attractive option, especially considering its large provider network. Coventry, a company they recently purchased, will concentrate on other states. But it is still undetermined if the Cleveland Clinic will be part of their network.
Aetna’s most affordable 2015 plans include Bronze Deductible Only HSA, Bronze $20 Copay, Silver $10 Copay, Silver $5 Copay 2750, and Gold $5 Copay. In several counties, Aetna’s Oh rates are the lowest available option. NOTE: Their prices in the Southwestern counties are VERY attractive (Montgomery, Warren and Butler).
Assurant - Recently, Assurant’s rates have not been competitive. In fact, from 2010-2013, often their prices for standard plans were about 40%-80% higher than most other companies. In 2013, they did not offer on-Exchange plans, although several off-Marketplace policies were available. However, for many years, Assurant (also known as Time) was one of the few carriers to offer “child only” plans on a short-term basis.
Their 2015 rate request would place them about 30% (on average) higher than Medical Mutual. While Assurant may gather some market share, we don’t expect the final numbers to be significant.
CareSource Headquarters In Dayton
CareSource – Based in Dayton, CareSource used to be known as “Dayton Area Health Plan.” They specialized in managed-care coverage for Medicaid recipients prior to the 2013 Exchange, which saw them offer numerous plans to consumers. No information is available regarding their projected 2015 pricing.
They don’t utilized brokers and seem rather uninterested in expanding. Customer-service, from our initial observation, is cordial, but not very effective.
SummaCare – Although only a regional carrier, (Northern portion of the state), SummaCare offered competitive prices in 2014 through four plans (Individual 750, 5000, 6350 and Value). They were all fully-compliant and often priced slightly less than Medical Mutual. There is no advanced information available on their 2015 projected rates.
Molina Healthcare – Most persons haven’t heard of Molina since they don’t participate in all portions of the state. Although they only started offering coverage in 1980, they have grown to become a Fortune 500 company. They offer a Bronze, a Gold, and four Silver plans at reasonable rates. For 2015, they have increased prices in some states, and projected decreases in others (Washington State).
Molina’s rates next year should remain about the same, with increases in certain counties. They do not offer coverage in all areas and typically are not competitive in most counties.
InHealth – Based in Westerville, this small company makes its Marketplace debut in 2015. Although they offered selected plans to consumers last year privately, like Molina, they are not a widely-known company. InHealth is expected to raise prices by about 10% compared to last year’s rates. However, they will still be extremely competitive with most other carriers, and probably one of the least expensive companies in some parts of the state.
Aultcare – Offering plans mostly in the Northern portion of the state, this regional carrier writes a lot of business in Summit, Medina, Stark, Tuscarawas, Mahoning, Carroll and Holmes counties. There has been no formal announcement regarding any price changes for 2015.
We will keep you informed on any changes or projections for Ohio Health Insurance Exchange plans for 2015. Additional Marketplace information regarding prices or policy availability will be regularly updated.
Premier – Available in the Dayton area, it’s difficult to predict pricing when it is their first year of offering coverage, either on or off the Marketplace. But it appears their rates will be extremely competitive for consumers that want an office visit copay instead of paying the entire amount out-of-pocket.
In many situations in Warren and Montgomery County, Premier will be the best option for purchasing a comprehensive plan. The provider network is Miami Valley Hospital-based and there is a wide selection of physicians and facilities in the area.
Ambetter – Part of the Buckeye Community Health Plan, Ambetter’s pricing will be among the lowest in many counties, including Hamilton and Montgomery. However, there coverage area is limited, although in Indiana, they also offer policies in many counties. Several inexpensive Bronze plans allow you to add three primary care physician (pcp) visits for a nominal charge.
October 14 2014 – Although Open Enrollment begins in a month, it is not expected that rates for all carriers (for the upcoming year) will be released until the first or second week of November. Although many consumers feel this delay is political-motivated, in fairness, many states have not completed their examination and approval process of carrier rate-change requests.
November 26 2014 – Prices have been officially released, and as expected, some carriers substantially increased rates, while others were able to match 2014 plan costs. Enrollment times have been drastically cut with the help of redirect software. The quickest way to compare 2015 Ohio Marketplace plans is to use our Direct Enrollment Link that will save time, money and perhaps a lot of frustration!
December 11 2014 – Even if you don’t change coverage for 2015, it’s still important to verify that your primary care physician (PCP) is still considered “in-network” from your current carrier. Each years, may physicians add and delete companies from their “do accept” and “do not accept” lists. Since the online directories may not be updated until after Open Enrollment ends, a quick verification call may save you money.
February 2 2015 – When you file your taxes, if you received a federal subsidy, you must complete IRS Form 1095-A. This new addition to the IRS code is the official Marketplace Statement verification and works with Form 8962, the Premium Tax Credit statement. Form 8962 must be used when premium assistance has been received.