Since 2014 under Affordable Care Act rules, new ACA qualified health plans had just one rate for dependents from ages 0 to 20. In 2018 there will now be 7 different age based rates with the first for ages 0 – 14. Beginning at age 15 there will be a separate age rates per year up to age 20. The new member level age rating does not apply to grandfathered plans.
“A comprehensive marketing and outreach campaign has been a critical ingredient of Covered California’s success, and more importantly is a vital component of any effort to promote stability in individual markets across the nation,” said Lee. “Getting the word out is a proven way to promote enrollment and bring more healthy people into the risk pool, which lowers premiums and saves money for everyone.”
Western Health Advantage (WHA) has announced that the Department of Managed Health Care has approved their expansion for small group plans into the Bay Area. They also noted that they will not seek re-certification of their Covered California small group plans because of this expansion. WHA’s exit from the Covered California for Small Business plans does not affect their individual and family plan offerings through Covered California.
Covered California instructed health insurance companies to submit their rates assuming direct payment to fund the CSR subsidies would be continued, but to also submit a separate CSR surcharge to “load” any costs to fund this program onto Silver-tier plans for those who receive subsidies. As a result, Silver-tier consumers may see an additional “CSR surcharge” that averages 12.4 percent — ranging from 8 percent to 27 percent on the gross price of their premiums
Covered California’s board acted to place any rate increases caused by the uncertainty only onto Silver plans. While Silver level consumers will see an increase in the gross cost of their premiums, they will also see an increase in the amount of financial assistance they receive, leaving their net payment virtually the same.
SACRAMENTO, Calif. — A new analysis shows that Covered California continues to attract a healthy mix of enrollees, and the overall health of its enrollees improved from 2016 to 2017. This data is key to Covered California’s stability and will be used to help shape and inform rate negotiations with its 11 qualified health plans […]
We have analyzed the American Health Care Act, and as currently structured, it would greatly increase the ranks of the uninsured and increase costs for millions more. We will continue our work to both assess the potential impacts of new policies and focus on assuring that we administer the law that exists today.
The analysis found that Covered California health plan premiums could rise up to 49 percent if two key elements that have been in place for the past four years are changed: Cost-sharing reduction reimbursements are no longer directly funded as reimbursements to carriers, and the shared individual responsibility payment is not enforced.
Beginning April, 24 2017, Covered California will send notices to consumers to notify them they are at risk of losing their Advance Premium Tax Credit (APTC) and/or cost-sharing reductions for health insurance coverage through Covered California in 2017.
The impact of not providing direct federal funding of cost-sharing reductions is enormous, and not only puts the viability of the individual market in many states in peril, but would be a bad deal for the federal budget — costing more than $47 billion over the next 10 years,” said Peter V. Lee, executive director of Covered California.