California Health News

Children To Get Hit With Higher Health Insurance Rates In 2018

Young adults and children under 21 years old will see higher health insurance rates in 2018 under new age rating rules.

If you have children between the ages of 15 and 20, look for their health insurance rates to take a big jump in 2018. Small group plans for Kaiser and Sutter Health have announced they will implement the new member level age rating for plan members as young as 15 years old. This change to the rates could mean a significant increase for dependents ages 15 to 20 years old.

The U.S. Department of Health and Human Services (HHS) Notice of Benefit and Payment Parameters for 2018 Final Rule revised the ACA’s regulations concerning Fair Health Insurance Premiums. The Final Rule directs all health plan issuers of non-grandfathered small group and individual plan coverage (on and off the Exchanges) to revise the member level rating age bands used for individuals 0-20 years of age from using one age band to now create 7 age bands. The first age band cover ages 0-14, then single year age bands cover 15, 16, 17, 18, 19 and 20. This change will align with utilization of services while smoothing rate increases over time.

Still enforce is the maximum 3 child rate rule. Premium rates will be based in the 3 eldest children under 21 in the household. The fourth, or more, child under 21 pay no additional premium. As of September 19, 2017, Kaiser Permanent and Sutter Health have announced they will implement the new member level rates for small group plans effective in 2018. Additionally, Kaiser has said they will apply the new rating structure to their individual and family plans in California.

Children Get Higher Health Insurance Rates In 2018

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.

Center for Medicare and Medicare ACA new rate factors for individuals under 21 years old.

Premium ratios are based on adult rates. So by increasing the factor on which the child rate is calculated from the adult rate, the child premium rate will increase.

Kaiser health insurance rate increases for individuals between 15 and 20 years old for 2018.

This Kaiser table of the new child rate curve shows the increases to the rates by age.

Sutter Health Plus Silver Plan Sacramento region new age rates for 2018.

For small groups, employers and employees will be notified of the new under 20 year old rates at the time of their renewal. Kaiser says they will notify individual and family members with their 2018 renewal packages that should occur in the fall of 2017.

Blue Shield has filed rates with the Department of Managed Health Care that indicates that their individual and family plans will also have the new rates for dependents under 21 years old.

Rates filed by Blue Shield for Orange County Silver PPO plan showing rates by age for under 21 years old.