The health insurer with the largest share of the Obamacare online Wisconsin marketplace this year— Anthem Blue Crossand Blue Shield — will increase its rates for individual policies an average of 9 percent in 2015.
Because Anthem’s Compcare Health Services Insurance holds at least 25 percent share in the Wisconsin Affordable Care Act exchange individual market, the company’s rate trajectory is being closely watched in the state’s health care industry.
A spokesman for the company emphasized the 9 percent figure is an average for both Affordable Care Act exchange policies and non-exchange individual policies. Actual increases for specific policyholders will depend on the plan they select, their age, tobacco use and where they live, Anthem spokesman Scott Larrivee said.
Insurers are not required to disclose actual rate increases and prices until November.
“Rate filings reflect the information we have at hand, including addressing the rising cost of care, the new pool of customers, our experience with provider networks, new rating structures, and new taxes and fees,” Larrivee said. “These new rates help ensure that we can pay doctors, hospitals and other health care professionals to provide the care our customers need and deserve.”
Anthem’s exchange network in southeast Wisconsin includes Aurora Health Care andChildren’s Hospital of Wisconsin.
Anthem will face a major new competitor when open enrollment starts in November asUnitedHealthcare is entering the Wisconsin exchange. UnitedHealthcare has yet to reveal its rates.
A smaller competitor, Molina Healthcare Inc., plans to decrease its rates an average of 11 percent in 2015 for individual enrollees, as I reported Sept. 24. An executive with Long Beach, Calif.-based Molina said the price decrease results primarily from company executives’ belief that enrollees for 2015 will be in better health than first-year enrollees.
Some uninsured people didn’t enroll this year when the penalty for not enrolling was $95. The penalty on adults is set to increase to $325 for 2015 and $695 for 2016.
Molina enrolled nearly 3,000 people via the marketplace in Wisconsin this year. The number of Wisconsinites enrolled in the Affordable Care Act marketplace in 2014 was 139,815, according to the U.S. Department of Health Services. The federal agency runs the Wisconsin exchange.
Date: September 26, 2014