Anthem proposed to lower the premium next year for its most popular individual health plan by 8.4%, but to raise by 1.9% the cost for its small business plan.
Once again, Anthem’s HealthKeepers plans will be the only ones offered in the Roanoke and New River valleys for individuals who purchase health insurance through the government exchange. But at least nine other insurers will offer small businesses choices.
Anthem is the predominant carrier for much of Virginia.
Anthem explained its rate requests Monday during a State Corporation Commission Bureau of Insurance video hearing. The state will need to approve and submit the plans next week to the federal government.
“The bottom line is on our most popular plan is an 8.4% decrease,” Anthem’s Tim Connell said.
Connell showed a slide that priced its most popular silver plan for individuals with a $513 monthly premium this year, dropping to $470 in 2021. The exact prices can vary across localities and by age of the purchaser.
The plan will have the same $6,250 deductible, $35 copay and 35% coinsurance, and the out-of-pocket maximum will rise $400 to $8,550.
Consumers whose household income is at or below 400% of the federal poverty level qualify for subsidies through the Affordable Care Act that are based on a sliding wage scale. This year an individual making up to $51,000, and a family of four with annual earnings of $104,800, qualified for subsidies.
Julie Blauvelt, deputy commissioner of the Bureau of Insurance, said the amount of subsidies will likely decrease in 2021, as they are based on the premium for a benchmark silver plan. She advised consumers to compare plans, prices and subsidies before automatically renewing their current plans.
She said about 3% of Virginians purchase individual plans on the exchange, a number that has dropped since Virginia expanded Medicaid to cover low-wage workers.
She said she did not have current figures for Virginians whose health insurance is through a plan purchased by a small business, but in 2018 about 4% of residents were covered this way. Small businesses are those with fewer than 50 employees.
Blauvelt said most of the insurers have been working with small business owners affected by the pandemic by delaying premiums, but too much is uncertain to know whether it will affect the number of policies purchased in 2021.
She said there was a large spike of individuals in April nationally who lost their workplace insurance and purchased plans on the marketplace exchange. About 154,000 of these policies were sold that month, compared to past years when between 64,000 and 72,000 were purchased in April.
David Shea, an actuary for the bureau, said COVID-19 has created uncertainty for the insurers as they planned their 2021 rates.
He said that just nine of 26 rate filings included adjustments, and that the insurers in their initial filings were seeking higher increases of 2.4% to 8.4% that by last week’s deadline had dropped 0.2% to 3.7%.
“Whatever the carriers assumed by the end of last week is what’s in their rate hikes for next year,” he said.
The bureau needs to approve the carriers’ rates and then submit them to the federal government next week to be included in this fall’s open enrollment.
Source: Roanoke