Rate request: Average increase of 12.5 percent
Decision: Under Review
Public Comment Period: June 3 to June 23, 2014
On May 30, 2014, Anthem Health Plans, Inc. filed a rate request for an average 12.5 percent increase on individual health plans marketed on and off the state’s health insurance exchange beginning January 1, 2015. The company reported that the proposed rate change would affect approximately 66,200 policies.
The company says the plans marketed through Access Health CT will meet all the Essential Health Benefits criteria mandated under the federal health care reform law.
Anthem also said the rates also take into account other mandates related to the federal law such as guaranteed issue and new ratings rules, minimum actuarial value of 60 percent and taxes and fees.
In addition, the company is projecting that costs of medical services and demand for those services, known as “trend” will account for an 8.4 percent impact over the current rates. The company anticipates a “pent-up” demand for health services in 2015, the second full year of the Affordable Care Act, and higher morbidity – the influx of previously uninsured into insured risk pools. The morbidity adjustment, the company filed, is based on “a CDC study on the health status and life styles of both currently insured and uninsured populations.”
The company also noted that other factors affecting rates are taxes and fees, changes in benefit design, particularly on the pharmacy side. Anthem is accounting for 100 percent coverage of benefits for specific over-the-counter drugs obtained with a doctor’s prescription. Projections also include the estimated costs during 2014 and 2015 of the drug Sovaldi and other high-cost drugs to treat Hepatitis C.
Anthem said it intends to comply with all current laws and guidance but reserves the right to withdraw any portion of this rate filing.