State regulators cut rate increases for Vermont Health Connect

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State regulators cut rate increases for Vermont Health Connect

Wed, 09/03/2014 - 1:44pm -- tim

by Morgan True Rates for insurance products sold on Vermont’s health care exchange will increase in 2015, but not by as much as insurers had wanted, state regulators said Tuesday. Blue Cross Blue Shield of Vermont’s requested average 9.8 percent rate increase across health exchange products was revised down to 7.7 percent by the Green Mountain Care Board. Blue Cross covers 92 percent of Vermont Health Connect users who purchased commercial health insurance, or roughly 60,000 people. The remaining 5,000 commercial customers are covered by MVP Health Care. The company’s average rate request was reduced from 15.3 percent to 10.9 percent.

Two percent of the Blue Cross reduction was largely based on assumptions about a federal subsidy program that softens insurers’ entry into the exchange.

The board determined that MVP could lower its rates by lowering surplus funds, adjusting pharmacy cost estimates and by making other, smaller changes.

Greater detail on the reductions can be found here.

The rate increases approved by the Green Mountain Care Board are justified by “increased medical and pharmaceutical costs, scheduled changes in federal payments to insurers and federal rules governing coverage that are beyond the control of insurers and the state,” according to an email statement.

The approved rates are averages across the products an insurer offers on the exchange. The premiums for the various metal-level products will go up by different amounts in 2015.

The board “urges Vermonters to learn about their individual options, which may include subsidies that offset premium increases,” according to the statement.

The Office of the Health Care Advocate, a project of Legal Aid, was pleased with the board’s decision to reduce the requested rate increases, according to Lila Richardson, a staff attorney for the project, who responded by email.

In both cases, the advocate argued for additional modifications that would have reduced the rates even further, Richardson said, but the approved rates will hold premiums at “more affordable levels,” than the insurers’ original requests.

Vermonters with individual plans purchased on Vermont Health Connect should have their eligibility for subsidies redetermined during the open enrollment, which begins Nov. 15, she said.

“Changes in household composition or income can change the amount of subsidies, which can affect the amount consumers must pay more than these rate increases do,” Richardson added.

Members of the Green Mountain Care Board (from left): Betty Rambur, Allan Ramsay, Al Gobeille, Karen Hein and Con Hogan. Photo by Morgan Trues/VTDigger