Charts show sample rate requests for Oregon counties
(Salem) – The Oregon Insurance Division today posted health
insurers’ rate requests for small employer and individual health plans that
start Jan. 1, 2014. The plans reflect new benefits and new rules under the
federal Affordable Care Act.
Thousands of Oregonians are expected to gain private
insurance in the coming year with federal financial help. Consumers will have
more choices than ever before since federal law states that everyone qualifies
for coverage, even if they have a pre-existing health condition. Also, the
traditional insurers that make up Oregon’s already highly competitive health
insurance market will be joined by several new entities.
The 2014 health plans for small employers and individuals
will include new benefits and limit deductibles. While focusing on preventive
care, all plans will include doctor visits, hospital stays, maternity care,
emergency room care, prescriptions, and mental health/substance abuse coverage.
In addition to new benefits, federal reforms closed the gap
between rates charged to older and younger people. The changes mean insurance
costs may increase for some and decrease for others. For example, Oregonians
with serious health issues who are now covered in government-operated high-risk
pools can shop for competitive rates in the private market. They, along with
many other Oregonians, may qualify for financial help that will lower premiums
through Cover Oregon, the state’s new health insurance marketplace. Find
information at www.coveroregon.com.
Along with 16 insurers, two Consumer Operated and Oriented
Plans (CO-OPS) filed plans and proposed rates with the division.
The division’s rate review focuses on technical projections
about future claims costs but is open to public comment. Shopping for coverage
will be easier after the division makes rate decisions by early July and
insurers and Cover Oregon provide consumer-friendly information about plan
benefits and rates.
Insurance Division actuaries have started their thorough
technical review of the filings to determine whether the proposed rates are
justified and reasonable. Oregon Insurance Commissioner Lou Savage must approve
any rates before they can be charged to policyholders.
The division posted examples of proposed rates in seven
regions covering Oregon at http://www.oregonhealthrates.org/?pg=proposed_rates.html.
The charts show examples of rates because the amount a particular person pays
depends on age, location, how many family members are on the plan, and plan
choice. Tobacco use can increase the price of plans, too.
The proposed rates are for small group and individual
coverage, which will affect about 10 percent of Oregonians.
“Oregon has one of the nation’s most competitive health
insurance markets, and one of its most rigorous and public
rate reviews,” Savage said. “We will be looking closely at what rates are
justified in this reset of the market with new plans and new prices.”
The division’s rate website at www.oregonhealthrates.org
links people to key documents, including a schedule for public hearings. Also,
people can sign up for email notifications that alert them to rate filings,
public hearings, and rate decisions.
The Insurance Division is part of the Department of Consumer
and Business Services, Oregon’s largest business regulatory and consumer