Approved rates reflect state’s competitive market, reduction in uncompensated care
Salem — The Department of Consumer and Business Services' Insurance Division
has approved rates for 2015 individual and small employer health insurance plans,
and on average, they are lower than 2014 rates.
Although the rate changes vary by insurer, the average monthly premium for
an individual standard plan for a 40-year-old in Portland in 2015 is estimated
at $250, compared to $262 in 2014. For a similar small employer plan, the average
2015 premium is an estimated $308 per month, compared with $327 in 2014. A table
showing sample 2015 premiums can be found here: http://www.oregon.gov/DCBS/docs/Rate_filing_decision.pdf.
"Our rigorous review included public hearings and analysis to ensure rates
are reasonable and support a sustainable market," said Insurance Commissioner
Laura Cali. "Ultimately, the approved rates are lower on average than in
2014, reflecting the effect of competition and Oregonians' expanded access to
The rates, which affect about 10 percent of Oregonians, are for plans for businesses
with fewer than 50 employees and individuals who buy their own coverage rather
than getting it through an employer. The Insurance Division must approve any
rates before they can be charged to policyholders. The review included plans
that comply with the Affordable Care Act, as well as "transitional"
and "grandfathered" plans that existed before Jan. 1, 2014. Along
with 14 insurers, two Consumer Operated and Oriented Plans (CO-OPS) filed proposed
rates with the division.
During the review, the division's actuarial staff analyzed the justifications
that insurers provided to support their proposed rates. Some insurers lowered
their claims cost projections because of reductions in uncompensated care. Uncompensated
care is a term for medical services that go unpaid by patients without insurance
or who can't afford to pay their portion of the cost. With more Oregonians covered
by insurance with enhanced benefits, providers are reporting less uncompensated
care. If insurers did not account for this change in their rate proposal, the
Insurance Division lowered their projected claims costs and factored it into
the approved rate.
The issue of uncompensated care was also a focal point of analysis provided
by Oregon State Public Interest Research Group (OSPIRG). The division uses federal
grant dollars to contract with OSPIRG to represent consumers and participate
in the rate review process.
"OSPIRG's role - as well as the comments we receive from the public - are
very important in helping the division better understand the impact of rate
changes on consumers," Cali said.
The division will provide more information on the reasoning behind each rate
decision by mid-August when it posts decision summaries on www.oregonhealthrates.org.
Premium examples by region also will be available on www.oregonhealthrates.org
by mid-August. Changes to people's monthly premiums will vary depending on age,
location, how many family members are on the plan, and plan choice.