Salem - Beginning today, Oregon consumers can weigh in on proposed
health insurers' rates for 2015 small employer and individual health
benefit plans. During this public process, consumers can also review
insurers' cost and quality metrics, which insurers had to submit for
the first time this year. Examples of cost and quality metrics are
costs per member per month for emergency department visits and percentage
of women who receive breast cancer screenings.
The Department of Consumer and Business Services, Insurance Division
today posted health insurers' rate requests for small employer and
individual health benefit plans. The division must approve any rates
before they can be charged to policyholders.
"Oregon has a transparent and rigorous process for reviewing
health insurance rates," said Insurance Commissioner Laura Cali.
"Over the next two months, the division will conduct a thorough
review of each rate request to ensure the rates are reasonable and
Consumers have many options to participate in the public process:
The filings include plans that comply with the Affordable Care Act,
as well as "transitional plans" and "grandfathered
plans" that existed before Jan. 1, 2014. Along with 14 insurers,
two Consumer Operated and Oriented Plans (CO-OPS) filed plans and
proposed rates with the division.
The division posted examples of proposed premiums in seven regions
across the state at http://www.oregonhealthrates.org/?pg=proposed_rates.html.
The charts show examples of monthly premiums and the percentage change
from the rates approved by the division for 2014. The amount of premium
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.
"We value and encourage the public to participate in the process
and provide input," Cali said. "We continually strive to
provide clear information to help consumers better understand our
process and how we make decisions about health plans offered to Oregonians."
In addition, the division uses federal grant funds to contract with
the Oregon State Public Interest Research Group (OSPIRG) to represent
the public by choosing certain rate filings to review and participating
in public hearings.
The division will make decisions on rates by early August and post
consumer-friendly documents that describe the decisions. Plans will
be available starting Nov. 15, 2014, to purchase through Cover Oregon,
agents, and insurers.
The proposed rates are for plans for businesses with fewer than 50
employees and individuals who buy their own coverage rather than getting
it through an employer, which affects about 10 percent of Oregonians.
To search rate filings and find more information about the rate review
process, visit http://www.oregonhealthrates.org/.