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Big Differences in Costs for Colorado Small-Group Coverage Under Health Reform

May 22, 2013, 8:37pm MDT UPDATED: May 23, 2013, 9:42pm MDT
Reporter-Denver Business Journal
Monthly premiums vary wildly for individual andsmall-group health plans that are proposed to be sold in Colorado in 2014 --the first full year of implementation of the federal health care reform bill --according to officials at the Colorado Division of Insurance and a DenverBusiness Journal review of insurance filings released Wednesday.
For example, a typical 40-year-old non-smokingDenver-area resident wanting a "silver band" plan -- those for which70 percent of the costs are covered by the plan -- might pay anywhere from $265to $405 a month for an individual plan.
And an employer providing insurance to that same40-year-old as part of small-group plan might have to pay $459 a month for thatplan, according to a number of filings.
The full scope of filings for the 17 companies thathave submitted rate cases needed to sell individual and small-group insurancein Colorado next year was not available, as computer problems kept the Divisionof Insurance from being able to release all of the filings to the publicWednesday.
The number of 17 companies also was two lower thanInsurance Commissioner Jim Riesberg said last week that he expected to offer plans underthe new, more heavily regulated market, as there was a mixup with two companiesthat appeared to be four separate companies originally, division officialssaid.
But the initial reaction of health care activistswatching the filings was a positive one.
Dede de Percin,executive director of the Colorado Consumer Health Initiative, said the 17carriers submitting a cumulative 813 plans for the individual and small-groupmarkets ensures that prices will be kept at a reasonable rate because of competition,both in the general market and in the soon-to-launch Colorado health benefitexchange.
"It's good news. Some other states don't haverobust competition," de Percin said. "And we have more carriers thanwe thought and more choices than we thought. And that will drive competition inthe exchange."
According to a database released by the Division ofInsurance, at least 11 of those 17 carriers will offer policies in the exchange-- known as Connect for Health Colorado, which is essentially an Internetmarketplace for health insurance that will be available to consumers and smallbusinesses on Oct. 1.
Most of the state's largest carriers -- includingKaiser Permanente Colorado, Humana, Rocky Mountain Health Plans and Anthem Blue Cross and Blue Shieldof Colorado -- willsell multiple plans through the exchange.
By comparison, similarly sized Washington state hadjust nine insurers submit plans for its exchange, according to Kaiser Health News.And Montana had just three, Colorado Insurance Commissioner Jim Riesberg said.
"It's a new world for health insurance,"Riesberg said. "These will be new plans, with new premiums and new benefitpackages, developed to meet new requirements."
Those new requirements under the federal PatientProtection and Affordable Care Act, termed by some as Obamacare -- including 10essential health benefits, ranging from emergency care to mental-healthtreatment, that must be included in each policy -- have led insurers to speculate formonths that premiumsthat already have been on a consistent upward trend will go through the roof in2014.
An immediate comparison to current prices is hard tomake, as these new rates are being filed under first-time conditions,essentially creating new plans.
Plus, with individuals having to pay different ratesbased on their ages, their geographic locations, their smoking statuses and thelevel of plan they choose -- not to mention their ability to get tax subsidiesbased on their incomes -- exact prices are hard to pinpoint right away.
But the company that appeared to have the mostaffordable rates, at least initially, is a new one -- Colorado HealthOP, thehealth care cooperative launched to help slow the rise of premiums for ruralresidents and small rural businesses.
The co-op's average health premium for a 40-year-oldDenverite will be $265 a month, and the per-person cost of a small-group policywill be slightly higher than that, CEO Julia Hutchins said.
Colorado HealthOP can keep its premiums down, Hutchinssaid in an interview last week, because it offers a unique benefit structurethat lowers costs for people who make efforts to stay healthy and funnels allof its revenues back into improving the insurance plan.
Co-op members will elect the leaders of the company,and 50 percent of the board will be made up of customers who decide how the newcompany can improve benefits or lower premiums, she explained.
"This really is about turning health care on itshead," Hutchins said. "And while we have some connection to theAffordable Care Act, we're more of a vehicle for some of the goals of theAffordable Care Act."
Rate filings will continue to be made available in thecoming days on the Division of Insurancewebsite, and Riesberg and his staff will examine each of the filingsbetween now and July 31 to ensure that they meet the new requirements of thefederal law and that proposed rates are not excessive.
But with other states reporting far less participationin the exchange, observers remain excited.
"We have a pretty diverse market," de Percinsaid. "Obviously the insurers are seeing this as a great place to dobusiness."

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