Md. approves smaller rate hikes for CareFirst, lowers rates for 3 others


A 40-year-old non-smoker in Montgomery and Prince George’s counties would pay a monthly premium of $226.38 for Kaiser’s lowest-priced Silver plan, $227.15 for a CareFirst BlueChoice plan and $258.78 for UnitedHealthcare. (NHTSA)

Maryland officials approved final insurance rates Friday for consumers buying individual health plans next year under the federal health-care law. Regulators cut proposed premium increases by more than half for CareFirst, the region’s dominant insurance company, and approved lower rates for three other carriers.

CareFirst will be allowed to increase premiums but by much less than it had proposed. The increases will range from 9.8 percent to 16.2 percent instead of the 23 percent to 30 percent it sought in June.

Regulators approved lower rates for the Kaiser Foundation Health Plan, Evergreen Health Cooperative and All Savers Insurance; the rates will drop by an average of 14 percent, 10.3 percent and 6.7 percent, respectively.

The rates are effective Jan. 1, and individuals may sign up for new plans or renew existing coverage during the open enrollment period that will run from Nov. 15 through Feb. 15.

The rates don’t affect the group insurance plans that provide coverage for most Marylanders, such as those offered by large employers or employers who self-insure.

Under the federal health-care law, insurance plans sold on the online exchanges are categorized as bronze, silver, gold or platinum, based on how costs are shared. Bronze plans tend to have lower premiums but higher out-of-pocket costs, such as deductibles, co-payments and co-insurance.

According to a sample of approved rates for lowest-cost silver plans, a 40-year-old nonsmoker in Montgomery or Prince George’s County would pay a monthly premium of $226.38 to Kaiser, $227.15 to CareFirst BlueChoice, $231.19 to Evergreen, $258.78 to UnitedHealthcare and $345.22 to Cigna. UnitedHealthcare and Cigna are two new carriers in the market for next year.

The listed premiums don’t take into account financial help in the form of subsidies that many individuals may qualify for.

Maryland Insurance Commissioner Therese M. Goldsmith said the final approved rates and new entrants in the market reflect a “robust and competitive” individual insurance market.

Policy analysts are looking at the 2015 rates to determine how insurers are adjusting after the 2014 enrollment period, the first under the law. Large premium increases could reflect a sicker-than-expected mix of patients during the first enrollment period; a rate cut could be attributable to competition or a healthier-than-expected mix of patients.

A recent analysis by the Health Research Institute at PricewaterhouseCoopers predicts an average rate increase of 8 percent next year on the health-care exchanges, based on proposed increase requests from 31 states and the District of Columbia.

The 2010 health-care law bars insurers from charging consumers higher premiums based on medical conditions or gender. Premiums can vary by age and whether someone smokes. All insurers are required to offer a package of essential benefits.

Correction: An earlier version of this story said that regulators cut proposed premiums. Regulators reduced proposed premium increases. This version has been corrected.

Lena H. Sun is a national reporter for The Washington Post, focusing on health.
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