Health

Wellmark requests an average 8.1 percent increases in non-ACA plans

Rate increases for individual grandfathered plans subject to Iowa Insurance Division

Wellmark Blue Cross and Blue Shield of Iowa’s location at 600 Third Avenue SE in southeast Cedar Rapids. (Jim Slosiarek/The Gazette)
Wellmark Blue Cross and Blue Shield of Iowa’s location at 600 Third Avenue SE in southeast Cedar Rapids. (Jim Slosiarek/The Gazette)

Wellmark Blue Cross and Blue Shield — the Iowa insurer that recently rejoined Iowa’s individual market — asked the Iowa Insurance Division Wednesday for approval for rate increases for its grandfathered plans.

Wellmark requested increases ranging from 5.3 percent to 11 percent, depending on the plan, effective Jan. 1, 2019.

Grandfathered plans are those that predate the Affordable Care Act’s passage in 2010 and are allowed to exist under a provision of the law.

As of April of this year, the Des Moines-based insurer has about 63,500 members in individual pre-ACA plans, according to the insurer’s filings to the insurance division.

According to the Iowa Insurance Division, there were 37,088 grandfathered plans in Iowa as of October 2017. The 2018 estimations put about 35,000 plans in force for 2018.

Final rates are subject to approval from the state insurance division. ACA open enrollment begins Nov. 1.

According to a news release from the Iowa Insurance Division, both Wellmark and Medica — Iowa’s other provider of individual plans — filed preliminary paperwork to offer individual plans through the Affordable Care Act exchange for 2019 statewide.

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However, Medica’s proposed rate filing did not trigger a rate hearing, meaning the carrier did not file for a rate increase above 5.6 percent.

Last year, Minnetonka, Minn.-based Medica — which at the time was the only insurer on the state’s individual market — requested a 56.7 percent increase in rates from the Iowa Insurance Division “due to lack of certainly over the funding of cost-sharing reductions.”

Wellmark’s proposed rate filing is not subject to a rate hearing, as it is a new entity in the 2019 ACA individual market in Iowa.

Wellmark announced in February it would sell ACA-compliant plans on and off the exchange for next year. The company left the market in 2018, citing high costs and an uncertain political future for the Obama-era law.

“It is a positive that we expect two carriers to be offering coverage throughout Iowa in our individual ACA market,” said Iowa Insurance Commissioner Doug Ommen in a new release Wednesday.

In other rate requests, Golden Rule Insurance Co., which offers pre-ACA grandfathered and transitional insurance plans, proposed an 11 percent rate increase to the insurance division.

“It is projected that there will be 3,379 covered lives impacted by the rate change,” the Golden Rule filings stated.

Aetna Life Insurance Co. requested an average 32 percent rate increase for its small-group health insurance from the insurance division.

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According to the Aetna Life filings, there are 238 members on the small-group plans, which are provided by employers with up to 50 employees.

Aetna Health also requested a rate increase for small group health insurance, averaging at 19.3 percent. This could affect around 760 individuals currently covered by the plan.

Both rate increases would go into effect Jan. 1, 2019.

The Iowa Insurance Division will hold a hearing regarding these rate increases at 10 a.m., Aug. 18, in Des Moines. Public comment on the rate increases is now being accepted.

Earlier this month, the Trump administration, through the U.S. Department of Labor, released rules that would make it easier for small businesses and self-employed individuals to buy non-ACA compliant insurance.

These association health plans do not have to follow the same regulations set on individual policies by the ACA — a change in the market that the insurance commission is reviewing, said Ommen in the news release.

“While we review recent actions by the federal government regarding association health plans, what we do know is that middle-class Iowans cannot be left with a choice of coverage they can’t afford or going uninsured,” Ommen said.

“Entrepreneurs, farmers and early retirees relying on this market deserve and need to have a functioning individual health insurance market.”

However, Ommen was positive about the landscape for the 2019 insurance market, given recent legislative actions creating the Farm Bureau plan and an expansion of the Iowa Insurance Commission’s authority to approve multiple employer plans.

“At least for 2019, it appears Iowans will have some additional options,” Ommen said.

l Comments: (319) 368-8536; michaela.ramm@thegazette.com

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