Will those exchange menus work?

By BenefitsPro


By Allison Bell

More 2014 public health insurance exchange menu news has been pouring out -- and raising questions, in some cases, about whether exchange coverage prices will be too high, too low or just right.

Covered California, a state-based exchange agency, reported that it ended up getting 12 of the 13 carriers offered individual exchange slots and six of the six carriers offered small-group slots to sign contracts. Just one regional carrier -- Ventura County Health Care Plan -- dropped out.

The Wisconsin Office of the Insurance Commissioner announced that the federally run exchange in that state has attracted filing from 13 individual market "qualified health plan" issuers and nine SHOP carriers. Common Group Healthcare Cooperative, one of the new member-owned, nonprofit "CO-OP" plans created by the Patient Protection and Affordable Care Act, could be on both the individual and SHOP exchange.

Wisconsin has not yet released exchange prices.

In Indiana, the Indiana Department of Insurance has come out with an analysis of how PPACA seems to have affected 2014 exchange premium rates for a variety of different types of consumers.

For a 25-year-old single male in excellent health, for example, the cost of a bare-bones, "bronze level" would be about $212 per month, or 158 percent higher than the cost of comparable coverage today, officials said.

For a 55-year-old single female in poor health, the monthly cost could fall 43.5 percent, to $471, officials said.

Meanwhile, general-interest publications were still reporting about the recent move by Aetna Inc. to withdraw from the Connecticut exchanges -- its home-state exchange -- and from the Maryland exchange.

Insurance regulators in states like Georgia and Ohio have complained that the PPACA exchange system seems likely to increase coverage prices for many people in their states.

But Aetna told the Baltimore Sun that it believes regulators in some markets have been pressing it charge premiums that would be too low.

In some states, the range in monthly premiums between the most expensive exchange carriers and the least expensive carriers has been wide.

Exchange watchers are wording statements about exchange rate adequacy carefully.

At the American Academy of Actuaries, for example, representatives said simply that they believe that health premiums must be based on actuarial principles and that oversight ought to "involve strong actuarial representation."

"Premium rating oversight should be done in conjunction with insurer solvency oversight," the academy said.

At Moody's Investors Services, Steve Zaharuk, a senior vice president on the U.S. insurance team, said insurers are in uncharted waters when it comes to making assumptions about how the exchanges will really work.

At this point, determining whether rates are too high or too low is very difficult, Zaharuk said.

In some cases, more insurers could decide that the rates they would be offering through the exchange system would be too low and withdraw their plans, Zaharuk said.

Originally published on BenefitsPro.com