Californians buying individual and family health insurance policies are likely to see modest premium increases in 2015, with the overall average increase pegged at 4.2 percent, according to tentative rates released Thursday.
The actual rate will vary depending on the plan that is bought, and where it's purchased.
A 2015 consumer guide now available on the statewide insurance marketplace, Covered California, provides price breakdowns for every individual and family plan that will be offered in all 19 regions statewide.
The 170-page booklet shows average premium increases in Southern California and Central Coast counties that range from 4.3 percent in parts of Los Angeles County to a 6.3 percent average premium price hike in Orange County.
"These rates are good news for California and serve as an example how Covered California and the Affordable Care Act is working to expand coverage and to keep rate increases under control," said Covered California Executive Director Peter V. Lee.
The ten companies that will sell the 2015 individual and family plans through Covered California are:
- Anthem Blue Cross
- Blue Shield
- Chinese Community Health Plan
- Health Net
- Kaiser Permanente
- LA Care Health Plan
- Molina Health Plan
- Sharp Health Care
- Valley Health Care
- Western Health Advantage
The Contra Costa Health Plan is the only company that opted out of the 2015 Covered California market.
Health policy experts agreed with Lee that the Affordable Care Act is helping keep a lid on premium prices that frequently soared into the double digits before the federal health law’s full implementation last January.
"Before the ACA, rates in the individual insurance market were incredibly volatile," says Larry Levitt, senior vice president for special initiatives at the non-profit Kaiser Family Foundation (which is not affiliated with Kaiser Permanente). "Hikes of 30 percent or more were not unheard of," he noted.
In fact, Levitt says, Anthem Blue Cross announced increases of up to 39 percent in California just as the ACA was in the final stages of debate in Congress. "And the outcry may have played a factor in the bill ultimately passing," he says.
For 2015, Anthem Blue Cross has the largest premium price increases in the plans it will offer consumers in Los Angeles, Orange, Riverside, Santa Barbara, San Bernardino, Riverside and Ventura counties. At the other end of the scale, HMO giant Kaiser Permanente’s rates show price reductions for most of its plans in those same regions.
In a nod to significant rate hikes by Anthem Blue Cross - which is boosting some 2015 plan prices as high as 16 percent in parts of Los Angeles County – and by some of the other insurers, Lee said: "I want to recognize that not everyone is going to see only a very small increase…but for them they have the ability to shop.”
The next open enrollment period begins on Nov. 15, 2014 and ends on Feb 15, 2015.
Lee says his agency spent eight weeks negotiating various issues with the plans, including the size of provider networks. In its news release announcing the new rates, Covered California said that, "in response to customer feedback, some health insurance plans will offer expanded provider networks so that Californians can choose from a wider selection of doctors."
The issue of narrow provider networks has grabbed recent headlines.
Earlier this month, Anthem Blue Cross was targeted by a class action lawsuit that, among other things, accuses the insurance giant of "bait and switch" tactics and of misleading California consumers into buying plans on the individual market that had smaller-than-advertised provider networks, no out-of-network coverage and fewer other options.
On Wednesday, Anthem Blue Shield announced it has expanded the number of doctors in its "Pathway" network by 6,300 statewide.
"This year the focus is on ability, consistency and maintaining choices," Lee says. "In every corner of the state, consumers will have at least two plans to choose from and in most areas, where most of the Californians live, they can choose among five and six plans."
Lee says the premium prices are technically "tentative" until next month. That’s when the two state agencies charged with reviewing them – The California Department of Insurance and The Department of Managed Health Care– are expected to offer final approval.