Premium charges vary by insurer type, market size and competition
Health insurance premiums across the nation vary widely as the industry heads into the third open enrollment period under the Affordable Care Act.
Many national insurers, including Aetna and Cigna, have higher-than-average prices, which reflects their aversion to risk. Regional insurers, such as Premera Blue Cross, tend to keep prices low in order to remain competitive in the marketplace.
A recent Robert Wood Johnson Foundation report examines selected rating regions in 30 states from 2014 to 2015 to determine how and why prices for the lowest-cost silver plan differ for insurers. Some findings:
Blue Cross and Blue Shield insurers often offer the lowest premiums for their specific region. In more competitive markets, Blues insurers may price their plans aggressively with lower-price subsidiaries and a more limited provider network.
Medicaid-only insurers are fairly new to the marketplaces and price their products competitively.
Insurers in the non-group market priced competitively, as did many consumer-oriented and operated plans.
The report finds that Blue Cross Blue Shield insurers had the highest rate of participation of any insurer type, offering coverage in each of the rating regions examined from 2014 and 2015.
National insurers' participation increased from 28 rating regions to 45 between 2014 and 2015; co-op participation increased from 26 rating regions in 2014 to 32 in 2015; and regional insurers and Medicaid insurers increased their presence in 2015, but more modestly.
National insurers had the most entrances into the marketplace with 66; United Healthcare had 32 of the 66, while Assurant accounts for 22.
Many insurers proposed drastic rate hikes for 2016. The RWJF report concludes that's because some insurers reported higher-than-expected volume of claims in 2014 and because they don't know how they will be compensated by risk adjustment or risk corridors.
- here's the report (.pdf)