Thursday, October 13, 2016

Individual Health Insurance Rates Skyrocket for Health Exchange Market ( for Illinois

I just got back from a professional association meeting where a person from the department of insurance was presenting. What he presented is grim at best (slides are from that presentation). Below is a preliminary cut. I don't have the actual rates available to quote (they are coming any day), but by the look of the items below, it will be worse than bad. See my analysis at the end.

1. Selection of insurance companies available is less. Seven counties have one company available.

2. Rates for the LOWEST Bronze Level plan are going up 10% - 60%.

3. Rates for the second lowest silver plan (for which subsidies are based upon) are going up 25% - 60%

4. Rates for the lowest Gold are going up 40% - 70% with several counties not offering any gold plans at all.

What does this mean?

1. If you receive a subsidy, you will be protected for a majority of the increase due to your subsidy being dramatically increased. You may still pay more money.

2. Your choices are dramatically curtailed. Your best option will most likely be an HMO plan. Most carriers are driving towards that eventuality as it is the only way that they feel they can break even. Pretty much BCBS of Illinois (in my opinion) will be the only game in town as a quality carrier with decent rates. Cigna is joining the market in a few areas, but I don't have specifics.

3. If you need multiple specialists from multiple medical groups or the teaching hospitals (e.g. Northwestern Memorial, or a Northshore Hospital). You may not be able to access them via the exchange and would have to consider either a direct policy or if you have your own business, you may qualify for coverage (you no longer need two employees on the plan, but you do either need to have a husband/wife partnership that filed that way last year or at least one W2 employee - whether full or part time) that will give you access to the larger PPO networks. Contact me for specific details.

4. If you don't receive a subsidy, going outside of the exchange may give you more choices. Harken is leaving the Exchange market, but is still around if you go directly to them.

5. Some of you reading this won't be able to afford ANYTHING. If you fall into this category, I have several non-insurance programs that will avoid the penalty and typically cost significantly less (1/2 to 1/5 the cost of insurance). They do cover your bills, but you need to agree to their principals. Some have holes in the plan that need to be filled with another product, but overall, something is better than nothing.

Use this link to schedule a 15 minute call to discuss your situation.

Robert Slayton

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