Thursday, June 4, 2015


The Patient Protection and Affordable Care Act (ACA) contains a requirement that insurers that supply ACA-compliant products through Marketplace exchanges and that are planning to increase health insurance plan premiums by ten percent or more must submit their proposed rates to the state or federal government for review.  As part of the submission, rate increase justifications must be made accessible to the public. Rate review information can be found at  

In April and May of this year, insurers supplying ACA-compliant health insurance products to Illinois consumers through the Illinois federal/state marketplace posted substantially higher proposed rate increases for 2016.  Depending on the plan, Blue Cross/Blue Shield is proposing increases ranging from 12.83% (BlueChoice Preferred--Small Group) to 38.24% (BlueChoice Preferred—Individual).  Humana Health Plan’s proposed increase for 2016 is 19.09% for its HumanaOne 2014 HMOx—Individual product and 12.07% for the HumanaOne 2014 CPOS – Individual plan.  Time Insurance Company’s proposed increases are 35.69% and 42.43% for its two 2016 individual medical plans.  According to CNN Money, increases are needed because those enrolled through the exchanges are using covered services, including doctor visits, laboratory services, and prescription drugs, more than had been anticipated.  

It is unclear whether, after review, the rates will remain at the levels proposed.  And it is likewise unclear whether group plans will experience the same levels of premium cost increase.  But current indicators are that health insurance premiums for most plans will be significantly higher in 2016 than in 2015.