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NJ insurers file to raise premiums in 2018

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"The Federal Government's actions will drive costs higher and create additional uncertainty, making a volatile situation even worse," said Horizon chief financial office David Huber. - ()

Two of New Jersey's largest health insurance companies filed to raise health insurance premiums due to uncertainties over health insurance reforms caused by the federal government, and another, Oscar Health, is re-entering the New Jersey market after leaving last year.

Despite a bi-partisan agreement reached by U.S. Sens. Pat Murray (D-WA) and Lamar Alexander (R-TN) yesterday to restore cost-sharing reduction payments under the Affordable Care Act – an agreement initially endorsed by President Donald Trump – insurers still face uncertainty as there is no guarantee that the agreement will make it through Congress or be signed into law.

Horizon Blue Cross Blue Shield of New Jersey, the state’s largest health insurer, announced that state regulators have approved rate increases between 16% and 28% for policies the company will offer in the 2018 individual market. The state's Dept. of Banking and Insurance and the Center for Medicaid and Medicare Services would have to approve the filed rate hikes.

Horizon stated that the increase was due to three factors controlled by the federal government:

  • Weakened enforcement of the Individual Mandate: +8.5 percent
  • Elimination of federal funding for Cost Sharing Reductions (CSR): +3.9 percent
  • 2018 reinstatement of Health Insurance Tax: +2.3 percent

“Were it not for the three factors within the control of the Federal Government, Horizon BCBSNJ’s individual premiums would have an average increase of 9.6 percent,” the company said in a written statement. “Horizon’s previous average premium increases have been in the single or near-single digits, while annual increases in many other states were much higher rate. Nationally, the average federal exchange rates were 105 percent higher in 2017 compared to 2013, while New Jersey’s average rates were up 12 percent over that same period.”

AmeriHealth New Jersey announced an average 17.1 percent rate hike for its plans in New Jersey “based on many uncertainties in the individual market.”

According to figures released by the state’s Individual Health Coverage program, middle-of-the-road Silver plans will cost an average of $311.86 per month for AmeriHealth NJ’s IHC Silver EPO Advantage plan; $346.72 for Horizon BCBSNJ’s Omnia Silver HAS plan, and $349.30 for Oscar Health’s Silver Saver plan.

"Today's announcement confirms that Oscar plans are among the most affordable options New Jerseyans can choose for their individual and small business group health coverage next year,” Louis DeStefano, Oscar’s vice president of sales, said in an email. “Oscar is extremely excited to return to New Jersey and deliver an easy, seamless health care experience with access to high quality hospitals for our members."

David Huber, horizon's chief financial officer, warned Congress and the Trump administration that cost sharing reductions must be funded if health insurance is going to affordable for New Jersey residents down the road.
 
"The Federal Government’s actions will drive costs higher and create additional uncertainty, making a volatile situation even worse. If cost sharing subsidies are not funded, rates will increase further. Horizon remains true to our mission in 2018 by offering several plans, including our popular OMNIA Health Plans, to individuals and small businesses in every one of New Jersey’s zip codes,” Huber said in a written statement.
 
AmeriHealth, in a written statement, was quick to point out that Advantage and Tier 1 Advantage plans are still the lowest priced plans across the state in the Bronze and Silver metallic tiers, with the exception of Hunterdon county.
 
"In 2018 AmeriHealth Advantage will expand into six additional northern New Jersey counties, making the plans available in 13 out of 21 counties across the state. This expansion is the result of RWJBarnabas joining tier 1, which was announced yesterday. Tier 1 Advantage will remain available in 20 out of 21 counties."

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Vince Calio

Vince Calio


Vince Calio covers health care and manufacturing for NJBIZ. You can contact him at vcalio@njbiz.com.

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