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Medical insurance companies request hikes up to 41 percent in Colorado

June 6, 2016 Updated: June 7, 2016 at 10:47 am

Double-digit rate increases and shrinking options are ahead for Coloradans buying their own health insurance.

Prices may climb significantly in 2017 - some as high as 35 or 41 percent - across the state's individual market, the Colorado Division of Insurance announced Monday.

Further, about 92,000 people must find new plans next year after their carriers opted to leave the market.

The turbulence mimics a "market correction" seen elsewhere in the nation among health insurance companies, which have had trouble navigating the post-Affordable Care Act marketplace, said Marguerite Salazar, Colorado's insurance commissioner.

"They're really needing to take some time and sort out who this market is and then how to price it," she said.

Golden Rule, Colorado Choice and Rocky Mountain HMO requested rate increases of 35 to 41 percent for 2017, regulators said.

A few other carriers, including Cigna and Kaiser Foundation Health Plan of Colorado requested rate increases of 10 to 14 percent.

Only Denver Health's offerings, which are not available in the Pikes Peak region, remain relatively flat.

In requesting those rate hikes, insurers said their customers had sought more services, more frequently than had been expected, regulators said.

Salazar emphasized the rate hikes were merely proposals, and those plans must first gain approval by state insurance regulators before they can be sold this fall.

A public comment period runs through July 6.

"We haven't approved these rates - remember that we're still going to take a real hard look at why they think they need increases," Salazar said.

One thing is certain: Thousands of people across the state must shop for new plans when open enrollment begins Nov. 1.

Anthem Blue Cross and Blue Shield will no longer offer its preferred provider organization plans - meaning 62,310 Coloradans must find new coverage for next year, the agency said.

Also, UnitedHealthcare and Humana will exit the individual market, leaving more than 20,000 people seeking new coverage for 2017. And Rocky Mountain Health Plans will scale back its presence in the individual market to solely Mesa County, forcing another 10,000 people to find new coverage.

The departures come less than a year after regulators shut down Colorado HealthOP, leaving nearly 83,000 people scrambling for new coverage in 2016. The nonprofit startup proved wildly popular during its two-year run, but it was forced to close after federal grant funding all but dried up.

Only one new company - Bright Health Plans - is expected to enter Colorado's individual market, which caters to people who do not have access to government or employer-based health insurance.

The latest developments are unsettling, said Joe Hanel, spokesman for the Colorado Health Institute.

"There are just fewer options to be able to shop around," Hanel said.

Salazar framed the departures as a short-term issue, because some insurance companies - including UnitedHealthcare - have indicated they plan to return to the individual market once it stabilizes.

She also said it's indicative of individual markets across the country. Shoppers already appear to be switching insurance carriers every year in a bid to find lower prices, she said.

"While I'm sort of concerned, at the same time, everybody can still get insurance - nobody's getting blocked out of the market," Salazar said. "There will be plans for them to buy."

Salazar also suggested that fewer insurance options might be a good thing for Colorado, because that could lead to less confusion once open enrollment begins.

"Do we really need 1,000 plans?" she said.

Still, the shifting landscape has left some areas of Colorado, including many mountain communities and much of the Western Slope, with only one option for coverage.

In those areas, that lone remaining option is Anthem's HMO Colorado.

For that option, the company requested a 27-percent rate increase - attributing it to increases in its customers seeking services, higher medical and drug prices and the cost of helping cover Colorado HealthOP's unpaid medical claims.

The instability on Colorado's individual market appeared in stark contrast to plans for small businesses.

Only one company on the small group market - Rocky Mountain Healthcare Options - requested double-digit price increases for 2017, and five carriers said they planned to cut their rates.

Another wild card is the impact that federal subsidies may have on rates for plans purchased on Colorado's exchange, Connect for Health Colorado.

"For those people who have access to financial assistance through Connect for Health Colorado, any kind of increase in the rates would be basically offset by an increase in the financial assistance that they would receive," said Adam Fox, director of strategic engagement for the Colorado Consumer Health Initiative. "It's probably fair to say that the subsidies will be going up. By how much, I think, is the question."


Contact Jakob Rodgers: 476-1654

Twitter: @jakobrodgers

Facebook: Jakob Rodgers

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