No major jump in cost expected for Covered California health plans

08/02/2014 5:40 PM

08/02/2014 5:42 PM

Covered California consumers in the San Joaquin Valley will see slight changes in cost for health insurance premiums in 2015 depending on the plan they choose and where they live – some up, some down.

Overall in California, premiums are increasing on average 4.2 percent, Peter Lee, executive director of Covered California, said Thursday. Covered California is the state’s health benefit exchange created for the Affordable Care Act.

About 1.4 million Californians enrolled in health plans through Covered California during the open enrollment for 2014.

California is split into 19 regions for health insurers. Premiums vary by region.

In Region 10, which includes Stanislaus, San Joaquin, Merced, Mariposa and Tulare counties, the average premium decrease is 1.9 percent. The lowest plan’s premium rate is 4 percent lower than in 2014 and the highest plan has a 7.3 percent increase. Those counties will continue to have four insurance companies offering plans: Anthem Blue Cross, Blue Shield, Kaiser Permanente and HealthNet.

Almost 70 percent of the 61,500 consumers in the region who enrolled for 2014 chose Anthem health plans, and 18 percent went with Kaiser plans. Premiums are expected to drop 3 percent for Anthem customers and 4 percent for Kaiser members, but will increase 6 percent for Blue Shield plans. Increases for HealthNet plans will range from 6 to 9 percent, Covered California said.

The monthly premiums for Covered California plans depend on the person’s age, the level of coverage, and eligibility for federal subsidies that lower the cost.

For a 40-year-old adult, the 2015 premiums in Region 10 for silver plans (covering 70 percent of medical bills) will be $288 per month for the Anthem plan, $319 for Kaiser, $345 for Blue Shield and $402 for HealthNet.

A 60-year-old consumer will pay more for the same coverage: $612 for Anthem, $676 for Kaiser, $732 for Blue Shield, $855 for HealthNet.

About 90 percent of people in the first enrollment blitz were granted subsidies that reduce their costs. Next year, a 40-year-old customer with silver coverage in Region 10, earning $17,505 a year, is expected to pay $27 monthly for Anthem, $58 for Kaiser, $84 for Blue Shield and $141 for HealthNet. Subsidies are available in 2015 for individuals earning between $17,505 and $46,500 annually.

The exchange did not release anticipated costs for family health plans. The projected rates from insurers are tentative and will be reviewed by state regulators. The next enrollment period is set to begin Nov. 15.

Covered California will resume efforts to enroll younger adults, who represent a large segment of the uninsured. For a 25-year-old not eligible for assistance in Region 10, the cheapest option will be catastrophic coverage costing from $150 to $213 per month, depending on the insurer. Silver coverage will be $226 for Anthem, $250 for Kaiser, $271 for Blue Shield and $316 for HealthNet.

Cheaper rates are available for young adults who qualify for subsidies.

For consumers in Fresno County, which is part of Covered California Region 11, the average premium in 2015 is up by 3 percent. But the premium rates range by the type of plan: The lowest plan has an 8.5 percent decrease in the premium rate and the highest plan has a 6.5 percent increase.

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