Federally-Facilitated Marketplace Benchmark Plan Rates to Increase 7.5%

Marketplace benchmark plans—the second-cheapest silver plan available in states that use the HealthCare.gov platform—will see an average price increase of 7.5% for coverage year 2016, though rate changes will vary dramatically from state to state. Reported rate changes do not take into account advanced premium tax credits, which lower monthly costs for the “overwhelming majority” of Marketplace consumers, and which are determined using benchmark plan prices. After tax credits, about 8 out of 10 returning HealthCare.gov customers will be able to buy a plan for less than $100 a month, and about 7 out of 10 returning customers will be able to buy a plan for less than $75 a month. Premium increases will be in the single digits for most consumers, according to Kevin Counihan, the CEO of HealthCare.gov. CMS also found that HealthCare.gov customers who changed plans within the same metal tier between 2014 and 2015 saved an average of nearly $400 after tax credits, compared to those that stayed in their same plans.

Some HealthCare.gov Functionalities Launching Early, While Others Delayed

Window shopping for 2016 plans, which launched one week before the start of the open enrollment period, allows consumers to see estimates of total yearly costs including premiums, deductible, copayments, and other costs based on how much medical care an individual or family will use. New HealthCare.gov functionality that will enable consumers to look up whether a prescription drug is covered or their doctor is in a particular plan's network may be delayed, as reported by The New York Times. Because the insurance industry reported issues with the accuracy of the data used for the new HealthCare.gov tools, the new functionality will launch when HHS is confident with the data provided by the insurers. No specific date has been given.

Kansas: Insurer Covering Half of Marketplace Enrollees Withdraws for 2016

Coventry will not offer health plans on Kansas’s Federally-facilitated Marketplace for coverage year 2016, though it will continue to offer plans outside of the Marketplace. Approximately 45,000 Kansans, or 53% of Marketplace enrollees, will be required to select new coverage either off the Marketplace or from one the Marketplace’s four remaining insurers, including new entrant United Healthcare.

South Dakota: Carrier to Exit Marketplace, Two Remain

DakotaCare announced that it will not offer individual plans through the State's Federally-facilitated Marketplace for coverage year 2016 due to sustainability concerns, leaving Avera Health Plans and Sanford Health Plan as the two remaining carriers. DakotaCare issued approximately 33% of the State’s individual Marketplace policies for 2015. Following this announcement, South Dakota’s carriers confirmed their rate increases for 2016. Rate hikes average approximately 13% for Avera and Sanford’s individual plans sold on and off the Marketplace, while DakotaCare and Wellmark—the State’s other major insurer off the Marketplace—averaged increases that range up to 63% and 43%, respectively.