PROVIDENCE – Blue Cross & Blue Shield of Rhode Island has accepted the Direct Pay rate hikes authorized by Health Insurance Commissioner Christopher F. Koller, leading to average premiums of $518.26 per month, effective April 1.
The rate hike affects about 14,000 individuals who buy their coverage directly from Blue Cross and are not eligible for employer-based or government coverage. It’s the first increase since 2008; last year, Koller rejected a request to boost rates by 5.9 percent.
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This year, Blue Cross sought a 10.2 percent average hike, then agreed to a stipulation with Attorney General Patrick C. Lynch’s office, which acts as a consumer advocate in Direct Pay rate hearings, that reduced the hike to 9.5 percent.
The deal took the decision out of the hands of the hearing officer, John A. Cogan Jr., Koller’s executive assistant for policy and program review. But Koller had the power to reject the deal, and he did, saying it didn’t meet Blue Cross’ obligation to “employ pricing strategies that enhance the affordability of health care coverage.”
Specifically, Koller objected to including the state health insurance premium tax in the rates, and to including several assessments for state programs, such as for adult and child immunizations and home services, that are built into group rates.
Koller estimated that the changes would reduce the rate hike to 7 percent; Blue Cross said it will actually be 6.1 percent.
Blue Cross had a choice of accepting Koller’s decision, or appealing in court. It submitted a letter last Thursday accepting the smaller hike and detailing the resulting rates. A copy is posted online, with a rate chart.
Individual rates vary substantially depending on subscribers’ age and gender and whether or not they pass medical underwriting – plus, of course, which plan they choose.
The average premium for medically underwritten policies is expected to be $306.82 per month, while the non-underwritten policies will average $807.82. Actual premiums range from $100.43 for men under 25 in a $5,000-deductible plan, to $1,117.31 for subscribers over 65 getting the HealthMate Coast-to-Coast $500-deductible plan.
