Why Florida regulators OKed higher premiums than health insurers asked

medical dollarsToday’s puzzler: Why did Florida health insurers ask for an average 17.7 percent increase in premiums for 2017 but state regulators approved an average of 19.1 percent?

Things changed since rates were initially filed in May, the state’s Office of Insurance Regulation said in a statement Tuesday.

“The approved percentages varied by about 2 percentage points from the original May requests, with a  few exceptions,” the statement said. “The primary reasons for this are (1) companies received official risk adjustment numbers from CMS (Centers for Medicare & Medicaid Services) in June (2) several insurers decided to write only off-exchange policies in Florida during 2017.”

The agency went to cite several examples.

“Aetna, who has a commitment to expand in 2018, has indicated that it will not participate in 2017,” the statement said. “United announced before the May filings that it would not participate on the exchange for 2017. United filed and withdrew an exchange filing under a subsidiary (Harken). Humana filed for participation in only a few areas of the state but did not disclose this information publicly.”

These decisions “changed office and company estimates of the risk pool that companies expect to insure,” the statement said. “Some companies estimate that they will grow more because of the lack of participation in the exchange market by these insurers. All of these insurers continue to write either individual or group products off-exchange.”

Florida 2017 health premiums

Company                                                           Requested  Approved

On and Off Exchange
1. Blue Cross and Blue Shield of Florida, Inc.     14.5%           19.0%
2.  Celtic Insurance Co,                                            4.3%            20.0%
3. Florida  Health Care Plan Inc.                         12.3%             15.4%
4. Health First Commercial Plans Inc.                 8.4%               11.7%
5. Health Options Inc.                                         13.8%                 18.9%
6.  Humana Medical Plan Inc.                            43.6%                36.8%
7. Molina Healthcare of Florida Inc.                  10.6%                17.4%
8. Harken Health Insurance Co.                                          Withdrawn
Off Exchange Only
9. Aetna Health Inc.                                             20.8%              22.0%
10. Aetna Life Insurance Co.                             28.9%                25.0%
11. AvMed Inc.                                                     27.5%                27.3%
12. Cigna Health and Life Insurance Co.          -0.6%                -1.5%
13. Coventry Health Care of Florida Inc.         14.1%                  11.8%
14. Freedom Life Insurance Co. of America     17.4%                17.4%
15. Sunshine State Health Plan                           0.0%                 0.0%
Average                                                                 17.7%                 19.1%

Source: Florida  Office of Insurance Regulation

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