<p>dstark: assuming the large employer market is self-insured (‘aso’) plan, the individual/small biz market will (always) be more expensive – by design. The individual market is subject to state taxes, for example, that the ASO plans not. Individual plans have brokers to feed; ASO plans do not. Individual plans have marketing expenses to recover; ASO plans do not. Under ACA, the medical loss ratio is ~85%. In large ASO plans, it is closer to 95%.</p>
<p>(Assumes similar age-ajusted pools; if the large employer has a bunch of old geezers, however…)</p>
<p>dstark, is your daughter still an actuary with an insurance company? Could you ask her whether insurance companies think the risk pool for private insurance for 2014 is significantly less healthy than the typical risk pool for a large employer? And for 2015? We don’t know the answer to this question, but insurers have to know.</p>
<p>Pretty much all of them. There is no reason not to. It is foolish to continue to pay state insurance taxes and marketing costs when one can use those dollars in other ways.</p>
<p>I also have a relative that is working with insurance companies to get them ready for ACA.</p>
<p>The insurance companies dont know for sure who is going to sign up. They know where their potential customers are. They are going after them. </p>
<p>The insurance companies have different views of the risk of the signees. This stuff is in the
papers now. Kaiser thinks there is more risk in Cal than Anthem for example. </p>
<p>I did briefly talk to my relative this week. ACA is a multi year deal. The insurance companies are going to adjust. The insurance companies do think they are going to make money.</p>
<p>Bluebayou, if the large companies are self insuring and saving a lot of money, why do people think the large self insured companies are going to move their employees to exchanges?</p>
<p>^^perhaps I’ve missed it, but I’ve never read anything about large companies dumping ee’s on the Exchanges. Small-to-medium sized companies, however…</p>
<p>But one reason that large companies may drop medical is the cost. It is much cheaper to pay the penalty than ASO claims. Heck, large employers could even raise the wages to help offset the exchange premiums. However, that is probably not very competitive for recruitment/retention of ee’s.</p>
<p>6723 was a response to some now deleted posts.
Kmcmom, I think we see variations by state (and within a large state) partly because each has its own demographics and density. And average health. Plus a little history and culture thrown in. Then, it seems there is a similar difference among businesses and can reflect their own culture differences. </p>
<p>There’s also an interesting commentary by Peter Ubel, in Forbes 12/3, suggesting, in part, how companies not offering healthcare have an unfair advantage. But bloggy, I think.</p>
<p>There is no reason to shout down people who tell you their premiums went up and are trying to answer why they think it happened. They have an equal right to post as the rest of you who have no insurance issues whatsoever but like to hang out here. </p>
<p>This thread is primarily for people who are actually in the market trying to buy insurance. So it is important to understand why someone is far happier to get an year reprieve on their old insurance rather than sign up to the new policy because the difference is twice or whatever poetgrl said it was originally.</p>
<p>What we are trying to understand is why someone like Hanna gets an unbelievable premium in 200+ range while someone like poetgrl was being asked to pay 1500+ per month for 2 + 2(?). </p>
<p>The questions I am raising are the following:</p>
<ol>
<li><p>Is the issue because poetgrl is in a State where there is less competition?</p></li>
<li><p>Is that State pool more riskier than other States with cheaper insurance?</p></li>
<li><p>Are there more States where the pricing went up much higher (I have heard Wyoming)?</p></li>
</ol>
<p>Again, this thread is not to praise or bury ACA. </p>
<p>It exists solely to help people and when it loses its purpose, you no longer have a place to post. Please remember that when you shout down people who are not happy about their plight.</p>
<p>We all know hat some people are getting a great deal and others have had their insurance go way up. </p>
<p>It does seem silly to bash on anyone who tells their story. </p>
<p>If I look at the rates for the individual health plan my family had in 2011 vs today for same plan through broker or exchange - it is almost 35% higher, just for 2014. That is a bunch. </p>
<p>The question will be, what happens with these plans from year to year? We are a captive audience, and until legislative fixes are implemented, we will be utilizing these plans and prices can keep going up. </p>
<p>Maybe poetgirl’s state has less healthy subscribers or too few on individual market?</p>
<p>Isn’t Hanna single and younger, with no dependents? Plus whatever adjustment for MAGI. The KFF links glance at cost differences for single vs family.</p>
<p>Yesterday, when “average” costs by state came up, I found a by-state summary, using two Silver, one Bronze. Since it was limited that way, didn’t account for some other variables, I didn’t bring it here. There are also some explanations about why WY is higher.</p>
<p>ps. the personal stories are illustrative-- from them, I learned many points to cover/questions to ask, for my family. But some earlier posts made it seem we are all facing the same choices and limitations- especially for lurkers, that could mislead. We need to check our own options carefully.</p>
<p>The premium jumps are not just varying by state, either. My sister lives in central CA and her costs are higher but not by much. Meanwhile, LA and SF have seen doubling and tripling of rates.</p>
<p>And are we talking about rates or rates after subsidies? Because we are also paying for those subsidies somehow.</p>
<p>^Yes. I remember someone from MN or WI mentioning that while in their metro area it is unbelievably low but in some other area in the state, it is much higher. It basically depnds how many health providers they have in a region relatively speaking. We don’t have a lower rate although we have many providers in our metro area.</p>
<p>“The question will be, what happens with these plans from year to year”</p>
<p>SL… You asked that question before. I amswered it. ;)</p>
<p>You wont see 30 percent a year increases once ACA settles down. </p>
<p>The increases are going to be similar to the increases in healthcare costs plus increases for aging. If healthcare costs increase 5 percent a year and aging costs rise about 2.5 percent a year, you will see increases if rates of approximately 7.5 percent a year.</p>
<p>States use different methods for setting rates - rate bands, community rates and adjusted community rates. Here is an overview of these - </p>
<p>
</p>
<p>I believe the law requires community rating or adjusted community rating. The law also requires that states adequately regulate premiums. Below is an article from the National Conference of State Legislatures that reviews states’ efforts at regulating rates. </p>