Coventry Health Care seeks double-digit price hike for health plans

June 02--Coventry Health Care is seeking approval for double-digit premium increases for its 2016 individual health plans, according to rate information made public Monday by the federal government.

Insurance brokers had considered the health plans sold by the Maryland-based insurer to be among the cheapest with the most extensive provider networks available to Missouri consumers.

But Coventry's strategy appears to have caught up with it, and the insurer is now asking federal regulators to approve an average rate increase of 23 percent for plans sold in the St. Louis area. The proposed hike affects roughly 70,000 consumers in the area.

"Our goal is to offer competitively priced products at a rate that will allow us to cover the cost of doing business while offering our customers high-quality products that meet their health care needs," said spokesman Rohan Hutchings in an emailed statement.

Under President Barack Obama's health law, insurers can't deny coverage based on pre-existing medical conditions. As a result, any customer can sign up for any plan as long as he or she can afford it.

During the first two years of insurance enrollment under the health law, many consumers seeking individual coverage flocked to the least-expensive plans, which in the St. Louis area were often Coventry policies.

But that potentially left the company liable for hefty bills from customers who went without health insurance before Obama's law took effect because of costly pre-existing medical conditions.

In its filing information, Coventry said the combination of higher provider rates and increased use of health services by customers led to the double-digit premium increase. The insurer said it expects its medical costs to rise nearly 10 percent next year.

"The claims experience for these plans has been worse than anticipated," the company said in its rate filing information. "Part of the rate increase is needed to ensure that we can continue to offer coverage in this market."

Insurance brokers said big premium hikes can allow insurers to shed customers that cost a lot to care for.

"It could push those people to leave and try something else," said Emily Bremer, insurance broker and president of the Missouri Association of Health Underwriters. "But they may end up finding that they priced it too high and everyone migrates."

Coventry stressed that the 23 percent rate increase was only an average and that some consumers could see far less of an increase. Others could face a steeper hike.

The double-digit increase applies to plans sold directly by Coventry and those available for purchase on HealthCare.gov, the federal online health exchange for consumers who don't get insurance on the job.

The bulk of Coventry's rate increase will fall on HealthCare.gov customers who bought its "preferred provider organization" network. Those rates could jump nearly 30 percent. Also affected are Carelink and FocusedCare customers, who are facing a proposed increase of 19 percent.

Consumers who bought Coventry plans outside the HealthCare.gov platform are looking at a 28 percent premium jump.

The information published Monday only includes individual health plans seeking a price increase above 10 percent. It doesn't take into account other price changes that may affect consumers, including higher deductibles or copays. There also is no break down of which age groups or plan types will face the brunt of the increased rates.

Of the insurers selling plans on HealthCare.gov in the St. Louis area last year, only Coventry is seeking rate increases above 10 percent for 2016.

UnitedHealthcare is seeking an average 16 percent premium increase for about 8,800 customers, but only for plans not available on HealthCare.gov.

Plans offered by Anthem BlueCross BlueShield and Cigna were not included in Monday's rate disclosure, suggesting any premium increases for 2016 would be below 10 percent.

About 250,000 Missourians have health insurance purchased through HealthCare.gov.

Monday's disclosure was the earliest the federal government has publicly released plan pricing since Obama's law took effect. Previously, plan pricing was released only days before people could begin buying coverage. Enrollment for 2016 plans will begin Nov. 1.

The Consumers Council of Missouri, which sued the federal government last year for not releasing rate information quickly enough, applauded the early disclosure.

"We feel quite pleased that they did follow through and do it," said Joan Bray, the council's executive director. "It is not something they have done before."

The council is partnering with the Missouri Foundation for Health to review the 2016 price increases. They plan to submit comments over the next several months to the federal government for "unreasonable and unjustified" price increases in an effort to lower the rates.

Jordan Shapiro -- 314-340-8114

@jordanshapiro13 on Twitter

[email protected]

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