Health coverage to rise for some CT small businesses

Sep. 17--Health insurance premiums will spike 9 percent next year on average for Connecticut employers choosing small-group coverage, the result of rising drug costs, increased demand for medical services and the reinstatement of a health insurer tax according to the state's industry regulator.

The Connecticut Insurance Department released last week the rate changes it approved for 2020 across a small segment of insurance plans that enrolled more than 240,000 people last year, setting final rates after collecting input from carriers and health consumer advocates. The department is allowed to change rates it deems excessive, inadequate to cover costs or discriminatory.

Average rates will go up by a smaller margin for those who purchase coverage through individual plans, at 3.65 percent on average. But those figures mask far wider swings for some depending on the plan -- as high as 16 percent for individuals and 27 percent for small groups, though some plan members will see percentage declines into the low double digits.

The majority of Connecticut residents -- more than eight in every 10 entering last year -- get coverage under large-group plans from corporations, government agencies and other entities, including smaller companies who do so through plans offered by the Connecticut Business & Industry Association. The insurance department does not oversee plans underwritten by employers, with such self-funded plans under the purview of the U.S Department of Labor and other federal agencies.

Open enrollment begins Nov. 1 in Connecticut, with this year's deadline set for Dec. 15. Special enrollment exceptions are allowed for life changes like a new job, child, relocation or losing existing coverage; and with those qualifying for Medicaid or the Children's Health Insurance Program able to enroll any time.

The Connecticut Insurance Department held a hearing in early September to take testimony from Anthem and ConnectiCare, the two remaining carriers providing coverage under the Access Health CT insurance exchange. Created under the federal Affordable Care Act, state insurance exchanges were designed with the goal of providing alternative options for those having difficulty finding coverage otherwise.

It was the first set of rate deliberations for Andrew Mais, whom Gov. Ned Lamont named in April as insurance commissioner to replace Katharine Wade in the role. Whereas Wade's decisions drew extra scrutiny given her previous career as a government affairs manager for the Bloomfield-based carrier Cigna, Mais took the job with a background in insurance regulation, first with the New York Department of Financial Services and with the Wilton resident joining Deloitte later as an in-house expert on the topic.

Anthem had requested an average increase of about 15 percent for individual plans it will make available on the Connecticut Insurance Exchange, with the department approving a 6.5 percent bump on average for more than 27,000 people covered under those policies. Anthem got most of what it sought for its small-group pricing, with an average increase of 14.3 percent for about 44,000 people insured by the small businesses where they work, with Anthem having filed for a 14.8 percent hike.

More than 75,000 people getting ConnectiCare coverage through the state exchange will see rates rise 2 percent. Close to 24,000 more who get off-exchange small-group coverage from ConnectiCare will absorb a 3 percent increase on average.

Premiums will go up between 8 percent and 9 percent for small businesses employing more than 45,000 people who secure coverage through Oxford Health Plans and parent UnitedHealthcare, with Harvard Pilgrim Health Care rates to rise about 7 percent.

A tax penalty will not be in effect next year that under Obamacare had been levied on those who did not get health insurance coverage, intended as a strategy to reduce overall health-care costs by getting people to see doctors for checkups; and to chip away at the number of instances in which hospitals foot the costs for emergency room care provided patients who lack insurance.

[email protected]; 203-842-2545; @casoulman

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