Want a better Obamacare rate? You may have to call the movers.

Aug. 04--Under preliminary Obamacare rates announced by Covered California, premiums on exchange plans will rise by an average of 5.7 percent in Sacramento, Placer, El Dorado and Yolo counties.

That's less than half of the statewide average of 12.5 percent, and consumers could virtually avoid an increase altogether if they shop around.

But in 22 counties stretching from Del Norte to Tuolumne, premiums on plans sold through the exchange are set to increase by an average of 33.2 percent. Residents who switch plans can save a little, but still face an average hike of about 29 percent.

According to Covered California, the disparity reflects the number of insurance carriers serving a particular area as well as the number of providers. Rural areas often have less competition between providers, and there's also less coordination of care -- which helps keep costs down -- between the providers that do exist.

The differences also reflect who is buying the coverage and how many services they are using, according to the California Association of Health Plans.

Northern California consumers, on average, pay 78 percent more than those in Southern California. A 40-year-old in Northern California, for example, would pay an average monthly premium of $496 compared to $379 in Southern California.

The same regional differences exist with CalPERS' purchase of health coverage for state employees, the exchange said.

Everyone in the Covered California region that includes Sutter, Yuba and 20 other counties in line for Covered California's highest average premium increases next year will have two insurance companies to choose from: Anthem and Blue Shield. Some residents, depending on where they live, also might be eligible for plans offered by Kaiser Permanente.

Missing from the region's lineup for 2018 will be Health Net, which is pulling its health-maintenance organization and health savings plan products.

In the Sacramento region, all consumers will have access to at least one insurance company, while some can choose from as many as four: Blue Shield, Health Net, Kaiser and Western Health Advantage.

Seventeen of California's 19 pricing regions reflect county boundaries. Consumers in Los Angeles County, though, pay different premiums based on where they live.

An enrollee in Monterey Park, in the county's eastern pricing region, faces an average premium increase of 13.4 percent. On the other side of Interstate 710 in Los Angeles, in the western region, consumers are in line for a slightly smaller average increase, 13.2 percent.

This week's Covered California rates now go to the Department of Managed Health Care for public review. The agency expects to finish that process by October, a spokesman said Thursday.

Jim Miller: 916-326-5521, @jimmiller2

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