Individuals who buy health insurance through Healthcare.gov could see big increases in their premiums next year.

Requests are varied — Blue Cross Blue Shield of New Mexico is proposing hikes between 49% and 65% — but several insurers are seeking double-digit increases, according to a list of proposed rate increases of 10% or more that the Centers for Medicare and Medicaid Services posted Monday on Healthcare.gov.

“So far, hundreds of health plans have requested this double-digit increase, often citing increased costs due to (the Affordable Care Act),” according to Sen. Lamar Alexander (R-Tenn.), chairman of the U.S. Senate Committee on Health, Education, Labor and Pensions.

The posted rate increases — which reflect the cost before subsidies — are subject to a review process that “allows for officials, experts and the public to examine and question why a particular health insurance plan’s yearly increase in its premium is high (10% or greater) before it is finalized,” according to CMS.

“These specific rates will be subject to vigorous rate review and revision and the final rates consumers will see this fall will reflect the breadth of choice and competition in the marketplace,” says CMS Acting Administrator Andy Slavitt.  

In 2015, premiums rose by 5.4% on average across all reporting states, according to PricewaterhouseCoopers’ Health Research Institute. Nearly one in three Healthcare.gov consumers who re-enrolled this year chose a different plan, CMS says. 

The final rates for the 2016 coverage year for all states will be published by Nov. 1.

Employers’ premiums on the rise

Employers can expect rising premiums, too. Overall claims costs are expected to increase 7% to 10%, resulting in even higher premiums, according to a Wells Fargo Insurance survey of more than 65 insurance companies.

“The results of the survey indicate rising cost trends that will force companies into a delicate balancing act of providing competitive benefits while also managing costs effectively and complying with regulations,” says Dan Gowen, national practice leader with Wells Fargo Insurance’s employee benefits national practice.

That’s where advisers come in. 

“Employers need to have a realistic expectation of what will happen to their health care cost if they don’t make any changes to their plan or health of their employee population,” says Gowen. “Partnering with their insurance broker and employee benefits adviser to project costs is a critical first step for a business’ strategic and financial planning for 2016.” 

Register or login for access to this item and much more

All Employee Benefit Adviser content is archived after seven days.

Community members receive:
  • All recent and archived articles
  • Conference offers and updates
  • A full menu of enewsletter options
  • Web seminars, white papers, ebooks

Don't have an account? Register for Free Unlimited Access