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Health Insurance

Insurers to pay $11 million in Georgia rebates

A federal rule on health insurers’ spending will bring $11 million in rebates to Georgia individuals and employers this summer.

Federal figures released Thursday show that 304,000 Georgians will benefit from the refunds, with an average rebate of $53 per family, as a result of the “Medical Loss Ratio” (MLR) rule on 2013 insurance plans.

1088819262-1249Created by the Affordable Care Act, the MLR standard generally requires health insurers to spend at least 80 percent of the premium dollars they collect on medical care or activities to improve the quality of health care.

In Georgia, $5.5 million will go to refunds to 180,000 individual consumers, while $5.4 million will go to employers in the small-group market. In both these sectors, the required threshold is 80 percent.

The large employer market, where the minimum requirement is 85 percent, accounts for just $270,000 in refunds in Georgia for last year’s health plans.

Humana plans in Georgia will have to pay the highest amount in rebates — $4.5 million combined in the small-group and large employer market. full story

Exchange subsidies draw conflicting court rulings

More than 190,000 Georgians are enrolled in the health insurance exchange created by the Affordable Care Act.

But if a D.C. federal court ruling announced Tuesday on exchange subsidies is ultimately upheld, that Georgia number could shrink precipitously.

Healthcare Cost

The U.S. Court of Appeals for the District of Columbia ruled Tuesday that the language of the ACA allows subsidies, or discounts, only for people who obtain coverage through exchanges run by the states, and not by the federal government.

Georgia is among 36 states whose insurance exchanges are federally run.

About 95 percent of Georgians enrolled in health plans in the exchange have received subsidies to help them afford their premiums, according to the state insurance department.

The 2-to-1 ruling by a three-judge panel of the court — if not overturned on appeal — would be a tremendous setback for President Obama’s health care law.

Without subsidies, the price of health insurance for millions of people in Georgia and the 35 other states with federally run exchanges would rise sharply, making it generally unaffordable.

The judges suspended their ruling pending an appeal by the administration. The Obama administration said it would appeal to the full circuit court, a process that could take up to six months, and stressed the ruling would have no impact on consumers receiving monthly subsidies now, Reuters reported.

Also Tuesday, a three-judge panel of the 4th U.S. Circuit Court of Appeals in Virginia ruled unanimously to uphold the subsidies provision, saying the wording of the law was too ambiguous to restrict the availability of the funds. The ruling was announced shortly after the D.C. decision.

 

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Fourth insurer plans statewide exchange offerings

UnitedHealthcare is the fourth health insurer seeking to offer insurance statewide in Georgia’s exchange next year.

The Minnesota-based company would join Coventry, Time Insurance Co. and Blue Cross and Blue Shield of Georgia in offering health plans in all regions of the state.

Healthcare Cost

This year, Blue Cross was the only statewide insurer in the Georgia exchange, which was created under the Affordable Care Act.

Counting the four that plan statewide offerings, there are nine insurers applying to participate in the Georgia exchange to some degree. The state’s insurance department released rate data for eight of the nine applicants earlier this month, but omitted data from UnitedHealthcare, saying it had an incomplete application.

The agency said Friday that the application is now complete, and it released United’s proposed rate information. full story

An early, encouraging glimpse of 2015 rates

At least three health insurers plan to offer insurance statewide in Georgia’s exchange for 2015.

This year, only one health plan – Blue Cross and Blue Shield of Georgia – went statewide in the exchange.

And the proposed Blue Cross rates for next year’s exchange will decrease by an average of 7 percent.

Healthcare Cost

Those were among the immediate highlights of data on proposed premiums, released by Georgia’s department of insurance, from the health plans seeking to participate in the state’s exchange next year.

A total of nine insurers are seeking to offer exchange plans in 2015. That’s up from five insurers for the current year.

The 2014 insurance exchange featured stark variability in rates between metro Atlanta, where multiple plan choices were offered, and southwest Georgia, where only a single insurer offered plans. The southwest Georgia region had some of the highest exchange premiums in the country this year.

“It looks to me that the market is becoming more competitive,’’ Bill Custer, a health insurance expert at Georgia State University, said Wednesday. “This is what you would expect to see in the second year of this.” full story

More insurers seek to join 2015 Georgia exchange

UnitedHealthcare, Coventry, Cigna and Time Insurance Company have each submitted plans with the state to offer health insurance in the federally run exchange in Georgia next year.

They join the five holdovers from this year’s exchange that are also submitting rates for review: Alliant Health Plans, Blue Cross and Blue Shield of Georgia, Humana, Kaiser Permanente, and Peach State Health Plans.

lb_uhc-logoThe state’s deadline for applications for the Georgia exchange was midnight Monday. Glenn Allen, a spokesman for state Insurance Commissioner Ralph Hudgens, said late Monday afternoon that other insurers’ filings could come in before that deadline. full story

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