State regulators have unveiled the health insurance prices that Utahns will pay on the Affordable Care Act’s online insurance marketplace, or exchange.
Prices vary by county and competition is fierce, with 96 plans to choose from statewide, according to a 354-page report by the Utah Department of Insurance. In most counties, the gap in price between one plan and the next closest is small, the difference of a dollar or two per month.
But in the state’s most populous county, the spread is wider, and one insurance company, Kentucky-based Humana, is a clear outlier.
The for-profit insurer sweeps Salt Lake County with the lowest-priced plans in every category — bronze, silver, gold and platinum — and by a good margin.
“In Utah there’s a lot of pressure on companies because our individual market isn’t well-developed and is totally dominated by [nonprofits] SelectHealth and Regence BlueCross BlueShield,” said Lincoln Nehring, a health analyst at Voices for Utah Children. “They had to compete on price to get their foot in the door.”
Altius, another big national carrier, also came in with lower-than-average prices. But Humana underbid everyone, charging $19 to $74 less per month for its lowest-cost silver plan than the next company.
That may seem like chump change, but multiplied over a year it adds up, a calculus many of Utah’s 378,000 uninsured may be inclined to make.
Insurance experts, however, caution against shopping on price alone.
“Cheap is great. But if you’re going to use your insurance, monthly premiums are only part of the picture,” said Tanji Northrup, Utah’s assistant insurance commissioner. “You have to look at your out-of-pockets costs, too.”
All plans must cover certain “essential” health care services. But they are rated according to their actuarial value, or the percentage of health expenses they cover. The higher the metal level (gold versus bronze) the more you’ll pay in monthly premiums, but the lower your out-of-pocket costs will be.
Consumers should also pay attention to the size and strength of an insurer’s provider panel, said Northrup. “Ask if a plan covers your doctor or the hospital you like to go to.”
Insurers are able to negotiate better prices by promising to funnel all their policyholders to a small number of doctors and hospitals.
Northrup said Humana came in with narrow networks, but they aren’t alone. SelectHealth offers a range of policies, some covering 10 hospitals and others covering 43, she said.
The insurance department reviewed Humana’s rates to ensure they weren’t irresponsibly low.
Prices posted Tuesday on the exchange are guaranteed for 12 months. “An insurer can’t come back in two months and say, ‘We underpriced our plans, and we need to raise the rates,’ ” said Northrup.
But don’t expect the rock-bottom deals to last.
“The carriers have gone in somewhat blind to offer these rates. A year from now it will probably look quite a bit different,” predicts Rep. Jim Dunnigan, R-Taylorsville, an insurance broker.
Reinsurance, a federal pool of money used to protect insurers from heavy losses, is artificially keeping rates low on the exchange, said Dunnigan. But it phases out during the next three years, he said.
Consumers will have a chance to switch plans during the next open-enrollment period in October 2014, and Humana may not be able to sustain its market edge.
Arches Health Plan, the state’s only health co-op or member-governed insurer, is the price leader in Washington County.
“We were pleased to see we were competitive in most counties,” said Arches CEO Linn Baker.
In Utah County, SelectHealth offers the best silver-level deal. In Cache and Weber counties, the prize goes to BridgeSpan, an arm of Regence BlueCross BlueShield.
Find Utah exchange prices here
This 354-page report by the Utah Department of Insurance shows the rates for individuals and families for the health insurance plans being sold on the new exchange.
Counties see a range of prices
Here’s a snapshot of prices for “silver-level” plans posted Tuesday on healthcare.gov, the Affordable Care Act’s online health insurance marketplace. Statewide there are 96 plans from which to choose. Prices vary by county and depend on a purchaser’s age and family size.
Here are the ranges of monthly premiums before subsidies — available to many Utahns based on income — are applied.
27-year-old • $203-$269
40-year-old • $216-$286
*Family plan • $780-$1,032
Salt Lake County
27-year-old • $162-$255
40-year-old • $173-$271
Family plan • $623-$978
27-year-old • $209-$263
40-year-old • $223-$279
Family plan • $803-$1,008
27-year-old • $219-$269
40-year-old • $233-$286
Family plan • $842-$1,032
27-year-old • $189-$263
40-year-old • $201-$279
Family plan • $727-$1,008
* A family is defined as two parents age 40, and three or more children under 21.
Source: Utah Department of Insurance
Save the date
O On Oct. 9 at 7 p.m., The Salt Lake Tribune and KCPW will co-sponsor an Affordable Care Act town-hall meeting at Salt Lake City Main Library’s auditorium, 210 E. 400 South. Jennifer Napier-Pearce will moderate a discussion with a panel of experts, who also will answer questions.