State health analysts have signed off on the rates and plans proposed for California’s health insurance exchange under the Affordable Care Act.
The California Department of Managed Health Care said its actuaries conducted “a thorough review” of the plans to be offered for individual insurance coverage effective Jan. 1, 2014.
While expected, the approval is a key advancement toward opening the California health insurance marketplace on Oct. 1. Several delays with elements of the Obamacare scheme have made headlines in recent weeks, but none has affected the individual health care exchange, which is by far the major component of the reform in California and nationwide.
Covered California was among the first of the Affordable Care Act exchanges to go public with its proposed offerings, releasing the health plan proposals in late May. Thirteen health plans will be offered to individual policy buyers.
“DMHC actuaries carefully reviewed the proposed rate filings from each of 13 qualified health plans that will offer coverage in the individual market through Covered California. Upon close scrutiny, the DMHC found that the plans have justified their proposed premium rates,” said department director Brent Barnhart.
Leading insurers in the exchange include Blue Shield, Anthem, Health Net and Kaiser Permanente. (Aetna, UnitedHealth and Cigna decided not to participate.)
Shoppers won’t be able to determine exact rates for their ages and locations until fall, but detailed examples are given in the Covered California rate proposal (PDF)
Consumers will have an average of five plans from which to choose, depending on the region, the marketplace said. Represented are HMOs, PPOs and exclusive provider organizations (EPOs).
In California, proposed rates and increases for individual or small-group health plans must be filed with the DMHC. The department does not have the authority to deny or approve rate changes, however.
Here is the department’s description of the review process:
Health actuaries review the health plan’s underlying medical costs and trends, as well as other factors, to determine whether the health plan’s proposed rates are justified. During the actuarial review, DMHC actuaries and staff also review the public comments posted to the DMHC web site.
A complete list of the health care insurers participating in the Affordable Care Act marketplace in California follows:
- Alameda Alliance for Health
- Anthem Blue Cross of California
- Blue Shield of California
- Chinese Community Health Plan
- Contra Costa Health Plan
- Health Net
- Kaiser Permanente
- L.A. Care Health Plan
- Molina Healthcare
- Sharp Health Plan
- Valley Health Plan
- Ventura County Health Care Plan
- Western Health Advantage
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