As the late great Paul Harvey used to say, “I am Paul Harvey, and this is the rest of the story.” I am reading in the Chicago Tribune that the health insurance rates for 2016 are going up an average of 6.1% in Illinois. It also says the national increase is 7.3%. Now these are based on the second lowest price Silver plan which is generally one of the most popular plans. This is where Paul Harvey jumps in. As an insurance broker and can speak from the rate increases my clients are getting. Let’s start in Illinois. I have a couple in their early 40’s in Plainfield who is getting an increase with Blue Cross and Blue shield from $493 per month to $719 per month. That is about 32%. I have a family of three where the ages are a couple in their early 60’s and a 24 year old child in Park Ridge, going from a Bronze plan at $906 per month to $1270 per month. This is also an increase of near 30%. My third example is a single male in his late 30’s residing in Woodridge. He has a gold plan which was priced at $370 last year. His plan was canceled as blue cross cancelled their large network of doctors and hospitals. His plan will move to a smaller network of doctors where he will lose his doctor and still get an increase of about $4 per month.
You see when you compare apples to apples we see large 25 to 30% increases. When someone is reduced in coverage you see a smaller increase. The last example cannot be counted when you are comparing apples to apples since the plan he had and the network he had no longer exists. I have another family of five on a silver plan whose silver plan was cancelled. If they stay with Blue Cross and Blue Shield of Illinois they will pay less for insurance this year since Blue Cross is canceling that plan and network. The plan they are moved to however, does not have the children’s pediatrician in the network or their dermatologist. They can move to the Blue Cross HMO and get the pediatrician, but then they lose both the family doctor and the wife’s OBGYN. If they change to say United Health Care they can get all of their doctors and hospitals but it will cost them about $50 per month more for that privilege.
Moving to the State of Texas I have a client in the Houston area whose PPO plan was cancelled by Blue Cross as well. He is being moved to an HMO which is generally seen a step down in coverage, but to do so it will cost him $300 a month more.
My last example comes from the great state of Ohio. This family of three has a Silver plan with Medical Mutual of Ohio, who by many is considered the best carrier in the state. His plan is going from $840 to over $1000. This is in the neighborhood of a 20% increase. So this is not isolated to one state or one carrier.
As a broker I am seeing near 25% for most of my current clients in Illinois, Ohio, Texas, and Indiana, Some of my other states not as much, but pretty much all double digits.
So when reading about smaller rate increases you need to know the “rest of the story”