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Small Business Employee Benefits and HR Blog

Florida Health Insurance Exchange Update – Plan Rates & Carriers

Flordia Health Insurance Exchange RatesOn August 7, 2013 the Florida Office of Insurance Regulation (FOIR) released proposed individual health insurance plan rates and carriers for the Florida Health Insurance Exchange. The FOIR also released analysis of these plan rates in comparison to the current market.

On average, individual health insurance plans offered through the exchange will increase 30%-40%. However, most Florida residents will be eligible for health insurance premium subsidies that will cap their premium cost at 2%-9.5% of household income, depending on income (read more on health insurance premium subsidies here).

Florida Health Insurance Exchange – Individual Health Plan Rates 

The FOIR published a “Notice of Premium Impact Template,” which compares Florida’s gross annual premium before and after the implementation of the Patient Protection and Affordable Care Act (PPACA). In an attempt to provide an "apples to apples" comparison, the report compared the projected cost of a Silver Plan to the average cost of a hypothetical standard risk plan adjusted to reflect the value of a Silver Plan.

The predicted cost of the Silver Plan was based on the average costs of premiums for midlevel plans from the 11 insurers that will be offering insurance in Florida starting in 2014. The document notes that “these PPACA plans are new products, with new benefits and requirements, so it is not possible to directly compare them to an existing product sold in Florida. But it is possible to provide some idea of the expected impact of changes.” 

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Source: Florida Office of Insurance Regulation.

Florida Health Insurance Exchange – Reasons for Rate Increases

This notice was released a day after Florida’s insurance commissioner Kevin McCarty said that rates would rise an average of 5-20% for small businesses and 30-40% for individuals. However both he and the FOIR ensure that these premium increases are due to the fact that the new insurance plans will offer a broader and better quality range of health benefits. Some of the reasons that the Office of insurance Regulation provide for the price increase include:

  • The requirement that health insurance coverage be offered to everyone, even if they have a preexisting medical condition

  • The requirement that new benefits be offered, such as for substance abuse and mental health conditions

  • The requirement that insurers charge the same health plan costs to men and women

  • The limitation on how much your age can affect health plan costs

  • New taxes and fees

According to the Miami Herald, the smallest premium increase is a 7% increase from an HMO plan of Humana, which rose from $293 to $315. The largest increase comes from a Sunshine State Health Plan, which went up from $293 to $464, a 59% increase.

Currently many Florida insurance plans offer extremely low coverage health plans at cheap rates that only cover catastrophic events. Starting January 1, 2014 these plans will no longer be allowed, as every plan is required to cover a set of essential health benefits as defined by the federal government. In addition, insurance companies will no longer be able to deny coverage to the 7.8 million non-elderly Floridians with pre-existing medical conditions, and will be restricted on what they can charge elderly citizens for out-of-pocket expenses.

Florida Health Insurance Exchange – Carriers 

Eleven Florida insurers plan to offer 308 plans through the exchange in Florida, according to state insurance officials. Many counties will have a wide range of insurers to choose from, but other counties such as Bay, Franklin, Glades, Jefferson, and Madison will have only one option. Statewide, the carriers are:

  1. Aetna Life Insurance Company

  2. Blue Cross Blue Shield Of Florida

  3. Cigna Health And Life Insurance Company

  4. Coventry Health Care Of Florida

  5. Florida Health Care Plan, Inc.

  6. Health First Insurance Company PPO

  7. Health Options, Inc.

  8. Humana Medical Plan, Inc.

  9. Molina Healthcare Of Florida, Inc.

  10. Preferred Medical Plan

  11. Sunshine State Health Plan Inc

To view the number of companies offering plans by county see the FOIR’s Health Insurance Plan Distribution by County.

What questions do you have about the Florida Health Insurance Exchange rates and carriers? Join the discussion in the comments below.

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