We have all experienced many changes in the way we do business and our personal lives since the pandemic. Some of the technology that we have always had available to us, we have had to learn and utilize and found some great rewards in doing so. On the other hand, the quarantine came with some big price tags shown in the statics below. Because the insurance companies have properly priced products from the no underwriting provision of the ACA to the unexpected consequences of the pandemic, we are experiencing group and individual renewal rates in the single digits. This is a good time to get a free quote on your existing coverages. If you feel benefit changes should be considered, the numbers will tell you what to do.
These statics are for the individual market segment.
TRENDS IMPACTING THE GRANDFATHERED/ MOTHERED PREMIUM INCREASES
Several factors add to the rate increase, the following are key drivers:
• 6% increase in high-cost claimants — the number of members who have greater than $50,000 in claims increased.
• 16% increase in retail pharmacy costs.
• 47% increase in the costs of dermatology treatment.
• 82% increase in costs for a class of high-cost specialty drugs used to treat serious conditions like cystic and pulmonary fibrosis.
RENEWING GRANDFATHERED/MOTHERED POLICIES
Each year, Wellmark assesses the market and members’ needs to ensure they are offering the best options. For 2022, Wellmark will renew grandfathered and grandmothered plans. Members in these plans can keep the health insurance coverage they trust. They get access to plan designs that are unique and provide broader access and benefits than other plans available on the Marketplace.
TRENDS IMPACTING THE ACA PREMIUM INCREASES
For the ACA membership, the medical services and prescription drugs being used by this population is on an upward trend and include these key drivers:
• 15% increase in the use of professional services, such as physician office visits, psychiatric office visits, and physical therapy.
• 18% increase in high-cost claimants — the number of members who have greater than $50,000 in claims increased.
• 83% increase in the use of mental health services.
• 181% increase in costs for ambulance services.
RENEWING ACA POLICIES
It’s important for Wellmark ACA members to know that these are base rate increases and do not consider members’ subsidies. So, members may have no change or even a decrease after their subsidy is applied. And with recent legislation changes, members may qualify for an even larger subsidy, which would result in a lower monthly premium. We encourage members to go to Healthcare.gov to update their member information.
This is the time of the year that we complete many certifications and prepare for the fourth quarter, the busiest time of the year for the health insurance industry. This is the time of the year that is ideal for you to call me for 2022 planning.
Wellmark small groups ACA (Affordable Care Act) clients will receive communication regarding free COBRA/State Continuation administration services. We also have information to share regarding renewal process updates and COVID-19 expirations/extensions effective 7.1.2021. Some other Health Insurance Headlines include IRS Updates and HSA Contribution Limits for 2022. The Marketplace Extends Special Enrollment and New Tax Credit Eligibility and we can assist with these clients as well.
Please call me for a FREE consultation – 515.285.6766