A Healthy Blog

Massachusetts health care — wonky, with a healthy dose of reality

Health Connector Discusses modifications in ConnectorCare premiums

Health Connector Discusses modifications in ConnectorCare premiums

September 12, 2016

On Thursday, the Health Connector Board met to award the final Seal of Approval (SoA) for plans to be sold through the Health Connector in 2017. This included a review of premium changes in the ConnectorCare program and plans for member communication and outreach for open enrollment. The meeting sparked big headlines, including the lead story in the Boston Globe (see below). Materials from the meeting can be found here.

Boston Globe: Subsidized Health Plan raises rates 21%

Due to an increase in rates offered by some health plans, the Health Connector reported that many members will have higher premiums upon their 2017 plan renewal. This will particularly impact individuals enrolled in Harvard Pilgrim HealthCare, Neighborhood Health Plan, and Health New England. Members receiving only premium tax credits or no subsidies will see a 19% premium increase.

That’s going to have a big impact on people. There’s going to be a lot of shifting and a lot of disruption.’Until now, the Health Connector “smoothed” the difference in premiums between the lowest and highest cost plans in the ConnectorCare program. After considering budget constraints and alternative solutions, the Health Connector has decided to discontinue most premium smoothing in the ConnectorCare program beginning in plan year 2017. However, the Connector will continue to “smooth” plans offering premium rates less than $35 different from the lowest cost plan for 2017 only.   Continuing smoothing as it has been implemented would cost $51 million ($35 million after federal reimbursement). The significantly reduced premium smoothing in 2017 will cost $4.2 million ($2.1 million net).  

The impact this decision has on the most vulnerable members of the Commonwealth is apparent. The starkest change if for “Plan Type I” ConnectorCare members, whose incomes put them below the poverty level (about $11,800/year in income for an individual). In previous years, these members could choose any ConnectorCare plan and not pay a premium. Starting in 2017, they will pay anywhere from $0 to $165 in premiums, depending on their choice of plans.  

While the Connector has other insurance plans that are less expensive and have comparable benefits, the individuals who choose to switch their plans will likely need to switch physicians and providers. The Connector Board stated that these changes are necessary in order to adhere to their goal of giving individuals options in light of their heavy budget restrictions.

The next Connector Board meeting is scheduled for Thursday, October 13th, 9am, at 1 Ashburton Place, 21st floor, Boston.

                                                                                                                                        -- Chelsea Canedy