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Increased Rates Coming to Affordable Care Act Members

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DES MOINES, Iowa - Affordable Care Act members across the state will see an increase in their insurance rates.

In January of 2015, Wellmark ACA members’ rates will increase 11.5 – 14.5%, CoOportunity will increase their rates 19% and Coventry Health Care will boost their rates by nearly 9%.

Wellmark’s executive vice president say the increase is based on the amount of services and prescriptions ACA members use and due to the number of people who do not pay their premiums.

“We had about 50 plus individuals actually purchase our policy, pay one month of our premium, seek services and then cancel their coverage,” says Laura Jackson.

Jackson says members chose to use their coverage on elective surgeries like gallbladder removals and nose jobs before canceling their coverage. Companies like Wellmark say as a result, they were forced to increase insurance rates to cover the cost of individuals who did not pay their premium.

The Iowa Insurance Division calls the tactic, “adverse selection.”

“It’s when people choose to receive benefits at their convenience,” says Tom Alger. “It’s a reality of the business of insurance and sometimes that does come into play and sometimes that affects future rates.”

Alger affirms “adverse selection” is within the rules but there is nothing insurance companies can do to prohibit members from taking advantage of the system. By law, companies have to re-issue Affordable Care Act polices when requested and are not allowed to ask how the members policy was used before they canceled their coverage.

“The hard part of this is, is that when you put a lot of people into the system you do have pent up demand and we all have to pay for it,” says Jackson.

Wellmark indiviual member rates will also increase by nearly 6 %. No other members of Wellmark will be affected.

13 comments

  • Dan

    wait a minute….. nose jobs are covered? And isn’t there a $ 6,000 to $ 7500 deductible anyway? And aren’t the Democrats telling us how good this is working out? And what is this free phone business about? They say the Obamaphone doesn’t exist but yet commercials saying it does?

  • Brutally Honest

    Anyone that isnt an idiot could see this coming a mile away! Force everyone to have ACA that can barely afford it anyway, get them all to sign up and now jack up the rates to where they cant afford it. Now they are damned if they do and damned if they dont, when they drop insurance because they cant afford it, now they will get fined at tax time for not having it. Good money maker right here!

  • Randall

    Sounds like customer abuse to me. Like buying a suit for a wedding, wearing it, and returning it to the store the next day for a refund. There will always be sour eggs and abuse within any system. All that is needed is a little system tweaking to disallow this fraud tactic. Obamacare is indeed helping the honest people. THE HONEST PEOPLE !!!! (You can quote me). Those abusing the system are the lowlife of society and the fraud they impose affects everyone. So sure, blame the bank when a crook robs it. Duh. Iowans… go figure.

  • Not Your Friend

    Hey you uninformed, clueless, trolls tell me how this is bad. I’d especially like to hear what you have to say about the last sentence. Less than 2 percent of Iowans will be affected by steep health insurance increases announced this week by state regulators. Leaders of Wellmark Blue Cross & Blue Shield stressed Thursday that most of their customers are not facing such steep increases. Among the 149,000 Iowans who buy individual policies from Wellmark, only 19,000 are seeing premiums rise by the 11.5 percent to 14.5 percent that the insurance division publicly approved Wednesday. The rest are facing increases of less than 6 percent, said Wellmark Vice President David Brown.

    That is a much smaller increase than such Wellmark customers were seeing several years ago. For example, Wellmark raised individual rates an average of 18 percent in 2010.

  • George

    The Affordable Care Act is still a huge improvement. Millions of people who needed health insurance now have it. No surprise there would be a rate hike after the initial year. Checked regular health insurance premiums lately? I would guess many of the complainers on here have Medicare. Oh horrors! Socialized medicine!

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