TALLAHASSEE, Fla. – The Florida Office of Insurance Regulation announced today that premiums for Florida individual major medical plans in compliance with the federal Patient Protection & Affordable Care Act (PPACA) will increase an average of 19% beginning January 1, 2017. Per federal guidelines, a total of 15 health insurance companies submitted rate filings for the Office’s review in May. These rate filings consisted of individual major medical plans to be sold both on and off theExchange. Following the Office’s rate filing review, the approved rate changes on the Exchange range from a low of -6% to a high of 65%. This information can be located in the attached “Individual PPACA Market Monthly Premiums for Plan Year 2017” document.
In addition, two tables showing the average estimated 2016 vs. 2017 health insurance premiums by Florida county in the individual market are being provided for a family of four with an income of $53,000 and a single individual with an income of $27,000. This analysis does account for federal premium tax credits (subsidies) to illustrate overall premium costs and both examples use the selection of a Silver plan. The Silver plan is the most frequently selected plan on the Exchange because it is the only plan where qualified consumers can take advantage of cost sharing assistance, while federal premium tax credits are available to qualified consumers at all plan levels through the Exchange.
The approved percentages varied by about 2 percentage points from the original May requests, with a few exceptions. The primary reasons for this are (1) companies received official risk adjustment numbers from CMS in June (2) several insurers decided to write only off-exchange policies in Florida during 2017. Aetna, who has a commitment to expand in 2018, has indicated that it will not participate in 2017. United announced before the May filings that it would not participate on the exchange for 2017. United filed and withdrew an exchange filing under a subsidiary (Harken). Humana filed for participation in only a few areas of the state but did not disclose this information publicly. All of these decisions changed office and company estimates of the risk pool that companies expect to insure. Some companies estimate that they will grow more because of the lack of participation in the exchange market by these insurers. All of these insurers continue to write either individual or group products off-exchange.
Federal review of the rate filing information has not been finalized by the Department of Health & Human Services (HHS) and is subject to change. Further information can be obtained from each insurance company, the Federal Governmentwebsite, the Office’sI-File Forms & Rates Filing Search System, and the Office’s Federal Health Care Insurance Reformwebpage.
About the Florida Office of Insurance Regulation The Florida Office of Insurance Regulation has primary responsibility for regulation, compliance and enforcement of statutes related to the business of insurance and the monitoring of industry markets. For more information about the Office, please visit