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Maine Releases Information on Health Exchange Insurance Rates
07/31/2013   Reported By: Patty B. Wight

Today the Maine Bureau of Insurance released rate information for new insurance products that will be offered through an online marketplace that opens in October. The new insurance products, which still need federal approval, are part of the Affordable Care Act, and are targeted to individuals and small groups. But if you're in this market and hoping for a quick and easy look at what insurance may cost you, think again. Patty Wight reports.

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The purpose of the online insurance marketplace is to make getting health insurance coverage easy and affordable. Potential buyers in the individual and small group market can compare different so-called insurance products online starting Oct. 1.

But while the marketplace may present information in an easy, understandable way, these preliminary rate filings - which add up to hundreds of pages of data and information - are anything but.

"It's the exact opposite of what the Affordable Care Act envisioned," says Joe Ditre, executive director of Consumers for Affordable Health Care. "It's almost impossible to tell how these prices compare to each other because these rate filings are so non-transparent. They are not obvious to the average consumer. They don't provide the actual rate sheets by product, so it's almost impossible to compare one to the other."

Two different companies in Maine are offering products in the online marketplace. One is Anthem Blue Cross Blue Shield. Company officials were unavailable for comment for this story. The other company is a new health insurance co-op, called Maine Community Health Options. Kevin Lewis is CEO.

"We do have a variety of plan options, for individuals and small groups, both on the exchange and off the exchange," Lewis says.

They offer four categories of plans, ranging from catastrophic coverage up to so-called "gold" coverage. The proposed insurance rates vary depending on a person's age and location. So, if you're a 25-year-old living in Portland, Lewis says, catastrophic coverage would cost about $160 a month. Silver coverage will cost in the low 200s.

"In a different geographic area - say Bangor - a 25-year-old seeking catastrophic coverage would have a premium of roughly $185," Lewis says.

Silver coverage ranges in the high 200s a month. This is just one example out of a myriad of ways insurance premiums will be calculated, and Lewis says it doesn't take into account potential tax credits and cost-sharing reductions some consumers may be eligible for, "and so those calculations will need to be done person by person, family by family," he says.

The Maine Bureau of Insurance estimates that, currently, less than 10 percent of Maine's population is covered in the individual and small group market. Still, the bureau is holding a series of public information sessions about the online marketplace and the Affordable Care Act from Aug. 15 - 30.

But Joe Ditre, of Consumers for Affordable Health Care, questions how helpful those will be. "To think that the average consumer will be able to understand these things and be able to come and speak to the rates in just 16 days is ludicrous," he says.

Ditre says Anthem and Maine Community Health Options should provide rate sheets that show easy, apple-to-apple comparisons of the insurance products well before the public hearings.

Ditre says if you're in the market for one of these plans, it's important to remember that if your income is at or below 400 percent of the poverty level, you will qualify for tax credits; and if your income is at or below 133 percent of the federal poverty level, you are not subject to the insurance mandate or penalties if you don't enroll.

Learn more about the online insurance marketplace under the Affordable Care Act. 


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