2023 Health, Dental, Small Group Insurance Rates Announced

Following in-depth reviews by independent actuaries and the Office of Value-Based Health Care Delivery, rates for regulated 2023 health, dental, and small group insurance plans were announced today. While premiums are rising steeply across the country, the extension of consumer-friendly subsidies through the Inflation Reduction Act, coupled with Delaware’s strong 2022 enrollment and 2023 Health Insurance Marketplace expansion, will limit consumer impact locally.

“This year, Delaware consumers have more carriers and plans to choose from than ever before, so they can find an affordable plan that meets their needs. We remain optimistic that this increased competition will lead to lower rates and higher care quality over time,” said Insurance Commissioner Trinidad Navarro. “Delawareans are facing rising costs in nearly every area of life and making difficult sacrifices to afford necessities – but let me be clear, no matter the financial cost, we cannot afford to sacrifice our health. We will continue to work to ensure that coverage is affordable and accessible to all residents.”

Two new health insurers will be joining the Marketplace for 2023. Before tax credits and subsidies, base rates for 21-year-old non-tobacco users range from $315 to $505 across 9 Aetna CVS Health plan options, and from $283 to $402 with AmeriHealth Caritas across 4 plan options. Returning ACA issuer Highmark Blue Cross Blue Shield of Delaware will be increasing rates 5.5% on average, with base rates for 17 plan options ranging from $249 to $618 including a catastrophic plan option. In the last few years, Highmark’s average rates have decreased roughly 10% despite this needed increase.

Plans on the marketplace are spread among metal-level categories – bronze, silver, gold, platinum and catastrophic – and are based on how enrollees choose to split the costs of care with their insurance company.

As always, Commissioner Navarro urges residents to be informed consumers and shop for the best plan for both their needs and their budget. 30 plans are available to Delawareans for the 2023 plan year, and local navigators are available to assist in choosing the right plan. Open Enrollment takes place November 1 through January 15.

Factors Involved in Expansion, Rates

Nationally, insurers are requesting increases due to inflation, increasing costs of care, and rising drug prices. In Delaware, both state and federal legislation contributed to the long-awaited carrier expansion and final rates.

“It’s no coincidence that Delaware was able to expand the number of carrier options on the Health Insurance Marketplace in the same year that laws limiting hospital price growth to appropriate, inflation-conscious levels became enforceable,” said Commissioner Navarro. “The hospital price growth law, for the first time in our state’s history, gave insurers leverage to negotiate lower costs for consumers while still ensuring that hardworking healthcare providers receive their fair share. We’re grateful to have worked with legislators and the Primary Care Reform Collaborative to put cost containment guardrails in place to curtail rising consumer expenses, encourage carrier expansion, and ensure the effectiveness of every dollar spent.”

With little financial limitations around hospital prices, private insurance plans pay the price – on average 224% more than Medicare plans, according to RAND Corporation.

During the rate filing process, questions also remained about the expiration of American Rescue Plan Act subsidies, which the department lobbied Delaware’s congressional delegation to extend. These subsidies lowered consumer costs significantly and contributed to the state’s largest-ever ACA enrollment, a year-over-year increase of 26.8%. Had these benefits expired, healthy consumers who were influenced to acquire coverage through the enhanced discounts may have left the marketplace, shrinking the risk pool and unbalancing rates. On August 16, President Biden signed the Inflation Reduction Act into law, extending subsidies into 2025.

Aside from potential enrollment increases due to the carrier expansion, future participation growth may come from Medicaid unwinding and income eligibility reviews. National efforts are underway to ensure smooth, affordable transitions to Marketplace coverage for those eligible.

Other ACA and ACA-Compliant Rates

Delta Dental will reduce both ACA and non-marketplace rates by an average of 4%, and Dominion Dental will increase ACA premiums by 2.2%. Metropolitan Life Ins. Co.’s small group non-marketplace dental plan rates will remain at their current level.

Returning off-market small group plans from Highmark will increase an average 2.4%, Optimum Choice plans will rise by 2.7%, and United Healthcare small group rates will increase by 2.8%. Aetna Health’s small group plans will increase 7.6%, and Aetna Life rates will increase 5.1% after an initial increase request of 8.8% was reduced. Aetna Health’s 9 off-marketplace individual plan rates will remain at their current level.

About ACA Plans

All ACA-compliant health plans offer essential health benefits, including coverage of pre-existing conditions, prescriptions, emergency services and hospitalization, mental and behavioral health coverage, outpatient care and telehealth, lab services, and more.

Open enrollment for 2023 Health Insurance Marketplace plans begins November 1. Residents may qualify to enroll or change plans based on special circumstances, such as income qualification, loss of health coverage, becoming a parent, or other qualifying factors throughout the year. Find out if you qualify for special enrollment.

Commissioner Navarro announces Health Insurance Marketplace expansion

Be aware of non-compliant alternative health plans


Commissioner Navarro Announces Health Insurance Marketplace Expansion

Consumers to have most options in history of Delaware Marketplace

After years of work to increase competition on the Delaware Health Insurance Marketplace, Insurance Commissioner Trinidad Navarro announced today that three health carriers intend to offer plans for the 2023 plan year – the most in the state’s history. AmeriHealth Caritas and Aetna CVS Health will join Highmark Blue Cross Blue Shield Delaware in offering coverage.

“Delaware’s Health Insurance Marketplace is more stable than ever before, with rates steadying and enrollment at an all-time high. The hard work we have put into this program is paying off, with multiple new carriers planning to offer 2023 coverage,” said Insurance Commissioner Trinidad Navarro. “I look forward to the benefits that increased competition will bring to our residents, and to continuing to improve healthcare accessibility and affordability across the state.”

From rising rates to insurer departure, the implementation of the Affordable Care Act in Delaware hasn’t always been smooth sailing. But with the state’s successful creation of a 1332 reinsurance program and federal threats of ending the critical program subsiding, rates have decreased more than 15% and remained stable, while enrollment has grown significantly.

“Today’s announcement is a testament to both the needs of Delawareans who have increasingly signed up for coverage, and to the strong regulatory environment we have built, which has helped insurers go from taking losses to being able to cover their expenses and consumers’ coverage needs.”

The announcement comes as carriers submit initial rate filings proposals pursuant to federal deadlines. These will undergo in-depth reviews by independent actuaries before the Insurance Commissioner approves and announces them later this year.


ACA Marketplace Rates to Decrease 19% in Delaware for Plan Year 2020

Dover, DE – Insurance Commissioner Trinidad Navarro officially announced the final approval of the 2019 Affordable Care Act (“ACA”) rates. Highmark Blue Cross Blue Shield of Delaware (“Highmark BCBSD”), the only insurer currently on the Marketplace, originally proposed a rate decrease of 5.8% for its 2019 individual Marketplace business. Commissioner Navarro, ultimately approved a decrease of 19%, after the implementation of a state-run reinsurance program, the first decrease ever since the Marketplace opened in 2013.

The approved decrease was a result of federal approval for the State of Delaware to implement a state-run reinsurance program as established pursuant to the 1332 State Innovation Waiver Application (“Waiver”). Under this program, individual market policies that meet certain minimum criteria, as set forth in the Waiver, will be eligible for reimbursement from a state-administered fund. The fund will be financed through a 1% assessment on the individual, small and large group market premium amounts for all health insurance carriers operating in those markets in Delaware. The assessment will take place annually and may vary depending on the federal government’s actions on the Health Insurance Industry Fee.

“I am happy to announce the first rate decrease in Delaware since the beginning of the Health Insurance Marketplace. In spite of the many efforts in Washington to dismantle the Affordable Care Act, we have been able to work with our state counterparts and stakeholders to give Delaware policyholders much-needed premium relief. I thank Secretary Walker for the work she and her team at DHSS put into seeing the Waiver across the finish line.”

Because this year’s filing may result in lower costs for many consumers, the Department urges consumers to examine their rates and reapply for coverage through the Marketplace.

Presently, approximately 23,000 Delawareans have health insurance through the Affordable Care Act and may be affected by these rates.

Please be advised that the proposed rate decrease will not apply to Delawareans on Medicare, Medicaid, or those with group or individual policies outside of the Marketplace.

 

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Contact: Vince Ryan

Office: (302) 674-7303

Email: vince.ryan@delaware.gov

                                                          

Delaware Department of Insurance

http://www.insurance.delaware.gov

Dover Office: 302-674-7300

Consumer Services Division: 1-800-282-8611


Dec. 15 Is the Last Day to Sign up for 2019 Coverage on Delaware’s Health Insurance Marketplace

Picture of DHSS Secretary Kara Odom Walker
DHSS Secretary Kara Odom Walker

NEW CASTLE (Dec. 13, 2018) – Delawareans have just days left to sign up for or to change their health coverage for 2019 through the Health Insurance Marketplace. Open enrollment ends on Dec. 15, with coverage for those who enroll by that date and who pay their first premium beginning Jan. 1, 2019.

State residents can sign up for coverage at www.HealthCare.gov or by calling 1-800-318-2596 (TTY: 1-855-889-4325). Free, in-person assistance is available through Westside Family Healthcare at 302-472-8655 in New Castle County and 302-678-2205 in Kent and Sussex counties. State-licensed insurance agents and brokers also can help individuals enroll or re-enroll and help employers update their coverage, at no extra charge. For contact information, go to www.ChooseHealthDE.com.

As of Dec. 8, 10,378 Delawareans had signed up for 2019 coverage through the Health Insurance Marketplace, a decrease of 10 percent from a similar period last year. For 2018, 24,500 people enrolled for coverage, including more than half who signed up for or renewed their coverage in the final week of open enrollment.

“We urge Delawareans who need coverage through the Health Insurance Marketplace to take action now to enroll. The deadline will not be extended,” said Department of Health and Social Services (DHSS) Secretary Dr. Kara Odom Walker, a board-certified family physician. “As a physician, I see the difference that having access to insurance, as well as the connection to care that coverage brings.”

Consumers can go to HealthCare.gov to shop for coverage for 2019, compare plans and to enroll before midnight Saturday, Dec. 15. Individuals who need help enrolling can receive free in-person assistance from federally funded and trained specialists at several Delaware organizations, including Westside Family Healthcare, Henrietta Johnson Medical Center in Wilmington and La Red Health Center in Georgetown.

Westside Family Healthcare is hosting drop-in enrollment sessions through Saturday. The schedule:

Bear/New Castle Health Center, 404 Fox Hunt Drive, Bear (near the Bear Post Office)

  • Thursday, Dec. 13: 4-7 p.m.
  • Friday, Dec. 14: 4-7 p.m.
  • Saturday, Dec. 15: 9 a.m.-noon

Fourth Street Wilmington Health Center, 1802 W. Fourth St., Wilmington

  •  Saturday, Dec. 15: 9 a.m.-noon

To speed up the shopping and enrollment process, Delawareans are asked to bring these documents or information with them:

  • Birth dates of those applying for coverage.
  • Social Security numbers for those applying for coverage.
  • Pay stubs, W-2 forms or other information detailing your family’s income.
  • Policy or member numbers for any current health insurance plans.
  • Information about any health insurance that is available to you or your family through a job.
  • If you have previously enrolled on the Health Insurance Marketplace, bring your log-in and account information.

About 82 percent of those enrolled on Delaware’s marketplace for 2018 received tax credits to help pay their monthly premiums. For those eligible for financial assistance, the average premium after tax credits in 2018 was $122 per month. Financial help is available to individuals with an annual household income up to $48,560 and up to $100,400 for a family of four.

“Many people don’t realize that they may be eligible for tax credits to help pay their monthly premiums,” Secretary Walker said. “If you are uncertain about your eligibility based on your annual household income, it’s best to contact a local enrollment assister to help walk you through the process, and explore your options.”

For 2019, Highmark Blue Cross Blue Shield of Delaware is the only insurer on Delaware’s marketplace, offering a total of eight plans for individuals and families – one gold plan, three silver, two bronze, one catastrophic and one platinum. The metal categories are based on how enrollees choose to split the costs of care with their insurance company. Bronze plans have low monthly premiums, but higher out-of-pocket costs when you need care; gold plans have high premiums, but lower out-of-pocket costs when you need care.

Two insurers – Delta Dental of Delaware, Inc., and Dominion Dental Services, Inc. – offer a total of 11 stand-alone dental plans, five with a low actuarial level (70 percent) and six with a high actuarial level (85 percent).

In addition to the Health Insurance Marketplace, some Delawareans might be eligible for coverage through Delaware’s expanded Medicaid program, which is open year-round. More than 10,000 Delawareans have received coverage under the Medicaid expansion. To be screened for eligibility or to apply for Medicaid benefits, go to Delaware ASSIST.

After open enrollment ends Dec. 15, Delawareans can enroll in coverage only if they experience a life event that qualifies them for a special enrollment period. Among the many qualifying life events are birth or adoption of a child, a permanent move, loss of other coverage through your job, and marriage.


Dec. 15 Is the Last Day to Sign up for 2018 Coverage on Delaware’s Health Insurance Marketplace

EW CASTLE (Dec. 11, 2017) – Delawareans have just days left to sign up for or to change their health coverage for 2018 through the Health Insurance Marketplace. Open enrollment ends on Dec. 15, with coverage for those who enroll by that date and who pay their first premium beginning Jan. 1, 2018.

State residents can sign up for coverage at www.HealthCare.gov or by calling 1-800-318-2596 (TTY: 1-855-889-4325). Free, in-person assistance is available through several Delaware organizations. State-licensed insurance agents and brokers also can help individuals enroll or re-enroll and help employers update their coverage, at no extra charge. For contact information, go to www.ChooseHealthDE.com.

As of Dec. 2, 8,846 Delawareans had signed up for 2018 coverage through the Health Insurance Marketplace, an increase of 7.3 percent from a similar period last year. For 2017, more than 27,000 people enrolled for coverage, including 73 percent who re-enrolled and 27 percent who were new enrollees.

“We urge Delawareans who need health insurance coverage through the marketplace to have a sense of urgency in signing up,” Department of Health and Social Services (DHSS) Secretary Dr. Kara Odom Walker said. “This enrollment season, the final deadline of Dec. 15 is six weeks earlier than last year’s deadline. Now is the time to shop and enroll on HealthCare.gov or to talk with a marketplace enrollment assister or insurance agent or broker about your coverage options.”

Consumers can go to HealthCare.gov to shop for coverage for 2018, compare plans and to enroll before midnight Friday, Dec. 15. Individuals who need help enrolling can receive free in-person assistance from federally funded and trained specialists at several Delaware organizations, including Westside Family Healthcare, Chatman LLC, Henrietta Johnson Medical Center in Wilmington and La Red Health Center in Georgetown.

About 81 percent of those enrolled on Delaware’s Marketplace for 2017 received tax credits to help pay their monthly premiums. Financial help is available to individuals with an annual household income up to $47,520 and up to $97,200 for a family of four.

“Many people don’t realize that they may be eligible for tax credits to help pay their monthly premiums,” Secretary Walker said. “If you are uncertain about your eligibility based on your annual household income, it’s best to contact a local enrollment assister to help walk you through the process.”

Highmark Blue Cross Blue Shield of Delaware is the only insurer on Delaware’s Marketplace after Aetna announced earlier this year that it would not sell marketplace plans for 2018. That means enrollees who have coverage with Aetna for 2017 must choose one of seven Highmark medical plans that are available for purchase in 2018 or they will be automatically enrolled in a similar plan offered by Highmark. Highmark’s plans include one gold plan, three silver, two bronze and one catastrophic. The categories are based on how enrollees choose to split the costs of care with their insurance company. Bronze plans have low monthly premiums, but high costs when you need care; gold plans have high premiums, but lower costs when you need care.

Two insurers – Delta Dental of Delaware, Inc., and Dominion Dental Services, Inc. – offer a collective 12 stand-alone dental plans, six with a low actuarial level (70 percent) and six with a high actuarial level (85 percent).

In addition to the Health Insurance Marketplace, some residents might be eligible for coverage through Delaware’s expanded Medicaid program, which is open year-round. More than 10,000 Delawareans have received coverage under the Medicaid expansion. To be screened for eligibility or to apply for Medicaid benefits, go to Delaware ASSIST.

Under the Affordable Care Act, individuals who can afford health coverage, but who choose not to buy it are subject to paying a fee when they file their federal tax return for the year they don’t have coverage. For 2017, the fee will be equal to the higher of these amounts: 2.5 percent of annual household income or $695 per adult, plus $347.50 for each child under 18. The maximum amount is $2,085 per household. In addition to the fee, consumers will be responsible for the total cost of any health care expenses they incur. Without changes by Congress, the same tax penalties will be in effect for 2018 as well.

Consumers can estimate their penalty using the penalty calculator on ChooseHealthDE.com.
After open enrollment ends Dec. 15, Delawareans can enroll in coverage only if they experience a life event that qualifies them for a special enrollment period. Among the many qualifying life events are birth or adoption of a child, a permanent move, loss of other coverage through your job, and marriage.

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The Department of Health and Social Services is committed to improving the quality of life of Delaware’s citizens by promoting health and well-being, fostering self-sufficiency, and protecting vulnerable populations.