Covered California consumers in the San Joaquin Valley will see slight changes in cost for health insurance premiums in 2015 depending on the plan they choose and where they live – some up, some down.
Overall in California, premiums are increasing an average 4.2 percent, said Peter Lee, executive director of Covered California – the state’s health benefit exchange created for the Affordable Care Act.
California is split into 19 regions for health insurers. The San Joaquin Valley is split into Regions 10 and 11. Premiums vary by region.
In Region 10, which includes Merced, Tulare, Mariposa, Stanislaus and San Joaquin counties, consumers will see their premiums decrease an average 1.9 percent, according to officials. The lowest plan’s premium rate is 4 percent lower than in 2014 and the highest plan has a 7.3 percent increase.
About 1.4 million Californians enrolled in health plans through Covered California during the open enrollment for 2014, including 61,000 consumers from Region 10. In this region, 93 percent of consumers received premium assistance. Covered California officials estimate that about 85 percent of consumers in this area will experience a decrease in their rates.
For consumers in Fresno County, which is part of Covered California Region 11, the average premium in 2015 is up by 3 percent. But the premium rates range by the type of plan: The lowest plan has an 8.5 percent decrease in the premium rate and the highest plan has a 6.5 percent increase.
As part of Covered California, insurance companies are assigned regions. Consumers in Region 10 will continue to have four insurance companies offering plans: Anthem, Blue Shield, Health Net and Kaiser Permanente.
Region 11 – Fresno, Kings and Madera counties – will continue to be served by three insurance companies: Anthem, Blue Shield and Kaiser Permanente.
“Health care is regional, it’s local, and it’s personal. This means that the costs and options for each consumer in California are different,” Lee said. “The average rate going up only 4.2 percent means that for some it will go up more and for some less, but all consumers now have the ability to shop. Consumers are not locked into one plan; they can stay with their plan or change and can often find a lower-priced option.”
And subsidy amounts are not expected to change much.
Ninety percent of consumers enrolled in health insurance plans through Covered California receive federal subsidies to help reduce their overall costs. In most areas, the amount of subsidy that individuals receive will either increase or remain very close to 2014 subsidy amounts, which means that any increase in premiums may be offset by an increase in subsidies.
According to officials, the current list of insurers is for comprehensive individual health policies only. Covered California plans to announce adult and family dental options available through Covered California, along with health insurance options for small businesses, at a later date.
Consumers can get a preliminary estimate of costs and premium assistance by using the 2015 Shop and Compare Tool on the Covered California website at www.coveredca.com/shopandcompare/#calculator.
The second open enrollment period will run Nov. 15 through Feb. 15.