BCBSNC Affordable Care Plan Rates

Blue Cross Blue Shield of NC released their premium rates for their various Affordable Care Act plans and while the numbers are very general, which makes it impossible to compare directly to your current plan if you have one, and there's also no way of knowing which subsidies you might qualify for until you can plug your income numbers into the formula. Those subsidies will be significant for some people:

Consumers can purchase the same BCBSNC ACA health plans, and access subsidies, from the Exchange or directly from BCBSNC. BCBSNC’s buy online tool facilitates the transaction for those who qualify for a federal subsidy (consumers purchasing their own coverage with income levels between 100 percent and 400 percent of Federal Poverty Level2). The subsidy impact will be significant for some. For example, a person earning 100 percent of FPL could pay $19.15 per month for a Silver plan.

And then there's this tidbit:

ACA health plans generally offer richer benefits than plans many BCBSNC customers choose today, according to the insurer. In addition to requiring richer benefits, the ACA eliminates the use of gender or health status in setting premiums.

At work we have BCBSNC's Blue Options coverage. It's age-banded so every five years the rates go up pretty significantly – for instance when I turned 45 I cost a lot more to insure than when I was 44 – but when I compare my individual rate with the chart of sample plans on the BCBSNC announcement page I see that my premium is more than a 40 year old's platinum plan, but my coverage (70% of cost) is about the same as the silver plan. This leads me to believe that, all things being equal, my individual coverage might be cheaper under ACA than with Blue Options. 

Another factor working against us at the office is that we have a very small group of three families so we have experienced some very steep increases over the last few years as we each breach those five-year age bands. We've been lucky in that our employer has covered our individual coverage premiums – family/dependent coverage is 100% out of pocket – but the only way to continue that each year has been by increasing co-pays and deductibles, and reducing the percentage of expenses covered from 80% to 70%. If the premiums continue to rise at the 10-30% annual rate we've been seeing the last few years then we're likely going to have to start paying a percentage of premiums out of pocket as well.  Combine those increased costs with access to potential subsidies and all of the sudden those ACA rates look more and more appealing, especially if our employer agrees to raises in lieu of health coverage. 

My prediction? Lots of small employers will decide to forego the headaches of administering a health plan and save some money in the process by prodding their folks to utilize the marketplace. That, of course, is exactly what the marketplace administrators want.

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