Kansas: Medica receives 29% avg. rate hike if CSR payments aren't made (vs. ~17.2% if they are)

Mon, 10/09/2017 - 3:53pm

I was a bit confused by the initial rate hike request for individual market carriers in Kansas, but it seems I was overthinking it. There will be three carriers offering indy market plans this year: Medica, Blue Cross Blue Shield of Kansas and Ambetter (aka Centene, but operating under the name "Sunflower State" here, which is just annoying).

Ambetter ("Sunflower State") is new to the state, so there's no "rate hikes" to speak of. My confusion was regarding BCBSKS, which is already on the KS exchange but didn't appear to submit any actual "rate change" request last time I checked. Louise Norris has cleared up this mystery:

There are no platinum plans available in the Kansas exchange for 2018, but there will be a total of 11 plans available in Johnson and Wyandotte counties, and 12 plans available in the rest of the state. All plans offered in the exchange must also be offered off-exchange, and there are no insurers in Kansas that offer only off-exchange plans.

Insurers have filed the following rate and plan changes for 2018:

Medica: 29 percent, based on assumption that cost-sharing reduction (CSR) funding will not continue (the additional cost to cover CSR has been added to silver plans). Medica has 7,574 members in 2017. Plans will be available state-wide in 2018, which includes an expansion into Johnson and Wyandotte counties, where Medica doesn’t offer coverage in 2017. A total of seven plans will be available, but they will be EPOs in Johnson and Wyandotte counties, and PPOs throughout the rest of the state. Medica capped enrollment at 10,000 for 2017, but confirmed that the enrollment cap will not apply for 2018.

Blue Cross Blue Shield of Kansas: No applicable rate increase because BCBSKS is offered all new plans for 2018. The plans that were offered in 2017 were called Blue Cross Blue Shield of Kansas Solutions, and they were HMOs. For 2018, they’re being replaced with EPOs from Blue Cross Blue Shield of Kansas. Plans will be available in all counties except Johnson and Wyandotte; a total of five plans (all EPO) will be offered.

Sunflower State Health Plan/Ambetter from Sunflower Health (Centene): No applicable rate increase because Sunflower is new to the individual market in Kansas. Plans will be available in Johnson and Wyandotte counties; a total of four plans (all HMO) will be offered.

There you have it: Even though BCBSKS is an already offering exchange policies, technically speaking they aren't increasing their prices because they're being replaced with all new policies with different specs anyway.

As a result, the "official" unsubsidized rate hike for Kansas boils down to Medica alone, even though they only hold a small portion of Kansas' total individual market: