Not many understand about health insurance. When insurance companies give their prices and the Colorado Division of Insurance each year, data and information are not readily available to the average consumer. Only those with industry knowledge can identify this information and understand if the payment is fair and impartial.
This is one of the reasons why Peak Health Alliance started in Summit County in 2018. The organization is a non-profit insurance purchasing alliance that hires an actuarial company every year to help them go through the documents they want from insurance companies. With the help of this company, and using their team’s knowledge of the industry, a small staff of five people is able to lower prices in the eight areas where they are currently working.
Currently, Peak Health is trying to do the same while looking at what Bright Health, which has been selected by insurers for the past few years, has written with the insurance sector.
The initial pricing, which was released on July 12, has caught the attention of some community leaders. Some are warning them about what it could mean in the pockets of the community.
“I think it’s unfortunate for the people of Summit County,” said Tamara Pogue, Summit County executive and former CEO of Peak Health. “Summit County residents are in financial trouble because of inflation, because of the high cost of housing. Adding one more thing hurts me a lot.”
According to Bright Health’s rate filings filed with the insurance division, the company is asking for a 7.8% increase, meaning all plans will increase by that number. But on top of that, the company is offering a 34% increase for its inventory in Summit County and surrounding areas, according to filings.
The Commissioner of Insurance of Colorado, Michael Conway, explained that this “part of knowledge” is a number calculated by Bright Health that takes into account how expensive it is to insure certain people. To begin with, the minimum rate is an increase for everyone, but insurance companies can increase the cost of payment depending on whether people smoke or not, their age, where they live and the size of the family.
In addition to the rating area, companies will also use “benefits” that the company uses to show what it believes are their goals, said Vincent Plymell, a spokesman for the insurance sector. Plymell said Bright Health is seeking a 2.9% increase in Peak plans.
That means that in counties including Summit, Dolores, Grand, Lake, La Plata, Montezuma and San Juan, the individual wage increases are about 49% higher than what is currently proposed, according to Plymell’s calculations using data from Bright records. Health.
The CEO of Peak Health, Anne Ladd, said that her organization is well aware of the changes they want, and with the help of their third party company, and the insurance sector, they are investigating why Bright Health has proposed such a solution. He said he felt that Peak Health had tried to be a “good neighbor” and said that the rate should not be so high.
“The question is, what is the right number, and I can’t answer that until we know more,” Ladd said. What do we think is the right number? What is a good number? Again, we’re not trying to put Bright out of business. That’s the last thing we want. We want our partner in business. We are looking for local donors in the business. We also want local citizens to have access to affordable health care. ”
According to the documents provided by Bright Health, the average increase of 2023 in all the places it guarantees is 21%. Last year, on average, plans did not increase but decreased by 0.6%. The last time Bright Health reported that its plans will increase in 2018 in 2019, where the increase was, on average, 7%. When it raised its number in 2017 to 2018, it was jumping 31%, on average.
Conway said the insurance division is investigating and analyzing data from Bright Health’s filings this year, as it does with all insurance companies. By law, insurance companies must register their rates with the insurance division before they can sell their products to the general public.
Conway said the insurance sector has 60 days to review the information and make sure companies don’t raise their rates. The division works with companies to come to an agreement and ultimately, the division approves the rates before open enrollment begins in November.
Conway said that these divisions often come down to agreements with companies. The last time the team challenged that number was in 2010.
Currently, this section is collecting public comments on these articles until Aug. 1. At that point, Conway said that anyone can comment. These can be people who want to give feedback on how the change will affect them and service providers who have experience of what it’s like to work with a particular company. While that doesn’t mean the insurance division won’t be cost-effective, Conway said the news is helpful as the agency continues to engage with the insurance industry.
Ladd said Peak is also in the process of analyzing Bright’s information and why he disclosed his post. Peak Health has until Aug. 1 for comment, and Ladd said this is the organization’s top priority.
He also encouraged the community to give their comments.
“Participate in public comments, and understand that this is a request and (where) we reach may be low,” Ladd said. “The question is how low.”
To submit a comment, visit the division of insurance website at DOI.Colorado.gov.
Final plans and fees for 2023 will be released in mid-October, and open enrollment begins Nov. 1.