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Payers Scramble to Set 2015 HIX Premium Rates

Christopher Cheney, for HealthLeaders Media, April 1, 2014

The clock is ticking and insurers operating on the new public health insurance exchanges have just two months to gather data on 2014 enrollees to help guide decisions on business plans for 2015.

With Monday's grinding close of the 2014 open enrollment period, insurers offering individual health insurance policies on the exchanges are pivoting their attention to setting rates and benefit products for 2015.

The final day of enrollment was frustrating for consumers and payers alike as the Healthcare.gov website was offline for several hours because of an apparent software problem and high volumes of users.

But now that all applications have at least been started in the system, payers' attention turns to the next phase. In the Final 2015 Letter released by CMS on March 14, the qualified health plan application submission window is set between May 27 and June 27. Between now and the end of June, insurers will be pouring over enrollment and claims data, as well as assessing market factors present in exchanges state-by-state, to craft their insurance policy offerings for 2015.


As HIX Enrollment Closes, Analysis Begins


"Insurers are already moving to learn as much about their new customers as possible," Ceci Connolly, managing director of Pricewaterhouse Coopers' Health Research Institute, said Friday. "They want to know about any existing health issues, but also try to determine what problems might be looming on the horizon. In this particular demographic, multiple chronic conditions are possible and the major challenge will be managing those efficiently."

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