BCBSNC Submits Revised Rate-Hike Request in North Carolina

Date: September 06, 2017

Here’s something you don’t hear every day: Blue Cross and Blue Shield of North Carolina is reducing its premium rate increase for Affordable Care Act individual policies in 2018. However, since the increase amount is dropping from 22.9 percent to 14.1 percent, the reduced rate is unfortunately still a double-digit hike.

Although there is still much uncertainty surrounding the ACA—including the question of whether cost-sharing reduction (CSR) payments to insurers will be made—BCBSNC said the updated rate request is due to information received about the projected medical costs of those covered under ACA insurance plans. In May, BCBSNC noted that the uncertainty surrounding CSR payments was to blame for its initially higher premium rate request and that the request would be under 9 percent if these payments were assured.

Cigna, the only other insurer selling ACA policies in the state, has requested a 31.9 percent premium rate hike for 2018, which impacts about 21,000 people. Cigna’s reach is limited to five counties around Raleigh, while BCBSNC is the only insurer offering ACA policies in 95 of North Carolina’s 100 counties.

The North Carolina Department of Insurance can now approve, reject, or reduce the rate increase, it has 90 days to do so, reported the Winston-Salem Journal.

Meanwhile, however, BCBSNC also announced that will be dropping its grandfathered plans that have been an alternative to ACA plans due to dwindling enrollment and the fact that the customers who remain have gotten older and sicker. This has created a situation in which the costs have become disproportionate to the number of people enrolled, and the insurer would have to significantly raise rates to keep them going. The decision will affect about 50,000 people, who will need to transition to the ACA marketplace.

Related Content: News | Healthcare | North Carolina

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