1. Health

Premiums for Obamacare to rise 9.5 percent overall in Florida

Published Aug. 27, 2015

Floridians who purchase individual health insurance plans under Obamacare will see their premiums rise by an average of 9.5 percent next year, the state Office of Insurance Regulation said Wednesday.

That's about $36 per month or $432 per year.

The average rate change varies widely by insurance company.

Four insurers offering plans on Florida's federally run Affordable Care Act insurance exchange will have average increases in the double digits: Aetna (13.9 percent), Humana (16.3 percent), Preferred Medical Plan (14 percent) and UnitedHealthcare (16.4 percent).

But some consumers will end up paying less for health insurance than they did in 2015. Celtic Insurance Co., Health Options, Florida Health Care Plan, and Molina Health Care are set to decrease their rates.

In many cases, the final rates are lower than what the insurance companies originally sought. For the first time since the ACA exchange opened in 2013, state insurance regulators had the ability to challenge proposed rate changes.

The state reviewed each proposal to "determine whether the proposed rate (was) reasonable in relation to the benefits offered by the plan," agency spokeswoman Amy Bogner said.

The insurance giant Aetna, for example, had originally proposed a 20.9 percent increase for its plans on the ACA exchange. State regulators cut that by one-third.

That didn't upset Aetna officials.

"Our rates fall well within the range of premiums being charged by our competitors," the company said in a statement. "We're confident our plans will deliver value for individual consumers purchasing coverage in Florida."

Humana was approved for a 16.3 percent rate hike — almost 10 percentage points higher than the increase company leaders sought in May.

Humana spokesman Mitch Lubitz said the change "reflected new information received from the Centers for Medicare and Medicaid Services regarding risk adjustment and reinsurance payments."

He added: "It is routine for the department and health plans to discuss and modify Marketplace rates between initial submission and their final approval," he said.

The overall upward trend didn't surprise observers.

Insurance companies had predicted they would need to increase rates to offset the high cost of new speciality drugs. The companies also said they determined 2014 and 2015 premiums by estimating how many enrollees would seek medical services — and the estimates turned out to be low.

"This is the first year that insurers have some data to work with," said Cynthia Cox, who studies the Affordable Care Act and its effect on insurance companies for the nonprofit Kaiser Family Foundation.

Still, insurers were generally satisfied with their offerings.

Florida Blue's west region market president David Pizzo pointed out that Florida Blue's average 8.9 percent rate increase was below the statewide average. The average rate increase for customers in the Tampa Bay Area, he said, would be even lower at 5.1 percent.

"We've taken a lot of steps over the last few years to be sure that we are reducing our administrative costs wherever we can," he said, adding that growing membership has also allowed the state's largest health insurer to keep premiums relatively low.

U.S. Department of Health and Human Services officials were "pleased that Florida was able to review rates and to significantly reduce proposed rates for more than half of the issuers in the state," spokesman Ben Wakana said.

"Florida's proposed rates for the 2016 plan year demonstrate that the Affordable Care Act is working to spur competition and transparency in the marketplaces, keeping premium increases to single digits and leading to affordable new choices for consumers," he added.

Open enrollment begins Nov. 1.

Contact Kathleen McGrory at or (727) 893-8330. Follow @kmcgrory.