N.C. department approves health insurance plan rates for exchanges

Jul. 30, 2013 @ 05:45 PM

The N.C. Department of Insurance announced Tuesday that it approved the rates for plans that three health insurers intend to sell through the federal health insurance exchanges in North Carolina.

However, the actual rates haven’t been publicly released.

That’s because the rate details were filed with the state’s insurance department as trade secrets, according to a department news release. Under state law, the department can’t release them without the insurer’s consent.

“That information will continue to be trade secret until released Oct. 1 on the exchange,” said Lew Borman, a spokesman for Blue Cross and Blue Shield of North Carolina, which is one of the three insurers that plan to sell insurance on the federal exchange in the state, in an email. “We don’t want to give our competitors who aren’t participating in the marketplace, or choosing only a few key counties, a heads up on our marketing and our plans.”

Gary Claxton, a vice president at The Henry J. Kaiser Family Foundation, the California-based health care policy foundation, said the rates have been made public in some states, and not in others. In some instances where they have been made public, he said that has led to companies re-filing to make rates more competitive.

“By making it a trade secret, you kind of lose that aspect for the potential for competition,” Claxton said. “You’re not getting that opportunity to have that happen.”

Along with Blue Cross and Blue Shield of North Carolina, the other insurers that plan to sell on the exchange in North Carolina are Coventry Health Care of the Carolinas and FirstCarolinaCare Insurance Co.

In addition to the rate information, Kerry Hall, a spokeswoman for the department, also said that areas served by insurers through the exchanges also are trade secrets.

Borman said in an email that Blue Cross and Blue Shield of North Carolina is the only insurer of the three that will offer plans on the exchange statewide.

FirstCarolinaCare Insurance Co., based in Pinehurst, is a subsidiary of the FirstHealth of the Carolinas health system that has offered employer-sponsored health insurance in the past, and is looking to make its entrance into the individual market.

The insurer wants to only sell insurance in its primary service areas of Moore, Hoke, Richmond, Montgomery, Scotland and Lee counties, said Emily Sloan, a spokeswoman for the health system.

Coventry Health Care of the Carolinas representatives could not be reached for comment.

All three insurers that filed to sell on the exchange have indicated intent to sell plans for individuals, according to the department’s release. Blue Cross and Blue Shield of North Carolina also intends to participate in the small group market.

The exchange is scheduled to open for enrollment on Oct. 1. At that time, people can go to the online exchange, entire their personal information and get a rate quote, Hall said.

Under the federal Affordable Care act, rates for non-grandfathered plans may vary only by family size, age, geographic area and tobacco use. She said they may not vary on factors such as gender or health status.

Products of other insurers operating in the state -- outside of the three that plan to sell on the exchange -- will also be available outside of the marketplace, according to the department’s release. However, the release said that the income-based federal subsidies to help eligible people with the cost of insurance will be available only through the exchange.

As the federal government will operate the state’s exchange, it will make the final decision as to which plans may be sold through them at the state level. The state’s approval announced Tuesday allows the insurers to continue the process to become certified by the federal government to participate in the exchange.

For information, go to the website www.healthcare.gov or call 1-800-318-2596.