NY individual rates set to fall 50% due to exchanges; plans also available to small businesses

  1. You have chosen to ignore posts from skeeter20. Show skeeter20's posts

    Re: NY individual rates set to fall 50% due to exchanges; plans also available to small businesses

    In response to FortySixAndTwo's comment:

    In response to skeeter20's comment:
    [QUOTE]

     

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    Do underwriters set rates?

    Yes. For employer groups the underwriter looks at age/sex factors, business factor, and for groups big enough, claims experience. 

    Or do they simply qualify people for plans and rates set by business?

     

     

     

     

     

     

     

     


     

     

     

     

     

     

     

     

     

     

     

     

     



    But, they don't really set the rates.  They chose off of actuarial tables for certain conditions, right? 

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

    Depends. For small group, rates can be pulled off a table, for the most part.

    For large groups the underwriter sets the rates based on blending manual factor with claims experience.

     

     

     

     

     



    Right.  But the point is, the underwriters don't set the rates, actuarials do.  Underwriters use pricing provided to them, and apply it to the case.

     

     

     

     

     

     

     



    Not sure how many times I can say this. Large group undrwriters set the rates NOT the actuaries. 

     

     

     

    For small group, technically yes, the rates are solely manual therefore based on actuary tables.

    So again, small group, actuary. Large group, underwriter.

    We good?

     

     

     

     

    We might be talking past each other.


    So, you have someone with a heart condition.  You sit down and come up with a number based on what?  Filed rates, or you just pull a number out of thin air?  Charge them $10, or charge them a million, based on what?

    I have no doubt that underwriters are determining the medical risk involved and pricing, but the rates are set elsewhere. 

    (Pricing and Rates are the same thing)

     



    Large group underwriting does not look at each individuals health situation. They look at the group as a whole. They look at the overall age/sex of the group AND the past claims experience to determine future claims cost. Large group underwriting does not charge each individual separately like in your example you gave above. They come up with a final ARM and then from there come up with the Single rate and Family rate.

     

    So for the last fcuking time. UNDERWRITERS set the rates for large employer groups. I am the one who was the underwriter....why the fcuk are you trying to tell ME who sets the fcuking rates? Do I tell you how your job works?

    Small group rates are the rates pretty much set from actuarial tables. 

     

    "I have no doubt that underwriters are determining the medical risk involved and pricing, but the rates are set elsewhere. "

    Pricing and Rates are the same thing

     



    I see the problem.  We are talking past each other.

     

    I understand that you use demographics and various rates to derive a "rate" or a premium for a person within a group.  You don't set the underlying rate.  in other words, you don't determine the cost or impact of, say, heart ailments on the rate.  you apply the rate to your demographic.

    To make the point even clearer, you don't go out and do primary research on the cost of heart ailments, derive a rate, and apply that to your demographic upon which you are setting rates.

    I understand that you look at a lot of these areas, health status rating, demographic ratings, expereince rating, and so on, to derive the perium.

    But, going all the way back to your earlier point that started all this discussion:  I don't see how your underwriting work gives you insight to the lack of coverage for pre-ex and lifetime caps.  Those sound more like underlying rate issues, not underwriting issues. 

    Maybe I am wrong.

    [/QUOTE]

    Pre-x and lifetime max is an underwriting issue.

    For example, the rates are derived based on X benefits. Those X benefits including lifetime max. So for X benefits the rate is $100 (Use $100 for ease)

    Now take X benefits and eliminate Lifetime max. As a result X beneifts is now a much richer plan because the limit has been lifted. So now there is potential for more claims costs. So now X benefits rate becomes $200 (or whatever, I don't know the actual mark up but it's more than $100) 

    So the underwriter need to adjust the rates for the richer benefits.

    For pre-x, plans will now be including individuals who have a known potential high claims cost. This needs to be factors into the rates in order for the rates to be high enough to cover costs.

     

     

    [/QUOTE]


    OK. Thanks for the explanation.

     
  2. You have chosen to ignore posts from skeeter20. Show skeeter20's posts

    Re: NY individual rates set to fall 50% due to exchanges; plans also available to small businesses

    In response to GregStillinMeffa's comment:

    FForbes debunked this the next day and the Times went mum.

     

    In the vast majority of states, Obamacare has the net effect of raising premiums by a lot, which has given rise to the term “rate shock.” In California, for example, a healthy 40-year-old today can pay $94 per month in the individual market; that rises to $234 a month under Obamacare: an increase of 149 percent.

    Obamacare even drives up costs in heavily regulated states. In 1993, Washington instituted progressive reforms similar to those of New York, though Washington’s were somewhat less punitive. This led me to expect that Washington, along with New York and a handful of other states, could see individual-market rate decreases under Obamacare. Much to my surprise, it turns out that even in Washington state, Obamacare will drive premiums upward by 34 to 80 percent. The average of the five lowest premiums for a 40-year-old in Washington today is $162; Obamacare will drive that up to $243.

    ghttp://b-i.forbesimg.com/theapothecary/files/2013/07/community-rating.png



    Wall Street Journal covered this as well this morning. 

    So, in other words, Obamacare, in the case of New York, actually undoes some tighter regulation.  So, in this narrow sense, Obamacare helps. 

    But, the whole proposition is like on Sons of Anarchy, when they find an ex-member who hasn't blacked out his tatoo.  the choice they give him is that they will burn it off, or cut it off.  Two bad options of which one is slightly better than the other. 

    The remaining option, which Soa (and liberals and progressives by extension) never want to consider, is leave the #$%^ tattoo alone. 

    the facts show that people will be better off if the federal government, and liberal state government take a different approach, that is, get out of the way of health insurers as much as possible.  Don't compare two bad progressive acts on healht insurance, one slightly worse than the other, and claim to be helping people, becasue you are not. 

     
  3. You have chosen to ignore posts from GregStillinMeffa. Show GregStillinMeffa's posts

    Re: NY individual rates set to fall 50% due to exchanges; plans also available to small businesses

    Rule changes stemming from the national health care law are likely to drive up average insurance premiums for small businesses and individuals next year, according to a study funded by the insurance industry.

    The analysis, by Wakely Consulting Group, projects President Obama’s health care law — supported by the Patrick administration — will tack an average of 3.7 percent on to premiums.

    That would be on top of typical base rate increases, driven by hospital and doctor’ fees and demand for medical care, which have ranged from 2 to 4 percent in recent years.

    Combined, the cost of insurance would almost certainly exceed the state’s benchmark for increases. The goal of a cost-containment law enacted last year was to cap overall increases at 3.6 percent — the rate of economic growth projected in 2014. The limit applies to out-of-pocket expenses and costs for larger businesses and government-insured residents, in addition to small employers and individuals.

    El Globo - July 17

     
  4. You have chosen to ignore posts from slomag. Show slomag's posts

    Re: NY individual rates set to fall 50% due to exchanges; plans also available to small businesses

    In response to GregStillinMeffa's comment:

    FForbes debunked this the next day and the Times went mum.

     

    In the vast majority of states, Obamacare has the net effect of raising premiums by a lot, which has given rise to the term “rate shock.” In California, for example, a healthy 40-year-old today can pay $94 per month in the individual market; that rises to $234 a month under Obamacare: an increase of 149 percent.

    Obamacare even drives up costs in heavily regulated states. In 1993, Washington instituted progressive reforms similar to those of New York, though Washington’s were somewhat less punitive. This led me to expect that Washington, along with New York and a handful of other states, could see individual-market rate decreases under Obamacare. Much to my surprise, it turns out that even in Washington state, Obamacare will drive premiums upward by 34 to 80 percent. The average of the five lowest premiums for a 40-year-old in Washington today is $162; Obamacare will drive that up to $243.

    ghttp://b-i.forbesimg.com/theapothecary/files/2013/07/community-rating.png



    This is where behavioral changes come into play.  A healthy 40-year-old paying $94/month for health insurance has financial trouble.  Nobody seeks out the cr8ppy coverage that $94/month that gives you - it's all they can afford.  So when that 40-year-old becomes not so healthy, he is less likely to go to a doctor, or god forbid an emergency room, because that $94/month insurance doesn't doa thing until he spends $5K - $10K out of pocket.  And of course, when it comes to medical issues, you never hear "thank god we didn't catch it early".

    So yes, some people will pay more in insurance premiums, but the hope is that these people will no longer have to run the numbers in their head before calling an ambulance or seeing a doctor, and that in turn will make the number of emergencies per capita decrease.  And that in turn will drive down costs, which in time will reduce premiums further.

     

     
  5. You have chosen to ignore posts from skeeter20. Show skeeter20's posts

    Re: NY individual rates set to fall 50% due to exchanges; plans also available to small businesses

    In response to WhatDoYouWantNow's comment:

    In response to skeeter20's comment:
    [QUOTE]So, in other words, Obamacare, in the case of New York, actually undoes some tighter regulation.  So, in this narrow sense, Obamacare helps.



    of course, to a simpleton, it doesn't matter what the regulation is.

     

     

     

    In response to skeeter20's comment:
    [QUOTE]the facts show that people will be better off if the federal government, and liberal state government take a different approach, that is, get out of the way of health insurers as much as possible. [/QUOTE]

     

    Blah blah blah, crap crap crap

    [/QUOTE]

    I guess when you are faced with the obvious, a few insults is all oyu can muster in response.

    I take it you are a bit surprized that the truth hit so close to your original post that it was a conspiracy, as it was a conspiriacy to hide the true reason for the numbers.

     
  6. You have chosen to ignore posts from skeeter20. Show skeeter20's posts

    Re: NY individual rates set to fall 50% due to exchanges; plans also available to small businesses

    In response to WhatDoYouWantNow's comment:

    In response to skeeter20's comment:
    [QUOTE]

     

    to answer the question, as it relates to New York, Obamacare does not change cost parameters

     

     


    Obamacare doesn't do anything about health care costs so stop pretending anyone claimed it did. What, do you want government to set communist price controls for health care costs?

     

     

    In response to skeeter20's comment:
    [QUOTE]

     

     preexisting conditions as it was already covered in NY.

     

    [/QUOTE]

     


    Yeah it kind of said that in the article so I don't know what kind of point you were attempting to make.

    NY required them to take people with pre-X. But there was no mandate, so there was nothing to absorb the cost of that.

    Now there's mandate + group bargain exchanges.

    Duh.

    [/QUOTE]


    The point was that Obamacare had little to do with it.  The truth is that NY went more progressive than even Obamacare, and people were paying the price.  So, in this case, and maybe in two or three other states, the rates will appear to go down, because progressives had already rammed through their stupid, insipid ideas on healht insurance, and have already done significant dameage to people, particularly in the middle class.

    That Obamacare takes these rates from absurd to merely outrageous is hardly a point I woudl hang my hat on if I were you.

     
  7. You have chosen to ignore posts from slomag. Show slomag's posts

    Re: NY individual rates set to fall 50% due to exchanges; plans also available to small businesses

    In response to skeeter20's comment:

    In response to WhatDoYouWantNow's comment:

    [QUOTE]

     

    In response to skeeter20's comment:

    [QUOTE]

     

     

    to answer the question, as it relates to New York, Obamacare does not change cost parameters

     

     

     

     


    Obamacare doesn't do anything about health care costs so stop pretending anyone claimed it did. What, do you want government to set communist price controls for health care costs?

     

     

    In response to skeeter20's comment:

    [QUOTE]

     

     

     preexisting conditions as it was already covered in NY.

     

     

    [/QUOTE]

     

     


    Yeah it kind of said that in the article so I don't know what kind of point you were attempting to make.

    NY required them to take people with pre-X. But there was no mandate, so there was nothing to absorb the cost of that.

    Now there's mandate + group bargain exchanges.

    Duh.

     

    [/QUOTE]


    The point was that Obamacare had little to do with it.  The truth is that NY went more progressive than even Obamacare, and people were paying the price.  So, in this case, and maybe in two or three other states, the rates will appear to go down, because progressives had already rammed through their stupid, insipid ideas on healht insurance, and have already done significant dameage to people, particularly in the middle class.

     

    That Obamacare takes these rates from absurd to merely outrageous is hardly a point I woudl hang my hat on if I were you.

    [/QUOTE]

    What makes NY more progressive than Obamacare?  The lack of a mandate?  Does that make the mandate a conservative component of Obamacare?

     

     

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