ACA premiums to increase by about 3 percent

DOVER — Individuals who have health insurance through the Delaware Health Insurance Marketplace will see their premiums increase by an average of 3 percent, the state announced Tuesday.

Approximately 20,000 people have coverage with Highmark Blue Cross Blue Shield of Delaware through the Marketplace, which was established by the federal Affordable Care Act, also known as Obamacare. The increase is far lower than last year’s hike of 25 percent.

Highmark had requested a 5.7 percent jump.

“Even though I’m pleased that the Department was able to approve a rate which is 47% less than the proposed rate, I recognize that this increase places an additional burden on thousands of families,” Insurance Commissioner Trinidad Navarro said in a statement.

“Because our regulatory work doesn’t end with a rate filing approval, I also wanted to mention that Highmark will be rebating a total of $5,050,952.00 to their small group market members as a result of their administrative fees exceeding the mandated MLR (Medical Loss Ratio) rules. The rebates will be paid out by September 30, 2018.”

The increase does not impact Delawareans on Medicare or Medicaid or those with coverage outside the Marketplace, such as through their employer.

About 20,000 Delawareans have coverage through the Marketplace, down from 27,000 in October, according to the Department of Insurance.

Under the ACA, most people are required to either have health insurance or pay a fine. However, that provision was repealed by Congress in December, although it won’t take effect until 2019.

Launched in 2013, the Marketplace initially boasted 19 plans offered by Coventry Health Care, Coventry Health and Life, and Highmark Blue Cross Blue Shield of Delaware. Coventry was later acquired by Aetna.

In 2017, Aetna exited the market, pointing to a loss of about $700 million for individual policies between 2014 and 2016. The company’s decision left Highmark as the only participant in the First State.

Highmark received rate hikes of at least 22.4 percent in 2015, 2016 and 2017.

The company’s requested increase for the upcoming year focuses on silver plans, which are what the federal government uses to determine subsidies given to low-income enrollees. “Silver-loading,” as the practice is known, can result in bronze and gold plans becoming much cheaper. President Donald Trump last year ended some subsidies, increasing the cost of certain plans.

Highmark currently offers eight plans in Delaware, with three new this year. The coverage options include bronze, silver, gold, platinum and catastrophic plans, with monthly prices increasing the older the individual is.

For the five individual plans continuing from last year, the change ranges from a decrease of 8 percent to an increase of 14.6 percent. Three of the five plans in question will see higher premiums, with the catastrophic and gold options witnessing a drop in price.

The monthly premiums for 2019 range from $233.25 in the catastrophic plan for Delawareans no older than 14 to $1,831.44 in the platinum plan for ages 64 and up.

According to the state, more than 80 percent of enrollees received financial assistance to pay for their care.

Bronze plans have low monthly premiums but high deductibles and are often utilized by those who simply want to ensure they are covered in the event of a major illness or injury. Silver plans have higher premiums but lower deductibles, while gold plans have costly premiums but require planholders to pay less for individual procedures and treatments.

Platinum plans have the highest premiums of the four standard options but the lowest deductibles and are typically best for individuals who use health care frequently.

The Marketplace’s catastrophic plan has the cheapest premiums but is only for people under 30 or those who have hardship or affordability exemptions. The deductible for all plans in this category was $7,150 in 2017.

According to the Kaiser Family Foundation, about 31 percent of Delawareans enrolled in the Marketplace had a bronze plan, while 62 percent had a silver one.

For more information on the Marketplace, visit


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