BlueCross BlueShield of Tennessee asks for 19 percent rate hike

photo Aerial photo of BlueCross BlueShield of Tennessee headquarters in Chattanooga.

BlueCross BlueShield of Tennessee - the state's dominant health insurance provider - is asking to raise rates by an average of 19 percent for its exchange plans in 2015, according to documents filed with the state of Tennessee.

Meanwhile, Cigna is requesting an average rate increase of 7.5 percent in 2015, while Kentucky-based Humana would like to boost marketplace rates by an average of 14.4 percent.

BlueCross has the majority of Marketplace members in Tennessee by far -- 88 percent. "We're in a very competitive business, so we don't want to charge any more than is absolutely necessary," said BCBST spokesman Roy Vaughn. The requested rate increases, he said, will allow the company to "break even" for its plans on the federal exchange.

"Based on our claims experience through the first half of this year, we're paying out more than we expected," he said. "In fact, we're in a loss position that will be in the tens of millions of dollars."

That loss is due, in part, to the fact that more patients who signed up for health care on the exchange were sicker than insurance companies had expected. They tended to use more health services than the company predicted they would, too. According to the Chattanooga-based BlueCross, the relative poor health of patients accounts for about half of the proposed rate increase -- increases in the cost of medical care account for much of the remaining increase.

As a result, BlueCross said, the consumer will experience a rate increase between 6.1 percent and 21.7 percent, depending on the product he or she has bought. It's difficult to nail down the exact change in product price because Marketplace plans include health care options of various levels, which are priced differently based on the customer's age. In addition, the requested premium increases for all insurance companies would affect the price of the products before any federal subsidy.

Marketplace plans are a different animal from other health care options, thanks to the guidelines put in place by the Affordable Care Act. That being said, individual plans have been getting more expensive each year. According to the Commonwealth Fund, premiums increased in price by about 10 percent per year from 2008 to 2010 -- before the ACA went into effect.

These increases are not happening in a vacuum.

According to Kaiser Health News, insurers in several states, including New York and Colorado, have requested rate increases for 2015 as well.

In Georgia, however, BlueCross BlueShield was the only plan offering exchanges statewide, but new insurance companies are now entering the Marketplace. In Georgia, BlueCross has requested an average decrease in premiums of 7 percent.

"Initial rate filings will be reviewed by the state and many states have successfully lowered rates as part of this review, including Maryland, which lowered some double digit proposed rates for 2014 by a third, so consumers should keep in mind final rates will likely be lower than initial filings," a Department of Health and Human Services representative said in a statement.

In 2014, Tennessee had some of the most affordable Marketplace plans in the country, according to HHS data.

"Even with the rate increase that we're proposing, we expect our 2015 rates to still be among the most affordable options for consumers on the Marketplace for Tennessee," Vaughn said.

The proposed rates are subject to government approval.

BlueCross expects to know whether it will get the suggested 19 percent rate increase by early September.

Reach Shelley DuBois at 615-259-8241 and on Twitter@shelleydubois.