Exchange Prices in N.H. A Bit Higher
Granite State Benchmark Plan More Costly Than U.S. Average
Concord — When new health insurance markets launch next week, the sticker-price premiums for a mid-range benchmark plan in New Hampshire will average $360 a month for an individual, slightly higher than the national average, according to a federal report.
The Department of Health and Human Service released an overview of premiums and plan choices Wednesday showing the average individual premium for a benchmark policy known as the “second-lowest-cost silver plan” ranges from a low of $192 in Minnesota to a high of $516 in Wyoming.
The national average is $328, which reflects the sticker price before the application of tax credits that work like an upfront discount for most consumers.
Vermont is one of 16 states and the District of Columbia that opted to design its own exchange. A family of four with a household income of $50,000 would qualify for a $943 monthly subsidy, bringing the cost for the average “silver” level family plan in Vermont down to $229 per month, according to estimates on the state’s insurance exchange website, VermontHealthConnect.gov.
Wednesday’s report estimated that about 95 percent of consumers nationwide will have two or more insurers to choose from and will be able to choose from an average of 53 plan options.
In New Hampshire, just one company, Anthem Blue Cross and Blue Shield, will be offering health insurance plans through the new markets for the first year. Consumers will pick from 13 plans in four levels of coverage — five bronze plans, four silver, three gold and one catastrophic coverage plan.
All the plans cover the same benefits and include the same caps on annual out-of-pocket expenses, but differ in the amount of cost sharing through annual deductibles and copayments. Bronze plans — which have the lowest premiums and the highest cost sharing — cover 60 percent of expected costs, while platinum plans cover 90 percent.
The second-lowest-cost silver plan is important because tax credits are keyed to its cost in local areas. The administration report found that factoring in tax credits, a 27-year-old making $25,000 a year would see the premium for the benchmark silver plan drop to $145 in nearly every state, including New Hampshire. But if that hypothetical young adult used the tax credit to buy the cheapest bronze plan, he or she could cut the monthly premium to $94 in New Hampshire. In 2010, premiums in New Hampshire’s individual markets averaged $294 per month, according to the Kaiser Family Foundation.
For a family of four making $50,000, the monthly premium for the benchmark silver plan would be $859 in New Hampshire, compared to a national average of $774, but it would drop to $282 with the tax credit. If the family used its tax credit to buy the cheapest bronze plan, the premium would be $96 a month, $1 more than the national average.
Anthem has faced criticism for creating a smaller provider network for its individual plans. The network will include 74 percent of the state’s primary care providers, 85 percent of specialists and 16 of the state’s 26 acute-care hospitals. Hospitals in particular have complained about being left out, but Anthem officials have said including all hospitals would have made it impossible to keep premiums low. Network hospitals agreed to reimbursement rate concessions in exchange for the promise of a certain volume of patients, and without those concessions, premiums would have been 30 percent higher.
Only 16 of New Hampshire’s 26 hospitals were included in Anthem’s “Pathway Network,” the statewide web of providers covered in the 11 insurance plans offered on New Hampshire’s insurance marketplace. Valley Regional in Claremont, Alice Peck Day in Lebanon and Cottage Hospital in Woodsville were among the 10 left out of the network.