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DC Health Benefit Exchange Authority Executive Board Disappointed That 2015 Health Insurance Rates Aren’t the Lowest Possible Rates for Consumers

Tuesday, September 16, 2014

The D.C. Department of Insurance, Securities and Banking (DISB) has approved 2015 premiums for health insurance sold to individuals, families, and small businesses through DC Health Link—the District’s online health insurance marketplace created following the passage of the Affordable Care Act (ACA).

Last week, the Executive Board received input from independent actuaries (Mercer/Oliver Wyman Consulting Actuaries) retained by the Board to analyze proposed rates filed by insurers.  Below is a summary of the recommended rate changes compared to rates approved by DISB.

2015 DC Health Link Rate changes

  Mercer Analysis DISB Final
Carrier Individual Small Group Individual Small Group
CareFirst Blue Choice 2.30% 8.20% 7.60% 12.70%
GHMSI 4.00% 6.50% 5.50% 10.50%
Aetna Health n/a -9.00% n/a -2.80%
Aetna Life -13.20% -24.30% -6.10% -17.20%
United Health n/a -14.20% n/a -13.00%
Optimum Choice n/a -14.30% n/a -13.00%
United Mid Atlantic* n/a -0.90% n/a -0.30%
Kaiser 2.20% 6.80% 2.20% 6.80%

Note: Mercer did not opine on policy considerations like contribution to surplus (profit)

* Reflects the reduction over the carrier’s filed rates

“We are disappointed that District residents and small businesses won’t be getting the lowest possible rates on health insurance in 2015,” said Diane C. Lewis, M.P.A., chair of the DC Health Benefit Exchange Authority Executive Board. 

“We are here to advocate for the lowest possible health insurance premiums through DC Health Link,” said Kevin Lucia, J.D., M.H.P., chair of the Executive Board’s Insurance Market Working Committee.  “That’s why we hired a widely-respected actuarial firm to analyze this year’s proposed rates and to provide DISB actuaries with an independent analysis.”

As the insurance regulator, DISB has the responsibility to review and approve insurance rates. However, the ACA empowers health insurance marketplaces to certify qualified health plans and requires an assessment of whether premium increases are justified. 

District law further affirms this specific responsibility of the DC Health Benefit Exchange Executive Board to work on behalf of District consumers and small businesses to ensure affordable health insurance premiums in the marketplace.

Given the rates approved by DISB, the Board will be looking at all tools available to ensure that in the future, District families and businesses have the lowest possible premiums through DC Health Link.  The Board will look at hosting public forums for input from our customers and stakeholders.  Once reports by the independent actuaries are finalized, they will be available on