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Health Insurers Propose “Affordable Care Act” (ACA) Premium Rates for 2020

Public Invited to Submit Comments

BALTIMORE – Health insurance carriers are seeking a range of changes to the premium rates they will charge consumers for plans sold in Maryland’s “Individual Non-Medigap” (INM) and “Small Group (50 or fewer contracts)” (SG) markets  in 2020. The rates submitted by the carriers for the INM market include the estimated impacts from the state-based reinsurance program (SBRP) enacted in 2019 via a 1332 State Innovation Waiver (approved by the Centers for Medicare & Medicaid or “CMS”).
The Maryland Insurance Administration (“MIA”) has posted rate filing documents at www.healthrates.mdinsurance.state.md.us. On that website, consumers can review filings and submit comments, as well as find answers to frequently asked questions about the rate review process. A detailed set of exhibits are attached that outline all proposed rates submitted by carriers, to include stand-alone dental coverage.
“We are pleased with the rates that have been requested. It is obvious that the federal waiver and reinsurance plan crafted by Governor Hogan and the legislature have provided the positive results as intended,” said Insurance Commissioner Al Redmer, Jr. ”It’s important to remember that these rates are what companies have requested, and not necessarily what will be approved. There will be a thorough review of all the filings. As in years past, we may require changes.”
Click HERE for Exhibits.
Click HERE for FAQs.
In Maryland, for health benefit plans, only those rates approved by the Insurance Commissioner may be charged to policyholders. Before approval, all filings undergo a comprehensive analysis of the carriers’ analyses and assumptions. Public comments are considered as part of the review process. By law, the Commissioner must disapprove or modify any proposed premium rates that appear to be inadequate or excessive in relationship to the benefits offered, or are unfairly discriminatory. The MIA expects to issue decisions about rates for 2020 INM and SG products no later than mid-September. A public meeting will be held on July 16, 2019 from 2 p.m. – 4 p.m. at the Maryland Insurance Administration to seek comments on the proposed rate filings; a notice will be forthcoming.

For the INM market, carriers filed an average annual rate decrease of 2.9% affecting 202,400 members. Despite the average rate decrease, preliminary estimates indicate that subsidies could still increase. Carriers proposed the following average rate changes in the (INM) market:
  • CareFirst BlueChoice Inc. HMO – a -8.9% decrease;
  • CareFirst of Maryland Inc. and Group Hospitalization and Medical Services Inc. (GHMSI) (both CareFirst companies) PPO – a +9.1% increase;
  • Kaiser Foundation Health Plan of the Mid-Atlantic States HMO – a +3.9% increase.

Exhibits 1 and 1A provide further detail and context.

For comparison purposes, below are the proposed monthly premium rates, before any subsidies, for a 40-year-old, non-smoker in the Baltimore metropolitan area who buys the lowest-cost Silver plan, Off-Exchange.


​CARRIER ​CareFirst BlueChoice ​CareFirst of MD and GHMSI ​Kaiser
​Monthly Proposed Premium ​$364 ​$693 ​$366
Type of Network​ ​HMO ​PPO ​HMO
​lndividual Deductible​ ​$2250 ​$3000



For the SG market, carriers filed an average annual rate increase for the full year of +4.3% affecting 267,827 members. Rates can change on a quarterly basis and some employers contribute towards their employees’ premiums. The proposed average rate changes below are for plans that begin in the first quarter of 2020.
  • Aetna Health Insurance Inc. HMO – a +15.5% increase;
  • Aetna Life Insurance Inc. PPO – a +14.5% increase;
  • CareFirst BlueChoice Inc. HMO – a +0.6% increase;
  • CareFirst of Maryland Inc. and GHMSI PPO – a +8.4% increase;
  • Kaiser Foundation Health Plan of the Mid-Atlantic States Inc. HMO – a +10.0% increase;
  • MAMSI Life and Health Insurance Co. (a UnitedHealthCare company) EPO – a +12.4% increase;
  • United Healthcare Insurance Co. PPO – a +10.9% increase;
  • UnitedHealthcare of the Mid-Atlantic  HMO – a +6.9% increase; and
  • Optimum Choice (a UnitedHealthCare company) HMO – a +12.3% increase.

Exhibits 2 and 2A provide further detail and context.

For comparison purposes, below are the proposed monthly premium rates for 1Q20, before any employer contributions, for a 40-year-old, non-smoker in the Baltimore metropolitan area who buys the lowest-cost Silver plan, On or Off-Exchange.
​Carrier ​Aetna Health ​Aetna Life ​CareFirst BlueChoice ​CareFirst of MD and GHMSI ​Kaiser ​UHC MAMSI ​United HealthCare ​UHC Mid-Atlantic ​UHC Optimum Choice
​Monthly Proposed Premium ​$493 ​$525 ​$328 ​$437 ​$281 ​$327 ​$345 ​$281 ​$296
Type ​of Network​ ​HMO ​PPO ​HMO ​PPO ​HMO ​EPO ​PPO ​HMO ​HMO
In​dividual Deductible​ ​$6000 ​$6000 ​$3000 ​$2000 ​$4000 ​$5000 ​$5000 ​$5000 ​$4500
Rates being reviewed by the MIA do not affect health insurance plans offered by large employers or employees who self-insure, “grandfathered” plans purchased before March 2010, or federal plans such as Medicare, Tricare and federal employee plans.
About the Maryland Insurance Administration
The Maryland Insurance Administration (MIA) is an independent State agency charged with regulating Maryland’s $28.5 billion insurance industry. For more information about the MIA, please visit www.insurance.maryland.gov or follow us on Facebook at www.facebook.com/MDInsuranceAdmin or Twitter at @MD_Insurance or LinkedIn at https://www.linkedin.com/company/432297/admin/ or Instagram at @marylandinsuranceadmin.
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