Oregon Sets Affordable Care Act Insurance Rates

By Kathleen Doheny
WebMD Health News

Reviewed by Lisa Zamosky

July 16, 2013 -- After 2 months of review, the state of Oregon has approved rates for health insurance sold through Cover Oregon, the state-operated Marketplace created under the Affordable Care Act.

Cover Oregon will have 11 carriers, says spokeswoman Lisa Morawski. Rates and coverage will go into effect Jan. 1, 2014.

Insurance premiums will vary by age, geography, family size, and tobacco use. Four levels of plans -- bronze, silver, gold, and platinum -- will be available.

Here are some examples of premiums:

  • A single, 21-year-old nonsmoker in Portland could choose a silver plan (which pays 70% of medical costs) that ranges from $168 to $257 a month.
  • A single, 40-year-old nonsmoker in Portland could choose a silver plan that costs from $215 to $329 a month.
  • A single, 21-year-old nonsmoker in the Bend area could choose a silver plan that costs from $173 to $265 a month.
  • A single, 40-year-old nonsmoker in the Bend area could choose a silver plan that costs from $221 to $339 a month.

By October, Cover Oregon will show side-by-side plan comparisons. Its carriers include two consumer operated and oriented plans (CO-OPs). CO-OPs are nonprofit health insurers that give you another choice if you're looking for health insurance you can afford.

About 217,000 people are expected to sign up through the Marketplace, Morawski said. That includes individuals and people under small-group plans, but not those on Medicaid.

Subsidies (or financial aid) will be available based on personal income. A family of four can make up to $94,200 a year and still qualify for some type of financial assistance. For instance, a family of four making less than $36,000 a year will pay a maximum of $118 a month; a family of four making $94,200 would pay a maximum of $746 a month.

Twelve insurance companies and two CO-OPs submitted rates for approval for either individual or small-employer markets, according to the Oregon Department of Consumer & Business Services.

Oregon's Insurance Division lowered some of the rate requests for individual plans by up to 30%.

SOURCES: Lisa Morawski, spokeswoman, Cover Oregon. Cheryl Martinis, spokesperson, Department of Consumer and Business Services. Cover Oregon web site. Oregon Insurance Division: "Health Insurance Rate Review."

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