Hawaii Medical Service Association is notifying some members currently enrolled in older health plans that they will be moved to coverage compliant with the federal
Affordable Care Act as
of Jan. 1.
About 3,000 individual plan members will begin receiving letters today,
the state’s largest health insurer told the Honolulu Star-Advertiser.
Roughly 718,000 HMSA members who are covered through employers or Medicare and Medicaid — the government health
insurance programs for seniors and low-income residents — will not be
affected. Neither will the 17,000 people already
enrolled in ACA plans.
“Unlike the older plans that these members are currently enrolled in, ACA-compliant plans
include all of the essential health benefits mandated by the law such as prescription drugs, emergency care and hospitalization,” HMSA said.
Some members could see an increase in price depending on the benefit plan, however, they may also qualify for subsidies, HMSA said.
“We knew that we would make this change eventually but we wanted to give our members time to get used to the idea and give these new plans the time they needed to become stable,” said David Herndon, HMSA chief business operations officer. “Our first priority is to make sure that our members are well aware of changes that will affect them.”
Since the ACA, also known as Obamacare, took effect in 2015 rates among those plans have skyrocketed nationwide. Health insurance premiums jumped this year by an average 19.8 percent for HMSA and 24.1 percent for Kaiser Permanente’s Affordable Care Act health plans covering about 34,000 individuals. The
insurers cited higher use of medical services by some of the newly insured population and the uncertainty surrounding the ACA, including the federal government’s discontinuation of payments to insurers for cost-sharing reduction subsidies.
The state Insurance
Division, which regulates health plan rates, earlier this month announced that HMSA’s final approved 2019 average rate change for Obamacare plans would decrease
0.37 percent. HMSA had proposed an increase of 2.72 percent. The state’s
final approved average rate change for Kaiser was an increase of 12.9 percent, significantly lower than the 28.6 percent rate hike initially proposed.
Kaiser said it had previously moved individual plan members to ACA plans.
The federal law requires most Americans get health insurance or face tax penalties. However, a new tax law repeals the penalty
for people who don’t have health insurance as of 2019.
Open enrollment for ACA plans runs from
Nov. 1 through Dec. 15.
For more information or to apply for financial aid, go to hmsa.com or call 948-5555. Members may also visit an HMSA office.