Well, we are almost two weeks into the health insurance renewal season for small group medical plans in Georgia. So far so good. Most of our group clients are faring well. We have had a couple clients with challenging renewals. So far, however, we have been able to find them alternative plans that make the best of their unique situation.
Why does a group get a large premium increase? Most of the time it is because of changes in demographic information (they have hired older workers and/or terminated younger workers. Under the Affordable Care Act, premiums are based largely on the age of the insured individuals – and the pooled claims of that insurer’s small group ACA block of business.
Another reason for a large medical rate increase is high claims experience in a self-funded (level-funded) medical plan. These plans are not subject to the community rating provisions of the ACA. Thus, they may be a bit more volitile when it comes to claims experience.
No matter the reason, years of experience allows us to help our group medical clients. It is our chosen line of work and we enjoy helping our wonderful clients.