Health insurance premiums could go up by 33.4 percent next year for about 200,000 South Carolinians insured through the Affordable Care Act’s individual marketplace.
BlueCross BlueShield, which offers the only individual plan sold on the S.C. marketplace, has proposed the increase to the federal Health and Human Services Department.
According to the proposal, premiums last year did not cover claims paid, administrative costs, commissions, taxes and fees. The rate increase would reduce future losses, the company said.
Rebates would be paid to members of the BlueEssentials individual health plan if claims are “significantly less than anticipated.”
But the state’s insurance giant said it anticipates paying more, citing higher charges from doctors, more people seeking treatment and more expensive drugs. The company also said it could lose federal money used to pay large claims.
Federal subsidies would offset the premium increases for lower-income individuals if those subsidies continue to exist.
The S.C. Department of Insurance is reviewing BlueCross BlueShield’s proposal.
“Our responsibility ... is to make sure that the rate that is approved is the correct rate for both the consumer and the company,” said Insurance director Ray Farmer. “The law requires rates to be reasonable in relation to the benefits so that’s the criteria that we use.”
The state agency will decide whether to approve the rate-hike request by late September, Farmer said.