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Important Changes if You've Got Teens on your Health Insurance
Tuesday, November 14 2017

If you've got teenagers covered on either your individual or small group medical insurance plan, be prepared to pay higher rates for them because insurance companies must comply with new Member-Level Rating (MLR) requirements starting in 2018. This change is to help lessen future increases when a member turns age 21.  

Q: What is Member-Level Rating (MLR)? 
A:  Each member gets an assigned rate and these are then added together to determine the premiums charged to the subscriber and any dependents. 

Q:  What are the new regulations about age and rates? 
A:  The Final Rule directs all health plan issuers of small group and individual plan coverage (on and off the  Exchanges) to revise the member level rating age bands used for individuals 0–20 years of age from using 1 age band to now create 7 age bands. The first age band cover ages 0–14, then single year age bands cover 15, 16, 17, 18, 19, and 20. This change will align with utilization of  services while smoothing rate increases over time. 

Q: How does this impact rates? 
A:  Every year members get 1 year older and in most cases move to a new age band. The introduction of the new age bands changes how rates are calculated for members under 21. By 2019, having more age bands will allow a more gradual  increase as experienced today when turning age 21.  2018 is a transition year where all members age 0 to 20 will experience significant increases. 

Want to learn more about this change and how it will impact you? Call PNW Insurance Solutions at (425) 314-0988 and ask to speak with Wendee Allen

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