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Active Shoppers Pay Less on Health Care Exchange, Report Says

Phalinn Ooi/Creative Commons

It helps to be an active shopper when it comes to health insurance.

That's the takeaway from a new Kaiser Family Foundation report that says people who auto-renew their health insurance coverage may be paying more than those who shop around.

The researchers analyzed data from the federal health insurance marketplace. The exchange was launched as part of the Affordable Care Act, and plans are organized by colors for their cost and comprehensiveness.

The report compares the price of the lowest-priced silver plan in 2015 with the cheapest silver plan in 2016. The researchers found that enrollees would save an average of about $322 over a year if they switch to the new lowest-costing plan.

While the Kaiser report focuses on the federal health care exchange, a Louisville-based insurance agent said the same trend can be seen in Kentucky's health insurance exchange, Kynect.

"As you renew in the health insurance business, health insurance rates are always increasing," said Billy Fowler, CEO of The Benefits Firm. "If you're not shopping your plan, you're more than likely not in the best plan for yourself, and that's been true even before health care reform came through."

Fowler said new carriers and plans become available each year, which may lead to cheaper options than the plans people are already enrolled in.

But Cynthia Cox, who researches economics and policy of the ACA for Kaiser, said some Kentuckians who may be looking for a more affordable silver plan may not be able to find it if they were insured by Kentucky Health Cooperative. The co-op offered the lowest-cost plans in the state in 2014, but it announced recently that it's closing and won't offer plans next year.

"In general, where the co-op had existed and had been one of the lowest-cost plans, you are seeing premiums going up in a lot of those places across the country," Cox said.

Carrie Banahan, executive director of Kynect, said there will be plenty of choices for 2016 open enrollment.

"They might find more affordable options through Kynect, and I would just recommend that they check out their options," she said.

Banahan said a new web tool has been added to the Kynect website that shows shoppers what their out-of-pocket expenses could be.

"This cost-calculator will help individuals pick the most affordable plan and the best choice to fit their needs," Banahan said.

Cox said it's important to consider factors outside the cost of the premium, such as the deductible.

"And if you have a particular doctor that you want to see, you want to make sure that that doctor is in your network if you switch plans," Cox said.

Fowler said people are usually searching for the "best plan at the best price." He said if someone automatically renews their coverage, they should expect to renew at an increase.

He said premium increases varies widely between the individual or small-group market — they could be as low as 5 to 10 percent or as high as 80 percent.

"The pricing has gone up so much on the individual market in just a couple of years, and the plans are watered down," Fowler said. "The deductibles are higher, the out-of-pocket max is higher. The plans are just not as good on the individual market."

WFPL previously reported on some of the plans offered on the state's health insurance exchange. Open enrollment for 2016 is ongoing.

For example, Baptist Health offers various silver plans, including one with a premium of $189.62 and a $4,500 deductible. A patient’s co-pay for a primary care visit would be $20, while seeing a specialist is double that.

United Healthcare has silver plans ranging in premium price from $249.83 to $270.31 — and deductibles of $2,000 to $4,500.

Aetna offers one silver plan. It’s $253.12 a month with a $3,900 deductible. Visits to a primary care doctor are $10 under that plan.

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