January 1, 2014 marks the start of the changes that will impact health insurance for individuals and families who access their coverage either through individual contracts or through fully insured coverage provided by employers of 50 or less employees. Following are the changes which will have the greatest immediate impact :
- There will be no more medical underwriting or pre-existing conditions. Applications will no longer ask for medical history, although there will be questions about tobacco use.
- Rates will be unisex.
- Rate variance will be limited to 3 to 1 from the current 10 to 1. Currently rates for 64 year olds can be 10 times greater than those for 19 year olds. Starting January 1 these rates cannot be more than 3 times greater than the rates for 19 year olds.
- Companies will no longer have their premiums increased as a result of their industry.
How does this translate for the average consumer? There are some who will benefit while others will not.
- Those who have been unable to access health insurance coverage, have paid higher premiums due to health issues, have had coverage limited for specific medical conditions or had specific medical conditions excluded will find their premiums and benefits in line with other consumers.
- Gender neutral rates will see a reduction in rates for women in relation to rates for men, while male rates will see a relative increase.
- Those insured at the top of the age spectrum should see some reduction in rates while those closest to age 19 will likely see the largest increase in rates.
- Industries normally charged an extra surcharge should see some premium improvement which will be made up by those who had preferred rates in the past.