Health exchange premium up 5 percent in New Jersey
Premiums will jump by 5 percent in 2016 for a mid-level plan on the federal government's health insurance exchange in New Jersey, but that doesn't mean every customer will have to pay more.
The federal government unveiled plan details Monday.
Here's a look at the plans and what they mean.
There are four levels of plans on the exchange: bronze, silver, gold and platinum. Bronze plans have lower premiums, while gold and platinum have lower deductibles, copays and tighter caps on out-of-pocket expenses.
Before subsidies, the monthly premiums of plans available in New Jersey range from $270 to $680. A benchmark silver plan will be 5 percent more expensive in 2016, but some customers could have bigger hikes — or pay less next year.
This year, 254,000 New Jersey residents were covered under the exchange, which is a key part of President Barack Obama's 2010 health insurance overhaul.
THE NEW PLAN
Lawmakers in New Jersey have been scrutinizing new plans offered by Horizon Blue Cross-Blue Shield, the state's biggest health insurer. Its new Omnia plans group hospitals into two tiers. Plan members who use Tier 1 hospitals will have lower costs.
Officials at other hospitals and some lawmakers are concerned that steering patients to certain hospitals will hurt others, especially those in urban areas that use insurance payments to offset costs of providing low-cost care to patients without insurance or with Medicaid.
The Omnia plans are available on the private market to employers and also on the exchange, where details are now available publicly for the first time.
As expected, the premium cost is lower under the Omina plan than under other Horizon offerings. For instance, the monthly cost of a bronze Omnia plan for an individual would be $276; a similar traditional plan would be $381.
SUBSIDIES AND PENALTIES
Most people who buy plans on the exchange are eligible for subsidies in the form of tax credits. A single person with an income up to $47,080 would qualify for help, as would a family of four making less than $97,000.
People who do not have health coverage are subject to penalties, which rise each year. For 2016, an adult can be charged $695 for not having coverage; the charge for a child is half as much.
People can sign up for coverage on healthcare.gov from Nov. 1 through Jan. 31.