Location:
INSURANCE - HEALTH; INSURANCE - HEALTH - MANAGED CARE;
Scope:
Connecticut laws/regulations;

OLR Research Report


August 2, 2011

 

2011-R-0296

UPDATED INFORMATION ON CHARTER OAK PREMIUMS

By: Robin K. Cohen, Principal Analyst

You asked for an update of OLR Report 2011-R-0242 to reflect the Department of Social Services (DSS)' recent announcement that it is raising the Charter Oak Health Plan (COHP) premiums on September 1, 2011.

In the above referenced OLR report, we created a table showing (1) how state premium assistance for individuals with incomes under 300% of the federal poverty level (those who had enrolled in the program before June 1, 2010) was reduced per PA 11-44 and (2) the new, higher subsidized and unsubsidized premium amount enrollees would have to pay beginning September 1, 2011. We based the second number on information we found on the Charter Oak website from June 2010 and June 24, 2011. In the report, we assumed (and DSS verified) that the full $307 premium amount would not be rising.

In early July, DSS announced at the Council on Medical Assistance Program Oversight's monthly meeting that it would be raising COHP premiums in September. Last week, the COHP notified program enrollees that starting September 1, 2011, the full premium amount will increase from $307 to $446 per month. This was not something that the legislature directed DSS to do. Rather, DSS made the decision based on “overall higher medical costs incurred by the program.”

While the existing enrollees who do not get state subsidies will have to pay the higher amount (as will new enrollees who do not qualify for the state's Pre-Existing Health Insurance Plan), enrollees who receive subsidies will also have to pay more, on top of the increased amount resulting from PA 11-44, which lowered the state subsidies.

Table 1 adds a column to Table 1 in OLR Report 2011-R-0242 to show how the increased full premium affects all COHP enrollees.

Table 1: Charter Oak Cost Sharing for a One-Person Household

Income Level

Current State Subsidy

Proposed Subsidy

Enrollee Premium Contribution (pre 9/1/11)

Enrollee Premium Contribution (9/1/11 and after)—Based on Full Premium Amount of $307

Enrollee Premium Contribution Based on Higher Full Premium Amount of $446

Annual Deductible

<150% of the FPL

$175

$115

$129

$189

$215

$150

150% -185% of the FPL

150

100

172

222

287

200

185%-235% of the FPL

75

50

202

227

332

400

235-300% of the FPL

50

35

239

254

369

750

>300% of the FPL

0

0

307

307

446

900

Source: OLR analysis using COHP website information from June 2010, June 2011, and July 2011; DSS

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