Blue Cross and Blue Shield of Illinois (BCBSIL) recently filed its 2016 rates with the state. BCBSIL’s rate filings reflect our intention to offer an array of competitively priced products and services to our existing and potential retail customers on and off Get Covered Illinois, the Official Health Insurance Marketplace.

The filings reflect general increases in the cost of health care and overall changes in the makeup of our membership. Premiums for next year will depend on the general rates, plus factors like the number of people an individual plan covers, their ages, and where they live.

Every year there are differences in health care costs, and we adjust our rates to balance that, while offering our members the best insurance options possible. This is the first year since the Marketplace opened in 2014 that we have a full year of health care claims history to base our rates on.

When the Marketplace opened, we began offering new products and gained many new members. Until now, we had to use other data to project what we thought rates should be for Marketplace coverage because it was too early to have complete data on the actual cost of providing care. As a result, we posted losses for 2014 in the individual retail market. The 2016 rate filings are an adjustment that will allow us to keep providing coverage options across the state for people who don’t have insurance through an employer. These prices are a reflection of our members’ underlying medical costs.

Our commitment has always been to offer coverage in all counties of the state. Our rate filing reflects our intent to continue offering plans on and off the Marketplace.

We are working diligently to keep care simplified and sustainable for the retail market. We want to offer our products and services in Illinois for years to come.

There are consumer protections in place to limit our ability to raise premiums just to increase profits. For example, medical loss ratio (MLR) requirements require at least 80 percent of premiums to go to medical costs each year. If that requirement isn’t met, BCBSIL may need to give certain customers premium rebates.

BCBSIL will send letters to our members about 2016 premiums in the fall. For transparency, we will soon be posting alert FAQs on our website at bcbsil.com.

Proposed 2016 Rates FAQs

Who does this affect?
The 2016 rates will affect individuals and families who bought health insurance either directly from us or Get Covered IllinoisSM, the Official Health Insurance Marketplace.

Will my premium increase?
It depends. It’s important to understand that rates are not the same as premiums. Rates, which affect premiums, are based on several things, like region, pharmaceutical costs, and use of insurance benefits. However, your 2016 premiums will depend on the general rates, plus the number of people on your plan, their ages, and where you live.

Are increased rates about BCBSIL making more profits?
Rates are determined based on our members’ health care claims in previous years. When the Marketplace opened in 2014, we began offering new plans and set rates based on new requirements and what we thought member claims would be. Now that we have a full year of member claims with the new plans, we have a better idea of our costs. These costs are also affected by region, pharmaceutical costs, and use of insurance benefits, among other things. We are adjusting our rates so that we can keep providing coverage options across the state for people who don’t have insurance through an employer.

There are consumer protections in place to limit our ability to raise premiums just to increase profits. For example, medical loss ratio (MLR) requirements require at least 80 percent of premiums to go to medical costs each year. If that requirement isn’t met, BCBSIL may need to give certain customers premium rebates.

When will I find out about my premium? How will I be notified?
If your 2016 premium does go up, we will send you a letter in the fall to notify yo