Geographic rating areas are used by insurance carriers to price premiums. In Colorado, for 2014, health insurance carriers used 11 geographic rating areas as set by the Division of Insurance (DOI). For 2015, DOI consolidated the higher health costs regions into larger rating areas, reducing the number of areas from 11 to nine.
For 2015, areas 10 and 11, which include the mountain areas, were combined and called area 9, or the West area. However the West area does not include Mesa County, which is area 5, the Grand Junction area. Areas eight and nine were combined and called area eight, or the East area (comprising eastern and southern parts of the state). Individual plans for the West area will see an average premium decrease of 7.44 percent. In the East rating area, individual premiums will average a 5.01 percent decrease. As is the case with the statewide numbers, these are averages. Consumers in these areas will need to look at the specific details for the plans available in their area. The geographic rating areas are only one variable in determining premiums, and the rates in East and West areas are the product of many things, not just the area.
For 2015, some carriers have worked with healthcare providers in the mountain areas to lower the rates they charge, leading to lower-priced plans in some counties in those areas. Two carriers in particular that did such work are Anthem and Colorado Health-Op. However, such plans will not be available throughout all counties in a region, as not all providers and hospitals were able to negotiate with carriers.
It’s important to note that just as carriers providing individual health insurance in Colorado do not have to offer it in all areas of the state, carriers offering individual coverage in a geographic rating area are not required to offer it to all counties in an area. Thus not everyone in a rating area will have access to all the plans offered in that area.