Region’s insurers question report that Florida health policy costs $178 monthly

• By LIZ FREEMAN
• Naples Daily News
• Posted August 21, 2011 at 5:30 p.m.

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By the numbers

Monthly per person

Florida: $178

Georgia: $220

Massachusetts: $437

Nation: $215

NAPLES — Health insurance costs less in Florida than in Georgia, is the most expensive in Massachusetts and is dirt cheap in Alabama.

Where you live decides what you pay in health coverage, and the national average is $215 a month per person, according to the Kaiser Family Foundation.

The figures are based on policies purchased by individuals and not a group rate through employers.

Increasing insurance costs with higher deductibles and co-pays has become a way of life for families who buy their own policies, as well as for workers and their employers. The cost of family coverage went up nearly 90 percent from 2000 to 2008, according to a study last year by the Robert Wood Johnson Foundation.

In its recent report. Kaiser found the average individual premium in Florida is $178 a month while it is $220 a month across the state line in Georgia.

Some insurance professionals in the region are skeptical.

“It seems to be a bit low. For young people, that would be reasonble,” Wayne Sakamoto, past president of the Southwest Florida chapter of the Florida Association of Health Underwriters, said of the Florida average.

“That surprises me,” said Tim Shaw, owner of Tim Shaw Insurance in Southwest Florida. “That sounds low.”

Sakamoto estimates a more accurate figure for Southwest Florida would be $225 to $250 a month, taking into account that people buying policies for themselves are more likely in their 40s and 50s.

“It’s strange because the average consumer is not a very good consumer in the way they buy their plans,” he said.

Overall, residents in the Northeast can expect to write the largest checks, topping out at $437 a month for individual coverage in Massachusetts.

States that have adopted reforms to make insurance more accessible — namely Massachusetts, Vermont, New York and New Jersey — have higher rates because people with pre-existing conditions are able to enroll. In Vermont, the monthly rate is $401 a month, Kaiser said.

“Massachusetts is not a surprise. That may not bode well for (Mitt) Romney,” Shaw said, referring to the Republican presidential candidate and former Massachusetts governor.

Romney signed into law the 2006 health bill that provides coverage to nearly all Massachusetts residents. It has been considered a model for universal coverage elsewhere but premium rates in Massachusetts have skyrocketed.

The most affordable policies are in the South and some Western states, Kaiser said. Alabama residents pay an average of $136 a month and Idaho residents pay $167 a month.

Kaiser used data reported from filings to the National Association of Insurance Commissioners to develop its report. It also cautioned that the data cannot be broken down by age, medical costs and state laws, which vary on coverage benefit requirements.

Rate variations between states may lessen if and when reform through the federal Affordable Care Act go into effect in 2014, Kaiser said.

In part, individuals will be able to purchase coverage through exchanges set up by states and the federal law says insurers must cover a standard essential benefits package in all states.

Florida filed suit in federal court against the law and two dozen other states did the same.

A federal appeals court panel recently struck down as unconstitutional a key part of the federal law, requiring individuals to buy coverage, or pay a penalty, if they aren’t insured through an employer. The decision moves the case closer to the U.S. Supreme Court.

A federal appeals court panel recently struck down as unconstitutional a key part of the law, requiring individuals to buy coverage, or pay a penalty, if they aren’t insured through an employer. The decision moves the case closer to the U.S. Supreme Court.

In the meantime, the U.S. Department of Labor and the Department of Health and Human Services this past week unveiled new rules aimed to make it easier for consumers to compare benefits.

New forms will be available next year that will offer an easy-to-understand summary of benefits and coverage, and a uniform glossary of terms commonly used, such as “deductible” and “co-pay,”

Insurers also will be required to provide at least 60 days’ notice before any significant change is made in the plan or coverage.

“Workers and their families need clear and understandable information regarding their health coverage,” Labor Secretary Hilda Solis said in an announcement. “(This) proposal is a common-sense step that will help workers quickly and easily compare different coverage options in order to make more informed decisions.”

Sakamoto said the easy-to-understand forms will be helpful because most people don’t understand much about the plans they buy and they forget the terms.

“The biggie is the out-of-pocket (fees). People might do their homework but once they buy it, they tend to forget the details,” he said.

__ Connect with Liz Freeman at www.naplesnews.com/staff/liz_freeman