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Obamacare Rates in New Jersey: Premium may Increase in 2016-2017

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Obamacare Premium Increase Tracker

Obamacare Rates in N.J. may Rise 5 to 26 Percentage

It is likely that Obamacare rates in New Jersey (NJ) will rise from 5% to 26% as enrollment for health coverage through the Affordable Care Act for the year 2017 is to begin from1st November. An increase in the premium rate in the marketplace is due to continuous turbulence in the market. With the new sign-ups in about three months, it will be the fourth year for Obamacare.

Insurer companies have already announced rate filings for the coming new year and it is apparent that health insurance premiums for individual customers are going to be higher, the rise in premium is found faster than health care costs. Customers will actually realize about these increase when they go for the same coverage they had signed up earlier. Customers who find it hard to deal with the increased premium can opt for switching off their plans, the practice of switching the plan was adopted by 40% of the NJ returning customers last year too.


According to the insurers, rise in cost is due to several factors. Over the years, there has been a sharp rise in outpatient costs. There is also a surge in prescription drug costs. With the health care cost rise at the lowest this year, many government programs have been phased out which used to protect insurers from unexpected claims and poorly estimated risk; which contributed significantly in rate hikes.

Joel Cantor, director of the Rutgers Centre for State Health Policy is hopeful that everything will settle down and will take some time to work out everything. They have to respond to market flux. In reality, it is hard for insurers to know in advance to figure out expenses.

Earlier Start-up insurer companies had no experience or any feedback regarding on what base rates were to be fixed. It could also not be estimated that how tax penalties would motivate uninsured people to buy the coverage.

Obamacare Premium Increase Tracker

Obamacare Rates

There were five insurers providing coverage in New Jersey, now there will be four for the new enrollment; as UnitedHealthcare’s Oxford Health Plan has already pulled out as it went through loss nationwide.

The new rates for coming enrolment have posted at as “rate requests”. The State reviews the rates in order to ensure that at least 80% of it is used for health care.

A leading insurer in NJ, Horizon Blue Cross Blue Shield has decided to increase premium rates for its Omnia plans by 4.8%, while for its Advantage EPO plans, the increase will be 7.6%. The Omnia plans cover doctors and hospitals and about 189,000 customers had chosen it in 2016, whereas 57,000 customers had opted for the other plan. The company is to discontinue Gold Advantage plan in the coming year.

AmeriHealth, the second largest individual health insurance provider in theNew Jersey is to increase its premium for its 50,000 individual customers by 12.1%, whereas it will hike rate for its 14,000 members of AmeriHealth’s HMO plan by 26.3 %.

Another insurer of New Jersey And Health Republic Insurance is planning for 3.7% to 8.5%increase. At the same time, the company will provide its catastrophic coverage at a price reduced by 10%.

Oscar Health Insurance of New Jersey is also planning to increase is premium by 8.3% for Oscar Secure plan, whereas 15.6% for its gold-level tiered plan. The company has about 21,000 members.

The actual increase in premium for customers will be clear when they renew their enrollment. To reduce the premium, many customers may prefer to shift to network of doctors and hospitals from broad network or can exclude speciality hospitals.Customers can change plans only during the open enrollment period.

The Affordable Care Act in New Jersey requires that everybody is insured for health coverage. Those who don’t have coverage have to pay a penalty of $695 or 2.5 % of income in 2016 which will be adjusted to cost-of-living in 2017.New Jersey offers different tiers of healthcare plans such as bronze, silver, gold and platinum to make it easier for its people to choose from. According to the law, all plans cover at least basic services such as preventative services, outpatient services, prenatal, maternity and newborn care, emergency services, hospital care, prescription drugs, lab services, mental health and addiction treatment etc.

The state of New Jersey helps with financial assistance in different ways for Obamacare if they can’t afford to pay for it. For example, low-income families can get Medicaid; those who qualify for it get service for free. Based on your income and family size, you may qualify to get tax credits.

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