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ACA consumers set to get rebates, slightly lower rates next year

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Department of Health and Human Services
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Delawareans using the Affordable Care Act (ACA) marketplace get two pieces of good news this week.

The state’s Department of Insurance says rates on Delaware’s marketplace are dropping for a second straight year.  

Despite insurer costs related to COVID-19 testing and treatment for the past six months, Insurance Commissioner Trinidad Navarro says they’ll decrease 1 percent in 2021.  That comes on the heels of a 19 percent drop this year. 

“This year it was a much smaller decrease. But what it’s really telling us is - the market is starting to level out,” said Navarro.

The state has seen ACA rates increase in excess of 30% in recent years.

Navarro’s office also announced this week more $21.5 million in rebates will go to 2019 ACA customers through the lone ACA provider in the First State, Highmark Blue Cross Blue Shield Delaware.

Highmark is required through the ACA to spend 80% of the collected premium dollars on medical care and quality care measures. If the cost of care is less than the 80% on a given year, the excess funds go back to consumers.

Small businesses got rebates from Highmark last year, but this will be the first year individuals will receive the rebates as well - both those on the Delaware Health Insurance Marketplace and Highmark customers outside of the exchange in the individual market.

“A lot of things went into that: the cost of care, managing the care for our members and doing our best to be good stewards of the premium dollars that they pay,” said Highmark President Nick Moriello.

According to a state release, $12.6 million will be returned to 19,273 Highmark policyholders. The average rebate will be $656. Small groups and businesses will receive more than $8.8 million in cumulative return. 2,779 groups will receive an average rebate of $3,198.

Moriello says he's hopeful this year's ACA consumers will get rebates as well, but points to the ongoing pandemic as cause for uncertainty.

Open enrollment for 2021 - the ACA’s 10th anniversary - takes place from November 1st through December 15th.

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