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Many Health Connector users face higher insurance premiums

Jonathan Wiggs/Globe Staff/File

It’s time to go shopping for health insurance.

Beginning Wednesday, Massachusetts residents will be able to start browsing 2018 coverage plans on the Massachusetts Health Connector, the state’s insurance exchange, which serves more than 253,000 residents.

The open-enrollment period begins during a particularly tumultuous time. The White House recently decided to ax critical monthly payments to insurance companies that help subsidize coverage for lower-income Americans, a decision condemned by many Democrats and Republicans. To make up for the loss of the federal payments, officials at the Connector set unusually high premiums for the most popular mid-level coverage plans.


Most people who buy coverage on the Connector will be protected from the increases, because they will also receive tax credits to offset their costs. But tens of thousands of middle-income individuals who earn too much to qualify for discounts will be hit with the full cost increases.

Individuals who need coverage to kick in Jan. 1 must sign up by Dec. 23; they have until Jan. 23 to select a plan to begin Feb. 1. (This is more time than consumers in many other states will have to select plans.)

Here’s what you need to know about open enrollment:

Who should sign up?

Connector plans are available to individuals buying coverage on their own, such as those who don’t get health benefits from an employer. (Those of us who get health insurance through work may also be asked to sign up for 2018 coverage around this time of year, at work.)

Massachusetts law and the federal Affordable Care Act require everyone to obtain coverage or pay a penalty. Most people who buy plans on the Connector qualify for discounts to help them with the costs of coverage.

What are the options?

Consumer advocates and officials at the Connector, a state agency, encourage consumers to shop around. That’s particularly important this year because many individuals will face huge price increases if they stay in the same plan.


Altogether, consumers can choose from 52 plans offered by several insurers: Blue Cross Blue Shield of Massachusetts, BMC HealthNet Plan, Fallon Health, Health New England, Harvard Pilgrim Health Care, Neighborhood Health Plan, and Tufts Health Plan. (CeltiCare Health Plan and Minuteman Health will no longer offer coverage.)

The plans are divided into different tiers. Bronze plans have lower premiums and higher out-of-pocket costs, while gold plans have higher premiums and lower out-of-pocket costs.

Between those tiers are the silver plans, which are the most popular. But they are also going to increase the most in price, as a result of the Trump administration’s decision to end federal payments that help subsidize the plans.

In fact, some consumers could save money by leaving the Connector and buying coverage directly from an insurance company.

“We are agnostic as to where people land; we just want to make sure they have coverage,” said Audrey Gasteier, chief of policy and strategy at the Connector.

How much will coverage cost?

The cost varies widely, depending on which plan is selected. On average, monthly premiums for popular silver plans will rise about 24 percent in 2018.

People who buy plans on the Connector and receive tax credits to offset their costs will not feel the full effect of the increases. But some 80,000 people are not expected to qualify for credits, and they will have to pay everything out of pocket. (Connector officials are reminding these individuals to update their personal information with the agency in case they are, after all, eligible for discounts.)


The average premium for a 42-year-old adult buying a silver plan in Worcester will rise to about $444 a month, from $360 a month in 2017, according to the Connector. For bronze plans, the premium will rise to $357 from $334, and for gold plans, the monthly cost will increase to $523 from $453.

The health plans also have deductibles and other out-of-pocket costs that consumers must pay when they use medical services.

What is the Connector doing to reach out?

As usual, Connector officials plan to phone, e-mail, and write to members to remind them to enroll in coverage. They’re particularly focused this year on reaching the people whose premiums are going to spike by double-digits.

While federal health officials under the Trump administration have slashed the budget for outreach, Massachusetts plans to spend about $1.1 million to encourage people to sign up, about the same amount as last year. The state is also spending $1.6 million to pay for workers called navigators, who help people sign up for coverage throughout the state.

Members who don’t make any change will be renewed into the coverage they have now — but at the new, higher prices.

The Connector is posting critical information on its website, mahealthconnector.org. During the busiest days of open enrollment, the Connector’s call center will have 400 people available to answer questions. That’s about 100 more than last year.


“We are fully staffed and ready,” Gasteier said.

Priyanka Dayal McCluskey can be reached at priyanka.mccluskey@globe.com. Follow her on Twitter @priyanka_dayal.