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Update on Cost Sharing Reductions and 2018 Rate Increases - Providence

Here is a letter we just received:

The Trump administration stopped all cost-sharing reduction payments to health insurance companies who sell individual health insurance plans on the federal exchange on Oct. 13, 2017. As our valued producer partners, we wanted to make sure you understood how this change will affect our members and your customers.

Our 2018 silver plan rates are currently under review (redetermination) by the state of Oregon. This means all previously-published silver plan rates for 2018 plans are now invalid. The Division of Financial Regulation has ordered all insurance carriers that sell plans on the federal marketplace to increase the 2018 rates for all silver plans by 7.1 percent. This increase is in addition to the already approved silver plan rates finalized earlier this year. These changes affect silver plans, whether bought direct or through the Marketplace. These rate changes do not affect bronze or gold-tier plans.

Please note that the cost-sharing reduction payment changes do not affect the Advance Payment Tax Credit subsidies, which help people pay their premiums on the federal marketplace. They will continue through 2018 and people may find that tax credits that help pay for premiums will also increase, protecting them from most of these rate changes.

Providence will notify our members as soon as the state of Oregon finalizes 2018 silver plan rates or if the CSR funding is restored by Congress. We are planning to send a revised renewal communication to all affected 2017 plan subscribers.

Please note: Providence Individual & Family plans for 2018 do not provide any out-of-network benefits (except for emergency services). Our other commercial plans for the large and small group markets will continue to include out-of-network benefits.

Thank you for your valued business with Providence Health Plan.


Rob Tolle

Director, Medicare & Individual Sales

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