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Health Pool Premium Rate Information
Click Here for Current Regular Rate Tables
Click Here for Current Medicare-Disabled Rate Tables
- IMPORTANT NOTICE:
The Pool will discontinue all automatic bank drafts at the end of
December, and will start mailing premium invoices to Pool policyholders for
the extended coverage period from January 1, 2014 to March 31, 2014, when
all Pool coverage ends. You must continue to pay your Pool premiums
during this extension period in order for your Pool coverage to remain in
force. If you have lined up replacement coverage with an insurer, and
no longer need your Pool coverage after December 31, 2013, please send us a
written coverage cancellation request,
this form. You may also send a cancellation request by email
It is anticipated that Pool premium rates will increase effective March
1, 2014, by an overall average ±33%. Advance notice of the specific rate change
for each enrolled individual will be mailed by February 1, 2014 to all remaining
How are the Pool's premium rates determined?
The rules that establish how the
Pool's premium rates are determined are set out in Chapter 1506 of the Texas Insurance Code. This statute requires that the Pool determine appropriate rates through a review of the average rates charged by major Texas health insurers for individual health coverage. This average rate is called the
"Standard Risk Rate" and the Pool's actuary
periodically updates this Rate in order to reflect changes in the market, often referred to as
"trend". As a result, the
Pool's rates will increase when market rates go up. In addition to periodic trend rate increases, premium rates paid by members will also increase when the member moves up to the next age band, moves to a different zip code rating area, or changes tobacco use status.
State law requires the Pool to set rates to fully cover all costs, but not to exceed twice the Standard Risk Rate.
In addition to the trend adjustments to rates, the Pool is also required to make periodic adjustments to the premium rate table to reflect changes related to certain rating categories, including deductible plan, gender, age, tobacco-user status, and geographic location to more appropriately relate the
Pool's rates to the Standard Risk Rate and to reflect the Pool's actual claims experience.
You are allowed to change your deductible plan to a higher deductible once each year. It may be to your
advantage to increase your deductible plan, but you need to carefully review the lower premium and
compare the savings to the increased deductible associated with a higher deductible plan, and
the higher coinsurance and higher prescription deductible associated with the $7,500 plan.
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If you have any questions concerning the
Pool's premium rates, please contact the Pool's Administrator at 1-888-398-3927.