Over the years I have been impressed at the ways carriers slip in rate increases at renewal. The most obvious ones are the notices, if you even get a notice, of your new rates. These are usually accompanied by a letter explaining it is not your fault, and not the carriers fault, but claims have increased and some of that must be passed on to you.
This is not totally disingenous. The cost of medical care does increase every year. There are more claims this year than last and the amounts are higher than before.
Even still, people want to blame someone else, usually the insurance carrier. So it is no wonder that carriers will find creative ways to make the cost of coverage more affordable.
One somewhat subtle way to increase margins is with the HDHP where the deductible is tied to the HSA. One of the principle carriers in this market issues a policy where the deductible is allowed to float with the treasury guidelines. Policyholders are receiving December notices that their current family deductible of $5450 will increase to $5650 in 2007. This amounts to a 3% "hidden" rate increase.
Another carrier now renews clients on a quarterly basis. If you bought your policy in March of 2006 your renewal rate goes in to effect in January of 2007. This shortened year results in paying higher rates much sooner than expected.
Drug formulary's change over time which can in some cases shift more of the cost of your "usual" med into a higher bracket. And let's not forget those beloved drug copays.
Many plans now have generic copays in the $15 range. If your script calls for a generic and you simply present your card and pay as billed, you will pay $15 even though you could have bought the same med without the card for less.
Same is true for brand names. Your brand name med may have a $40 copay but the actual cost may have dropped to $36 meaning you pay more and the carrier pays less.
Did your med become available in a generic since you had it filled the last time? Many plans will not pay for a brand name med if a generic equivalent is available. That means when you "renew" your prescription you could find that your carrier is now only allowing the cost of a generic and you pay the balance.
These are just a few of the ways the cost of health care is passed on to the consumer. We could probably devote a week's worth of postings to this topic.