Health insurance rates in Alaska just keep on climbing, and so, for that matter, do the number of uninsured Alaskans.

Individuals seeking personal health insurance will see their rates raise an average of 17.5 percent this year, while businesses with two to 99 employees will see rates increase 21.7 percent, says Katie Campbell, actuary for the Alaska Division of Insurance.

Those increases compare with a nearly 32 percent average rate increase in 2008 for individuals and 28.8 percent for employers of up to 99 people, Campbell said Oct. 16.

When the rate increase goes into effect depends on the anniversary date of each individual or business plan.

The majority of large employers self-fund their health insurance plans and hire insurance companies to administer them. Because they are self-funded, they are not subject to state insurance regulation, Campbell said. These include the state of Alaska, oil companies, supermarket chains and other national firms operating in the state.

Average increase rates for large employers were unavailable, because those who do purchase such plans negotiate them individually, she said. Actual dollar costs of insurance plans depend on the size of the group, gender and industry, she said.

For a 30-year-old single male living in Alaska, according to a search of the Web site www.healthinsurance.org, premiums for health insurance may run from $82 a month for a plan with a $3,000 deductible to $292.20 with a $1,500 deductible and no co-pay.

For a family of four, including two 30-year-old adults, a 6-year-old boy and a 3-year-old girl, premiums ranged from $267 a month with a $7,500 deductible and 20 percent co-pay to $1,105 a month with a $1,000 deductible and 20 percent co-pay.

The Web site allows individuals who enter minimum information to see a variety of health care plans available. Individuals must then contact the specific companies listed to see if the plan they like is available to them or whether the company's underwriting regulations allow the firm to refuse them insurance.

Meanwhile, according to several studies, thousands of Alaskans remain uninsured, though the numbers vary depending on the study. The research does not specify whether these people are uninsured by choice, lack of ability to pay the premiums or because they were refused a policy.

According to Cover The Uninsured, a project of the Robert Wood Johnson Foundation, the number of uninsured Alaskans grew to 114,983 people by 2006-07, the latest years for which such statistics were available. Those numbers include 77,123 workers and 21,502 children. That compared with a total of 74,774 uninsured Alaskans in 1994-96, including 44,969 workers and 25,230 children.

According to the Health Insurance Resource Center, an Internet site that connects consumers with health insurance providers, 17.4 percent of Alaskans lack health insurance, up slightly from 16.8 percent in 2007.

Another study by U.S. News and World Report, published in April, ranked Alaska among 18 states where at least 19 percent of the working population, ages 19 to 64, had no health insurance.

In 17 other states, 14 percent to 18 percent of the working population in that age group was uninsured, and in just 15 states, fewer than 14 percent of workers of those ages were without health insurance, according to that study.

In Alaska, Premera Blue Cross is the only entity selling health insurance that has to have its rates reviewed and approved by the state, because it is a hospital medical service corporation, Campbell said.

Meanwhile, the state has no laws prohibiting Premera from developing underwriting criteria that allows Premera to refuse health insurance to people, she said.

Premera dominates the private health insurance market in Alaska, covering about 60 percent of those not covered by government health plans.

Jeff Davis, president of Premera Blue Cross of Alaska, told the Alaska Journal of Commerce in March that fast-rising medical costs and a surprising spike in the utilization of health care services in Alaska in 2007 were the driving factors in rate increases.

While other companies in the health insurance business are feeling the same pressures, rising health care costs are more acute in Alaska, he said.

A number of companies have been working in conjunction with health insurance firms to lower the utilization of services by encouraging better health habits, from sensible diets and regular exercise to medical tests - such as mammograms and colonoscopies - designed to detect health problems while they are treatable

"There is definite proof that union health care plans are trying to make their members use their plans more wisely," said Vince Beltrami, president of the Alaska AFL-CIO, the state's largest labor union. "If they have to use the plan less, it costs them less."

Individual unions only raise premiums or decrease benefits if they have to, where there isn't enough money to pay for services, he said.

If there is an increase to health and welfare, it comes out of the wage increase, said Beltrami, who has served as a pension and health and welfare trustee with the International Brotherhood of Electrical Workers.

Over the last six to seven years, Beltrami said, the plan he is insured under has seen premiums increase 100 percent.

Some 60,000 union workers in Alaska are all covered by health insurance, said Beltrami.

The union leader said he'd like to see federal health care reforms include a public option on health insurance.

Beltrami also said he agrees with Richard Trumka, president of the national AFL-CIO, who said in a recent appearance on an MSNBC talk show that American insurance companies have a stranglehold on the health care industry in America.

Trumka told MSNBC's Rachel Maddow that one or two companies control 96 percent of the market.

"Profits have gone up 1,000 percent and premiums have gone up 300 percent," Trumka said. "The only way to hold them accountable is to create competition and the only way you can create competition is with the robust public option. When you do that, they will face competition, and they will bring prices down. We will save at least $100 billion in the process. We are closer than we have ever been to getting real health care reform, but we're not there yet."

Still, the leader of one of the nation's most powerful unions thinks it can happen.

"American people are demanding it," Trumka told Maddow. "I think anybody who votes against it or tries to block it or tries to do things that will help insurance companies will pay the price at the polls. I think they ought to understand their job is not to make insurance companies happy; it's to make Americans healthy. That's their job, that's why we sent them there (to Congress) and ultimately we're going to get a health care bill that is real health care."

The U.S. Chamber of Commerce, meanwhile, opposes major sections of the health care reform, including the public option. Chamber officials say the proposed plans cost too much, and has spent millions of dollars in ad campaigns and lobbying efforts to oppose the measures.

On the web:

http://covertheuninsured.org/

www.healthinsurance.org/alaska

www.healthinsurance.org

Margaret Bauman can be reached at margie.bauman@alaska

journal.com.