California Health Insurance Market Annual Update

Annual California Health Insurance Market Update

The following contains information for our NAHP Alternative Health Plan Solutions and ACA/Obamacare plans for individuals and small businesses in the state of California.

California Alternative Health Plan Solutions Updates

IMPORTANT NOTE: All non-ACA/Obamacare alternative plans are available year-round. For both individuals and small groups. There is NO limited (open enrollment) period for these options.

NEW OPTION: As I mentioned in my Federal market update, I have recently come across a set of health plans that will work well for certain people in California. These plans are comprehensive coverage and compliant with ACA/Obamacare mandates. They also utilize a nationwide PPO network, so they offer a much better choice of providers than most ACA/Obamacare plans. All plans have a maximum out of pocket limit that will be $2,100 per year LESS than the maximum out of pocket for 2024 ACA/Obamacare plans. The standard rates for these plans are competitive with the full price without a subsidy on current, similar ACA/Obamacare plans for people in the 45-64 age range who do not qualify for a tax credit subsidy to purchase ACA/Obamacare plans. If you fit this criterion, please reach out to me to see if one of these plans might be a better option for you.

Individual Alternative Plans

For those who don’t qualify for a federal tax credit subsidy or the new California state tax credit to help pay for an ACA/Obamacare plan, we offer the following “health insurance buffet” of alternative plans.

For our Primary Fixed Benefit plans we now offer the following:

Philadelphia American – Health Choice Select fixed benefit plans.

Manhattan Life – Their newest and best fixed benefit plan – Affordable Choice Enhanced Fixed Benefit Plan. NOTE: The Affordable Choice plans have the BEST inpatient hospital coverage of any fixed benefit plan available today. They have also significantly upgraded their overall coverage.

Our Supplemental Plan lineup to pair with a Philadelphia American Fixed Benefit plan has expanded and improved:

REMINDER NOTE: All these supplemental plans pay in addition to ANY other coverage you have. So, they are NOT just for our alternative “buffet” plans. They can reduce/eliminate out of pocket costs (plus provide additional cash for bills and other costs) of ANY primary health plan (group, individual, Medicare, etc.)

• Accident Plans – In addition to accident supplemental plans from all our Primary plan companies (above), we offer separate LifeSecure Accident plans.
• Critical Illness Plans – Again, along with plans from all our Primary plan companies, we offer separate LifeSecure Critical Illness plans. NEW! From Manhattan Life we have a unique critical illness plan called Manhattan Life Critical Protection & Recovery Plans
• Cancer and Dread Disease Treatment – This is my favorite addition to our supplemental plans. Manhattan Life Cancer Care Plus Cancer and Dread Disease treatment plans.
• First Day Hospital Stay Protection – Along with plans from most of our Primary plan companies, Manhattan Life Out of Pocket Protection Plan is my favorite to include with whatever primary health plan YOU have to cover out of pocket costs from an inpatient hospital stay. That includes employer group plans, Medicare, etc.
• Hospitalization Buy-Up – NEW! We have a new plan from Enrollment First. When paired with their SelectMed Pro or Max plans (see below), this plan provides an extra $50,000 or $100,000 of inpatient hospital coverage. This can be a great addition to a Fixed Benefit plan as your primary coverage to provide extra protection for hospitalization.
• Preventive Care Plus Plans^^^ – For those who want the MOST comprehensive coverage for preventive care plus other outpatient services, we offer the Enrollment First SelectMed plans. There are 3 options Base, Pro and Max.
•  ^^^NOTE: To avoid the California state tax penalty for not having ACA/Obamacare compliant health insurance, one of the preventive care plans must be added to any alternative plan package. 
  

More information on all plans above can be found on each company’s page on our website and on our US Supplemental Coverage page.

Small Group Alternative Plans

In California the state regulations regarding level funded health plans make it extremely difficult to offer these plans to small businesses with less than 50 employees. As a result we do not have the ability to offer these plans at this time. We are continuing to monitor the market for opportunities to offer level funded plans to small businesses in CA.

California 2024 ACA/Obamacare Health Insurance Market Updates

Individual Plans

In 2024, with 12 carriers providing coverage across the state, all Californians will have two or more choices, 96 percent will be able to choose from three carriers or more, and 92 percent will have four or more carriers to choose from.

Changes to this year’s carriers include:

• Inland Empire Health Plan, one of the 10 largest Medicaid health plans in the nation that serves more than 1.6 million residents, will join Covered California and begin offering coverage in Riverside and San Bernardino counties.
• Aetna CVS Health, which joined Covered California in 2023, will expand into Contra Costa and Alameda counties next year.
• Health Net will expand into Imperial County, offering an additional HMO plan.
• Oscar Health, which serves just over 31,000 enrollees in California, announced that it will be withdrawing from California in 2024, following its withdrawal from several other markets nationwide in prior years. Enrollees will be given the opportunity to choose a new plan or to move to the carrier with the lowest-cost plan in the same metal tier.

The participating insurance companies are proposing average rate increases of just under 0.2% to about 15% for plans in 2024.

In California, the 2024 Open enrollment begins on November 1, 2023 and ends on January 31, 2024. A health plan must be purchased by December 31, 2023 to have coverage effective January 1, 2024. Plan purchases from 1/1/2024 to 1/31/2024 will start on February 1, 2024. There is also an early enrollment period starting 10/1/2023 for existing Covered CA customers to renew their coverage.

Small Group Plans

As with many states there is not much “new” to report with ACA/Obamacare small group plans in California.

California 2024 ACA/Obamacare Rate review:

California 2024 ACA/Obamacare Preliminary Rate review:

NOTE: Final approved rates are not readily available at the time of this writing. We will do our best to update this page with the approved rates as soon as we can.

California preliminary 2024 individual plan rate filing requests are as follows: 

Aetna – requested an overall average decrease of 0.89% varying by plan (not finalized yet)

Anthem Blue Cross – requested an average increase of 10.81% varying by plan (not finalized yet)

Blue Shield of CA – requested an average increase of 15.04% varying by plan (not finalized yet)

Chinese Community Health Plans – requested an average increase of 4.98% varying by plan (not finalized yet)

Health Net of CA/Ambetter – an average increase of 8.3% varying by plan (not finalized yet)

Kaiser – requested an average increase of 7.32% varying by plan (not finalized yet)

Molina Healthcare – requested an average increase of 8.57% varying by plan (not finalized yet)

Sharp Health Plan – requested an average increase of 6.12% varying by plan (not finalized yet)

Sutter Health Plan – requested an average increase of 6.47% (not finalized yet)

Western Health Advantage – requested an average increase of 5.46% varying by plan (not finalized yet)

California small group market rate filing requests look like this

Aetna – filed for an increase of 10.85% varying by plan and network

Anthem Blue Cross – requested an overall average increase of 5.37% varying by plan

Blue Shield of CA – requested an overall average increase of 8.24% varying by plan

Chinese Community Health Plans – requested an average increase of 4.93%  varying by plan (not finalized yet)

Cigna – requested an average increase of 12.61% varying by plan (not finalized yet)

Health Net – filed for an increase of 7.84% varying by plan and network (not finalized yet)

Kaiser – filed for an increase range of a 9.12% to 9.18% varying by plan and network. (not finalized yet)

Sharp Health Plan – requested an average increase of 4.37% varying by plan (not finalized yet)

Sutter Health Plan – requested an average increase of 8.72%  (not finalized yet)

United Healthcare – requested an average increase range of 5.22% to 5.46% varying by plan

Western Health Advantage – requested an average increase of 9.18% varying by plan (not finalized yet)

California 2024 ACA/Obamacare Approved Rates:

California individual plan approved rate filings are as follows:

Anthem Blue Cross – Received an average increase of % varying by plan

Blue Shield of CA – Received an average decrease of % varying by plan

Chinese Community Health Plans – Received an average decrease of % varying by plan

Health Net of CA/Ambetter – Received an average range of an increase of % to % varying by plan

Kaiser – Received an average increase of % varying by plan

Molina Healthcare – Received an average decrease of % varying by plan

Oscar Health Plans – Received an average increase of % varying by plan

Sharp Health Plan – Received an average decrease of % varying by plan

Sutter Health Plan – Received an average increase of %

Valley Health Plan – Received an average increase of %

Western Health Advantage – Received an average decrease of % varying by plan

California small group market approved rate filings look like this:

Aetna – Received an increase range of a % to % varying by plan and network

Anthem Blue Cross – Received an overall average decrease of % varying by plan

Blue Shield of CA – Received an overall average decrease of % varying by plan

Chinese Community Health Plans – Received an average decrease of %  varying by plan

Health Net – Received a range of a % decrease to a % increase varying by plan and network

Kaiser – Received an increase range of a % to % varying by plan and network.

Oscar Health Plans – Received an average increase of % varying by plan

Sharp Health Plan – Received an average increase of % varying by plan

Sutter Health Plan – Received an average increase of %  

United Healthcare – Received an overall average increase range of % to % varying by plan

Western Health Advantage – Received an average decrease of % varying by plan 

US Healthcare Resources and Shopping Services

I invite you to go to my US Healthcare Resources page and spend some time going through all of the different tools, services and providers that are available to help you become a better health care consumer. I believe these resources can help you lower your overall health care costs no matter what primary health insurance you have.

 U.S. Insurance Solutions is here to help

Remember, you are NOT in this alone…I am here to help! As your Personal Health Insurance Advisor, my goal is to make your life easier by taking the hassle out of finding the right health plan for your situation and needs.

To discuss your health insurance options and make sure you have the best possible health plan for your situation, please go to the link above with the image that says CALL ME and schedule a call with me on a day and time that works for you, and I will call you to review your options.